Arthritis and Tendinitis

What Is Tendinitis?

Tendinitis is an inflammation or irritation of a tendon, a thick cord that attaches bone to muscle. What Causes Tendinitis? Tendinitis is most often caused by repetitive, minor impact on the affected area, or from a sudden more serious injury. There are many activities that can cause tendinitis, including: y y y y y y y y y y Gardening Raking Carpentry Shoveling Painting Scrubbing Tennis Golf Skiing Throwing and pitching Incorrect posture at work or home or poor stretching or conditioning before exercise or playing sports also increases a person's risk. Other risk factors for tendinitis, include: DOCTOR recommended reading Achilles Tendon Problems
What is the Achilles tendon? The Achilles tendon connects the calf muscle to the heel bone. It is the biggest tendon in the human body and allows you to rise up on your toes and push off while walking or running. What are common Achilles tendon problems? The two main problems found in the Achilles tendon are:

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Achilles tendinopathy. Achilles tendinopathy refers to one of two conditions: Achilles tendon tear or rupture. An Achilles tendon can partially tear or completely tear (rupture). While a partial tear may cause mild or no symptoms, a complete rupture causes pain and sudden loss of strength and movement.

Read more about Achilles tendon problems

Related Tendonitis Terms
patellar, relief, treatment, knee, biceps, de Quervain's, tennis elbow, symptoms

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An abnormal or poorly placed bone or joint (such as length differences in your legs or arthritis in a joint) that stresses soft-tissue structures Stresses from other conditions, such as rheumatoid arthritis, gout, psoriatic arthritis, thyroid disorders, or unusual medication reactions

Occasionally an infection can cause tendinitis. Who Gets Tendinitis? Anyone can get tendinitis, but it is more common in adults, especially those over 40 years of age. As tendons age they tolerate less stress, are less elastic, and are easier to tear. Where Does Tendinitis Occur? Tendinitis can occur in almost any area of the body where a tendon connects a bone to a muscle. The most common places are: y y y y y y Base of the thumb Elbow Shoulder Hip Knee Achilles tendon What Are the Symptoms of Tendinitis? The symptoms of tendinitis include: y y Pain at the site of the tendon and surrounding area. Pain may gradually build up or be sudden and severe, especially if calcium deposits are present. Loss of motion in the shoulder, called "adhesive capsulitis" or frozen shoulder.

How Can I Avoid Tendinitis? To avoid tendinitis, try these tips when performing activities: y y y Take it slow at first. Gradually build up your activity level. Use limited force and limited repetitions. Stop if unusual pain occurs. Do something else. Try again later and if pain recurs, stop that activity for the day. How Is Tendinitis Treated? Initial treatment of tendinitis includes: y y y y Avoiding activities that aggravate the problem Resting the injured area Icing the area the day of the injury Taking over-the-counter anti-inflammatory drugs If the condition does not improve in a week, see your doctor. You may need more advanced treatments, including: y y y Corticosteroid injections. Corticosteroids (often called simply " steroids") are often used because they work quickly to decrease the inflammation and pain. Physical therapy. This can be very beneficial, especially for a "frozen shoulder." Physical therapy includes range-of-motion exercises and splinting (thumb, forearm, bands). Surgery. This is only rarely needed for severe problems not responding to other treatments.

Arthritis and Tendinitis
How Long Will Recovery From Tendinitis Take? Tendinitis may take weeks to months to go away, depending on the severity of your injury. Warning You should see your doctor if you experience any of the following: y y y y Fever (over 100 degrees Fahrenheit) Swelling, redness, and warmth General illness or multiple sites of pain Inability to move the affected area These could be signs of another problem that needs more immediate attention.

Exercises for OA of the Knee

Slideshow: Tips to Keep Your Joints Healthy

The more you move. . change positions often. or watching TV. Take breaks from your desk or your chair and move around. Whether you¶re reading. working.Slideshow: Tips to Keep Your Joints Healthy Move to Help Prevent Joint Pain Keep joints healthy by keeping them moving. the less stiffness you¶ll have.








.WebMD Slideshows View our slideshows to learn more about your health.

Joint Pain and Arthritis With overuse or injury. swelling. cartilage on the end of the joints can break down. causing a narrowing of the joint space and the bones to rub together. and tendons around them. Are You at Risk for ED? y Who gets it. Protect Your Body and Your Joints Injury can damage joints. Whether you¶re reading. Painful bony growths. but also loosens up the joints.Food Frauds y Sneaky little diet wreckers. This can lead to inflammation. Even a little weight loss can help. try sport-specific exercise -. Overstretched joints are more susceptible to injury. and possibly osteoarthritis. the most common type of arthritis. increasing the risk of muscle pulls. may form. stiffness. increasing the risk of cartilage breakdown. Healthy Weight for Healthy Joints Joints hurting? Lose just a few pounds and you'll take some strain off your hips. consider wearing braces when playing tennis or golf. how it's treated. Wear protective gear like elbow and knee pads when taking part in high-risk activities like slowly kicking before swimming. or watching TV. working. neck. the less stiffness you¶ll have. knees. The more you move. or spurs. especially for people with arthritis. Every pound you lose takes four pounds of pressure off your knees. Extra pounds add to the load placed on these joints. Keep Your Joints Healthy and Happy y Take The Joint Juice® Joint Health Assessment Now y Learn about Healthy Joints y Save 50% on Joint Juice Drink Mix Learn About Your Joint Health Pain Keep joints healthy by keeping them moving. and back. an autoimmune disease characterized by extreme inflammation. If your joints are already aching. This warms up not only the muscles. Low-Impact Exercise for Joints . People with excess body fat may also have higher levels of substances that cause inflammation. Instead. change positions often. Don't Stretch Before Exercise Experts now say that stretching before exercise actually causes muscles to tighten. ligaments. Take breaks from your desk or your chair and move around. Another type of arthritis is rheumatoid arthritis. So protecting your joints your whole life is important.

So include core (abdominal) strengthening exercises in your routine. If you don't get enough calcium in your diet. Strong bones can keep you on your feet. Know Your Joints' Limits It's normal to have some aching muscles after exercising. for example. Glucosamine for Knee OA Glucosamine is a natural chemical compound found in healthy joint cartilage. Even small increases in muscle strength can reduce that risk. Leave it on for up to 20 minutes at a time. Fatty coldwater fish like salmon and mackerel are good sources of omega-3 fatty acids. Dairy products and green. and prevent falls that can damage joints. Eat Fish to Reduce Inflammation If you have joint pain from rheumatoid arthritis (RA). eat more fish. That's because high-impact. Protect Joints With Good Posture Stand and sit up straight. Don't exercise so hard next time. you may have overstressed your joints. Full Range of Motion is Key Move joints through their full range of motion to reduce stiffness and keep them flexible.combined with chondroitin -. Strengthen Muscles Around Joints Stronger muscles around joints mean less stress on those joints. leafy vegetables like broccoli and kale are good sources of calcium. For more WebMD tips to keep your joints healthy. first speak with your doctor. Carry bags on your arms instead of with your hands to let your bigger muscles and joints support the weight. But if you already have arthritis. If you have arthritis. Never apply ice directly to the skin. Other Supplements for Joint Pain? . ask your doctor about supplements. as well as reduce inflammation. Omega-3s may help keep your joints healthy.pain reliever. Swimming can also improve posture. the less likely you are to damage your joints with falls or other injuries. Don't have ice or a cold pack? Try a bag of frozen vegetables wrapped in a towel.What exercise is good? To protect your joints.may provide some relief for moderate to severe pain caused by knee OA. Some studies have shown glucosamine -. your doctor or physical therapist can recommend daily range-of-motion exercises. Drink Milk to Keep Bones Strong Calcium and vitamin D help keep bones strong. Research shows that having weak thigh muscles increases your risk of knee osteoarthritis. Light weight-lifting exercises are another option. Be Careful Lifting and Carrying Consider your joints when lifting and carrying. pounding. your best choices are low-impact options like bicycling and swimming. The faster you walk. Range of motion refers to the normal extent joints can be moved in certain directions. But if your pain lasts longer than 48 hours. Yet the results of other studies have been mixed. It numbs pain and helps relieve swelling. If you have a sore joint. One easy way to improve posture is by walking. apply a cold pack or ice wrapped in a towel. Good posture protects your joints all the way from your neck down to your knees. and jarring exercise can increase your risk of joint injuries and may slowly cause cartilage damage. a cause of joint pain and tenderness in people with RA. Working through the pain may lead to injury or damage. click "Next". The more balanced you are. Strengthen Your Core How can strong abs help protect joints? Stronger abs and back muscles help with balance. Avoid rapid and repetitive motions of affected joints.and free -. Don't like fish? Try fish oil capsules instead. the harder your muscles work to keep you upright. Use Ice for Joint Pain Ice is a natural -.

a weekend warrior.'´ she tells WebMD. knowing how to protect your knees from damage can mean the difference between a fulfilling lifestyle and longterm. By ShahreenAbedin WebMD Feature Reviewed by Laura J. "I had tremendous pain in my leg anytime I'd squat down so I just kept my right leg straight. More Reading on Healthy Joints y y y y y Nine Ways to Protect Your Joints All About Joint Pain Save Your Knees: 6 Things to Avoid How Weather Affects Health. ginger. MD Whether you're a seasoned athlete. Many supplements used to treat OA pain and inflammation are not proven to be effective." Piplica tells WebMD. But I never saw a doctor for it. If you injure a joint. Talk to your doctor if you want to give supplements a try. 27-yearold Rachel Piplica was not at all prepared for the realization that her knee could sideline her from competitive skating for months.'" Piplica had experienced some warning signs during her previous season of skating as captain of her team. The doctor immediately said. The pain was so bad I just fell and crawled away. "I took one more stride and my knee just let go again. possibly years. Although some people have found relief with methylsulfonylmethane (MSM) for OA pain. Treat Joint Injuries Physical trauma can contribute to cartilage breakdown and OA. or totally laid-back when it comes to exercise. but she ignored them for the most part. Arthritis. or flaxseed. Martin. strained mobility. You may need to avoid activities that overstress the joint or use a brace to stabilize it. I heard a pop and it felt like my knee bent sideways. . Then take steps to avoid more damage. The Los Angeles fashion designer who skates under the name Iron Maiven tried to keep going. "Suddenly. 'I'm in a contact sport and this is what happens. Cruising on the track in the heat of a roller derby match. see your doctor right away for treatment.Health food stores are filled with supplements promising to relieve joint pain. Including Your Joints Newsletter: Healthy Bones. Others have tried Sam-E. and More 6 Ways to Ruin Your Knees Expert tips on how to avoid damaging your knees. its safety and effectiveness hasn't been determined. 'I think you tore your ACL. I just assumed.

"At least I would have been more careful. "In hindsight. Being overweight. An occasional ache here and there is common. (continued) 1. Knee problems can happen to anyone. the knees serve as your 'wheels' that get you around and allow you to be active.Knee deep: A complex and vulnerable joint Her torn ACL diagnosis confirmed. 1. the knee needs to move back and forth. you need to listen to them. "Because they're the main hinge between the ground and the rest of your body.. and even everyday wear and tear can ruin a perfectly good set of knees. tibia (shin bone). For Piplica. The knee's ligaments can tear. Expert tips on how to avoid damaging your knees. and pivot too. continued. "Life can really go downhill when you damage your knees. . so even 10 extra pounds can put a considerable load on those joints. who is a spokesman for the American Academy of Orthopaedic Surgeons and author of FrameWork . Here are six pitfalls you can avoid to save your knees. Metzl's rule of thumb: When the pain limits your ability to do what you normally do.´ says University of Pennsylvania orthopedic surgeon and sports medicine specialist Nicholas DiNubile. Although diet and exercise are critical for weight loss. If they persist. It's a complex hinge where the femur (thigh bone).´ says sports medicine specialist Jordan Metzl. "But knowing when you can and can't ignore pain is key. from the Hospital for Special Surgery in New York City. MD. its tendons can swell up. tendons.´ DiNubile says. it's a double-edged sword. a common and often disabling form of arthritis that wears away the knee's cushiony cartilage. fibula (next to tibia) and kneecap all come together. maybe that first injury could have been repaired earlier.Piplica quickly learned how susceptible the knees can be to injury. the knee is highly prone to injury." 2. Bound by an intricate system of ligaments. you need to have it checked out. "It's hard to find the right balance between mobility and stability. MD.´ she says. According to the CDC.´ he tells WebMD. Every pound of body weight yields five pounds of force on the knee. you need to have it checked out. Ignoring knee pain. twist a little.´ says DiNubile. and muscle. cartilage. two out of three obese adults suffer from knee osteoarthritis at some time in their life. "If your body is sending you signals. Ignoring knee pain. osteoarthritis can take hold.Your 7-Step Program for Healthy Muscles.unbeknownst to her -. these joints are responsible for sending nearly 15 million Americans to the doctor every year. Being overweight also increases your chances of osteoarthritis in the knee. although I don't know if I could have avoided this one altogether.followed by the more recent ACL tear. exploratory surgery revealed a torn meniscus she had endured in the past -. And it's not just athletes who suffer. According to the American Academy of Orthopaedic Surgeons.. Excess pounds also cause existing arthritis to worsen more rapidly. Bones and Joints.

"If your knees hurt, it's harder to lose weight through exercise,´ says Metzl. So he recommends activities that go easy on the knee. For example, opt for a stationary bike over running on the treadmill, and walk on a flat surface instead of hilly turf. If you're a die-hard treadmill fan, then go for longer sessions of walking punched with brief intervals of brisk walking or running every three to five minutes, DiNubile says. 3. Not following through with rehab and rest. The rest and rehabilitation period after a knee injury is critical to avoiding future pain or reinjury. Depending on the type of damage and treatment, recovery could last anywhere from a couple of weeks to several months. "During the rehab period, you need someone to help you tell the difference between something that just hurts, and something that's going to do you harm,´ says DiNubile. He tells WebMD that many of his young athlete patients are too eager to return to regular play as soon as they stop limping. He advises patients to work with an orthopedic surgeon, a sports medicine physician, a physical therapist, an athletic trainer, or some combination of these pros, in order to ensure proper focus is placed on gradually strengthening the knees. 4. Neglecting your ACL. One of the most commonly injured ligaments in the knee, the anterior cruciate ligament (ACL) is responsible for about 150,000 injuries in the U.S. every year. As Piplica learned firsthand, sports like roller derby that involve quick cuts, twists, and jumping, put the ACL at higher risk for rupturing. More traditional high-risk sports include soccer, basketball, football, and volleyball.

Expert tips on how to avoid damaging your knees. (continued)
4. Neglecting your ACL. continued... Women in particular have a two- to eight-times higher risk for ACL tears compared to men, mainly because the way women naturally jump, land, and turn puts greater strain on the ACL. However, male and female athletes alike can be trained to "rewire´ themselves and thus lower risks of knee injury. That's done through neuromuscular training, which involves supervised practice in improving agility, leg strength, and jump-landing techniques for better knee joint stability. These specialized techniques are effective in reducing risks of knee injury by almost one-half, according to a 2010 review of seven neuromuscular training studies. "Given what we know in how useful it can be in reducing ACL tears, it's irresponsible of coaches and parents to not require athletes to undergo neuromuscular training,´ says DiNubile. He recommends that athletes of any age who play ACL risk-prone sports should seek help from an athletic trainer or other trained professional to help avoid this debilitating injury.

5. Overdoing it. "You make gains in fitness when you work hard and then allow your body to recover. You can't do a hard workout every day," Metzl says. A sudden increase in intensity or duration of exercise can cause overuse injuries from repetitive strain. Tendonitis and kneecap pain are common symptoms in the knee.

Pushing too hard is also related to overtraining syndrome, a physiological and psychological condition among athletes in which they exceed their ability to perform and recover from physical exertion, often leading to injury or lowered performance. Be sure to include stretching exercises before and after working out. And follow hard training days with easy ones so your body can recover. 6. Overlooking other muscles around the knees. Weak muscles and lack of flexibility are primary causes of knee injuries, according to the Mayo Clinic. When the muscles around the kneecap, hip, and pelvis are strong, it keeps the knee stable and balanced, providing support by absorbing some of the stress exerted on the joint. DiNubile stresses the importance of building the quadriceps and hamstring muscles, as well as proper strengthening of the body's core muscles, including the obliques, lower back muscles, and upper thigh. His favorite tool to help accomplish this strengthening is a Swiss medicine ball. Other exercises to try are knee extensions, hamstring curls, leg presses, and flexibility exercises. Piplica recalls realizing just how weak some of her leg muscles were. "Roller girls are striding out so much with their outer leg muscles, but we aren't necessarily working our inner knees," she says. "I remember when I would run for exercise, my calves and shins would hurt so bad. That surprised me, because I thought if anything was strong, it was my legs.´ Piplica says she wishes she had been better educated about crosstraining activities for roller skaters, and what muscle groups they need to focus on to keep their knees healthy.

Expert tips on how to avoid damaging your knees. (continued)
6. Overlooking other muscles around the knees. continued... As she awaits surgery to repair her torn ACL, Piplica tells WebMD that her perspective on long-term care for her knees has definitely changed. "Half of me is frustrated about not being able to skate sooner, but the other half knows how important it is to get better so I don't do this again. I'm 27 years old with a serious knee injury preventing me from moving around. So I need to look beyond just skating, skating, skating. I don't want to have knee problems when I'm 40 or 50 because I'm not giving my body the kind of attention it needs right now."

Injection Therapy for Osteoarthritis
The content below was selected by the WebMD Editorial staff and is solely under WebMD's editorial control.

Exercises for OA of the Knee

Hamstring Stretch Warm up with a five-minute walk. Then, stretch. Lie down. Loop a bed sheet around your right foot. Use sheet to help pull and stretch leg up. Hold for 20 seconds. Repeat twice, then switch legs. Stretching is one of three important types of exercises for knee OA. Range of motion or stretching exercises keep you limber. Strengthening exercises build muscle strength to stabilize weak joints. Aerobic exercises, like walking, help lung and heart fitness.

Exercises for OA of the Knee
Calf Stretch Stretching exercises loosen muscles, improve flexibility, and help prevent pain and injury. Use a chair for balance. Bend your right leg. Step back with left leg, slowly straightening it behind you. Press left heel towards the floor. Feel the stretch in your back leg. For more of a stretch: Lean forward, bending the right knee deeper. Don't let the right knee go past your toes. Hold for 20 seconds. Do twice, then switch legs.

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Exercises for OA of the Knee Straight Leg Raise To try this leg strengthening move. Pause. Keep the right leg straight. Repeat 10 times. toes pointed up. Prop your back up on your elbows. slowly lower leg to ground. Tighten thigh muscles of your right leg. lie on the floor. then switch legs. With thigh still tight. Do another 10. Bend your left knee. Previous page Next page .not your back raise your leg. as seen above. keeping foot on floor. Relax. for five seconds. Rest. Slowly and smoothly use your thigh muscles -.

Simply tighten the thigh muscles. as seen in right-hand photo. Keep both legs on ground. Previous page Next page .Exercises for OA of the Knee Quad Set Is the straight leg raise too tough? Do quad sets instead. Relax. Then. Flex and hold left leg tense for five seconds. also called the quadriceps. switch to other leg. With these you don¶t raise your leg. of one leg at a time. Start by lying on the floor. Do two sets of 10. relaxed.

Too hard? Use your hands to help raise your leg. Previous page Next page . Repeat 10 times. Sit up straight in chair. such as walking or rising from a chair. Hold right leg in the air five seconds. keeping knee bent. Lift your right foot off the floor. Slightly kick back your left foot but keep toes on the floor. then switch legs. Slowly lower your foot to the ground.Exercises for OA of the Knee Seated Hip March This move can strengthen hips and thigh muscles to help with daily activities. Rest and do another 10.

Rest. Previous page Next page . Too hard? You can also do this exercise while seated. both knees bent.Exercises for OA of the Knee Pillow Squeeze This move helps strengthen the inside of your legs to help support your knee. Squeeze knees together. Hold for five seconds. Lie on your back. then do another set of 10. Repeat 10 times. See photo to right. Place a pillow between knees. Relax. squishing pillow between them.

Do another 10. Slowly lower both heels to ground. Previous page Next page .Exercises for OA of the Knee Heel Raise Hold back of chair for support. Hold for five seconds. Stand straight and tall. Rest. Repeat 10 times. Lift heels off ground and rise up on toes of both feet. Too hard? Do the same exercise. only sitting in a chair.

After a few workouts. Don't slouch. then repeat with left leg. Keep right leg straight and outer leg muscles tensed. Lower right leg and relax. Too hard? Increase leg height over time. you¶ll be able to raise your leg higher. Previous page Next page . Lift right leg out to the side. Repeat 10 times. Rest. Place your weight on left leg.Exercises for OA of the Knee Side Leg Raise Hold back of chair for balance. Do another 10.

Be sure your bent knees don¶t move forward of your toes. Place two pillows on chair. Previous page Next page . Use your leg muscles to slowly and smoothly stand up tall. Try with arms crossed (see left) or loose to your side. Sit on top. slowly lower yourself back down to sitting. Then. Too hard? Add pillows or use a chair with armrests and help push up with your arms. feet flat on floor (see left). with your back straight.Exercises for OA of the Knee Sit to Stand Practice this move to make standing easier.

shift your body weight to one leg but do not lock your knee straight. Lower raised foot to the ground. then switch legs. Slowly raise the other foot off the ground. Too easy? Balance for a longer time. Do twice. Previous page Next page . Or try with your eyes closed. balancing on your standing leg. Steady yourself on a chair. if needed.Exercises for OA of the Knee One Leg Balance Your goal is to do this hands-free. Hold for 20 seconds. This move helps when getting out of cars or bending. First.

Exercises for OA of the Knee Step Ups This move helps strengthen your legs for climbing stairs. both feet on the ground. Do 10 times. or lamppost for balance. then left. Follow with your right foot. then repeat another 10 times. Step up with your left foot. starting with right leg first. Stand on top. Previous page Next page .Too hard? Use a railing. Rest. Face a stable step. Then repeat. wall. Or try a lower step. Climb down in reverse: right foot down first. tall and with both feet flat.

relaxed. Keep arms and legs moving. It can reduce joint pain. But it's one of the best exercises for knee arthritis. walking may not seem like a great idea. strengthen leg muscles. Always ask your doctor before starting exercise when you have osteoarthritis. The best part -no gym membership needed. Previous page Next page . walk tall.Exercises for OA of the Knee Walking With stiff or sore knees. Good form is key: Look forward. and improve flexibility -.and it's good for your heart.

swimming. Don't give up favorite activities.Exercises for OA of the Knee Low-Impact Activities Being active may also help you lose weight. Many community and hospital wellness centers. and water aerobics. Talk to your doctor or physical therapist about modifying painful moves. and pools offer classes for people with arthritis. YMCAs. which takes pressure off joints. Previous page Next page . Water exercise takes weight off painful joints. Other exercises that are easy on the knees: biking. like golf.

Aim for 30 minutes a day. Ice painful joints and take acetaminophen or an anti-inflammatory pain reliever.Exercises for OA of the Knee How Much Exercise? Start with a little. If you can do it without pain. Take a break and ask your doctor¶s advice. like ibuprofen or naproxen. Previous page Next page Caring for Your Joints Here are nine tips to help you guard your joints against injury and diseases such as arthritis. Some muscle soreness is normal. Over time you¶ll build your leg muscles to support your knee and increase flexibility. if your doctor says it's OK. do more next time. but hurting or swollen joints need rest. It is information you can use daily to maintain healthy and strong joints. You and Your Joints .

if not all. Some research suggests that aerobic exercise -. the more wear and tear you put on your joints. Women who lose about 11 pounds reduce their risk of developing arthritis of the knees. Watch Your Weight for Healthy Joints Keeping your weight within a healthy range is the best thing you can do for your joints. wiggle your hips. Here are some tips for good joint health. Losing weight reduces pressure on your knees. especially those in your knees. which must support your entire body weight. try taking phone calls while standing. You don't want to strain the joint that you're trying to strengthen Caring for Your Joints (continued) Help Joints With a Strong Core Make sure your exercise routine includes activities that strengthen your abdominal (core) muscles. ligaments. including weight lifting.can wear and tear your cartilage. and wave your fingers to say bye-bye. Avoid exercises that cause joint pain. your joints don't have to do all the work. computer addicts. If you can't leave the office. The higher the number on your bathroom scale. Make sure you talk to your doctor before starting any type of exercise routine. The best way to care for your joints is to keep them and your muscles. Exercise for Healthy Joints Exercise can help you lose extra pounds and maintain a healthy weight. Weight-bearing joints. Opt for exercises that won't give your joints a pounding. If you don't have enough muscle.can reduce joint swelling. try low-impact exercises such as swimming or bicycling. Research has shown that with every pound gained. Know Your Limits for Your Joints' Sake Certain exercises and activities might just be too tough for your joints to handle. Smooth tissue called cartilage and synovium and a lubricant called synovial fluid cushion the joints so bones do not rub together. Joints and their surrounding structures allow you to bend your elbows and knees. and back.even sitting the wrong way or carrying too much weight -. Instead of step aerobics.activities that get your heart rate up -. and bones strong and stable. and back and helps prevent joint injury. of your body weight. This can lead to a reaction in your joint that can damage your joints and lead to arthritis. bend your back. such as your knees. a person puts four times more stress on the knees. Another healthy idea: Don't sit still! Couch potatoes. Build Muscles to Support Joints Strong muscles support your joints. Stronger abs and back muscles help you keep your balance and prevent falls that can damage your joints. That's why so many overweight people have problems with these areas of the body. Weight training exercises help build muscle and keep existing muscle and surrounding ligaments strong. Less movement means more stiffness in your joints. Take frequent breaks at work and stretch or go for a short walk. have to support some. That way. But any soreness that lasts . your joints take a pounding. You will likely feel some muscle pain after working out. and anyone else who remains glued to a chair all day long have a high risk for joint pain. hips. turn your head. But increasing age. injury -. Change positions frequently. So get up and get moving.A joint is the connection between two bones. hips.

Strong bones can keep you on your feet.longer than 48 hours means you need to take it easier next time. if you use a backpack. If you have a sore joint. it also contains omega-3 fatty acids. Hit the wrong bump in the road and you could be headed for a lifetime of joint pain. balanced diet helps build strong bones. Never apply ice directly to the skin. Posture is also important when lifting and carrying. you should never go without safety gear. Such pain could mean you've overstressed your joints. Eating Right Nourishes Joints A healthy. Salmon is particularly beneficial for your joints. Standing and sitting up straight protects your joints from your neck to your knees. and working through it may lead to injury or damage. kale. also help reduce stress on your joints during activities. Oranges may also give your joints a healthy boost. broccoli. be sure to put it over both shoulders instead of slinging it over one. Omega-3s promote healthy joints and reduce joint pain and swelling in people with arthritis. A second pair of hands always comes in -. Protecting Your Body Protects Joints Make sure you always wear a helmet. Preventing injuries can help ward off early onset arthritis. Make sure you get plenty of calcium every day. Being lopsided puts more stress on your joints. or guards. and figs. knee pads. Not only is it a good source of calcium. including work-related ones such as repetitive kneeling or squatting. Good posture also helps guard your hip joints and back muscles. You can also get omega-3s by taking fish oil capsules. Serious injuries or several minor injuries can damage cartilage. Even if you think you're a pro on a bicycle or on a pair of Rollerblades. Don't have ice or a cold pack? Try wrapping a bag of frozen vegetables (peas work best!) in a light towel. You can do this by drinking plenty of milk and eating foods such as yogurt. and elbow and wrist pads when taking part in high-risk activities.well. Don't be afraid to ask if you need help with a specific task or chore. Add Ice for Healthy Joints Ice is a great drug-free pain reliever. ask your doctor if calcium supplements are right for you. Recent research indicates that a diet that contains the proper amount of vitamin D is important for good bone and joint health. It helps relieve joint swelling and numbs pain. When lifting. If those foods don't tempt your taste buds. use the biggest muscles in your body by bending at your knees instead of bending your back. apply ice wrapped in a towel or a cold pack to the painful area for no more than 20 minutes. You should ask your doctor about the proper amount of vitamin D and ways you can get it. Some studies suggest that vitamin C and other antioxidants can help reduce the risk of osteoarthritis. handy! Perfect Your Posture for Good Joints Slouching is not good for your joints. Elbow and wrist braces. Mackerel is another source of omega-3s. and prevent falls that may lead to joint damage. For example. Knee Pain Overview .

which lies on the front of the thigh. The kneecap or patella rides along the front of the femur. The remaining bone in the calf. also twists and rotates. all of which connect the femur to the tibia: The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) provide front and back (anterior and posterior) and rotational stability to the knee. The thighbone or femur comprises the top portion of the joint. The knee. however. Anatomy of the Knee The knee joint¶s main function is to bend. One of the bones in the lower leg (or calf area). Tendons y o o o Tendons are fibrous bands similar to ligaments. more than just a simple hinged joint. and together with the quadriceps muscle they facilitate leg extension (straightening).Introduction to Knee Pain Knee pain is the most common musculoskeletal complaint that brings people to their doctor. and cartilage. tendons connect muscles to bones. The medial collateral ligament (MCL) and lateral collateral ligament (LCL) located along the inner (medial) and outer (lateral) sides of the knee provide medial and lateral stability to the knee. Cartilage y o o Cartilaginous structures called menisci (one is a meniscus) line the top of the tibia and lie between the tibia and the 2 knuckles at the bottom of the femur (called the femoral condyles). the tibia. The quadriceps and patellar tendons are sometimes called the extensor mechanism. The menisci's primary job is to provide cushioning for the knee joint. With today¶s increasingly active society. Knee pain has a wide variety of specific causes and treatments. Bursae y o . ligaments. straighten. Instead of connecting bones to other bones as ligaments do. The knee includes four important ligaments. Ligaments y o o o o Ligaments are dense fibrous bands that connect bones to each other. In order to perform all of these actions and to support the entire body while doing so. the fibula. the number of knee problems is increasing. tendons. The two important tendons in the knee are (1) the quadriceps tendon connecting the quadriceps muscle. the knee relies on a number of structures including bones. is not involved in the weight-bearing portion of the knee joint. Bones y o o o o o The knee joint involves four bones. and bear the weight of the body along with the ankles and hips. It only provides ligament attachments for stability. to the patella and (2) the patellar tendon connecting the patella to the tibia (technically this is a ligament because it connects two bones). provides the bottom weight-bearing portion of the joint.

and so on. compression can be used to keep the patella aligned and to keep joint mechanics intact. The prepatellarbursae lie in front of the patella.o o o o Bursae (one is a bursa) are fluid-filled sacs that help to cushion the knee. The knee contains three important groups of bursae. and by limiting further injury to tissue. compression. A pad over the kneecap. Most authorities recommend icing the knee two to three times a day for 20-30 minutes each time. a common goal is to break the inflammatory cycle. After an injury. Use an ice bag or a bag of frozen vegetables placed on the knee. The anserine bursae is located on the inner side of the knee about two inches below the joint. rest. Rest reduces the repetitive strain placed on the knee by activity. y o o PROTECT the knee from further trauma. helps to control the symptoms of some knee injuries (an example is a form of bursitis sometimes called housemaid's knee) by preventing further repetitive injury to the prepatellarbursae. This cycle of inflammation leads to continued or progressive knee pain. Icing the knee reduces swelling and can be used for both acute and chronic knee injuries. ice. and elevation. in some knee injuries. y o o y o o o y o o o . Rest both gives the knee time to heal and helps to prevent further injury. compression is another way to reduce swelling. Second. The cycle can be broken by controlling the substances that cause inflammation. Some common home care techniques for knee pain that control inflammation and help to break the inflammatory cycle are protection. In treating many types of knee pain. REST the knee. This regimen is summarized by the memory device PRICE. for example. substances that cause inflammation invade the knee. COMPRESS the knee with a knee brace or wrap. Knee Pain Overview (continued) Home Care for Knee Pain Inflammation is the body¶s physiologic response to an injury. The infrapatellarbursae are located underneath the patella. Compression helps accomplish two goals: First. This can be done with knee padding or splinting. which causes further injury. The inflammatory cycle starts with an injury. which leads to further inflammation. ICE the knee.

If you are concerned about the pain. Remember. This rule can also be applied to new knee injuries that are not disabling. Like all medications. Other signs and symptoms that demand emergency evaluation: Fever (which may indicate infection) Unbearable pain Drainage Large wounds Puncture wounds o o y o o o o o . Prop your leg up when you are sitting. Elevation works best when the knee -. If your symptoms have not gone away after trying a week of PRICE therapy and over-the-counter anti-inflammatory pain meds. Elevation also helps reduce swelling.or any other injured body part -. these drugs have side effects. act as anti-inflammatory agents. o o o Knee Pain Overview (continued) When to Call the Doctor for Knee Pain When you are deciding whether to call the doctor about your knee pain. you should consider going to the ER to be evaluated by a doctor because of the possibility of a fracture. Many fractures may require immobilization in a specific position or surgery. Acetaminophen (Tylenol) can also be used to control knee pain but does not have the anti-inflammatory properties of the NSAIDs. Still. this treatment is remarkably useful in many types of knee pain such as osteoarthritis. which naturally elevates the higher than the level of the heart. you should set up an appointment with your doctor or a sports medicine or orthopedic (bone and muscle) specialist to further evaluate the pain. you should call the doctor. These drugs directly control pain and.y o o o ELEVATE the knee. helping to break the inflammatory cycle. When to Go to the Hospital for Knee Pain y If you cannot put weight on your knee. Putting off seeing a doctor may hinder healing. a good rule of thumb exists for most long-term knee injuries. Elevation works with gravity to help fluid that would otherwise accumulate in the knee flow back to the central circulation. that this rule should only serve as a guide. at higher doses. You should not use NSAIDs if you have a problem with bleeding or stomach ulcers or some types of kidney disease. or use a recliner. however. however. y Over-the-counter pain medicine: Commonly used pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen (Aleve or Naprosyn) and ibuprofen (Advil or Motrin) also play a role in the treatment of knee pain.

Do you still have normal sensation in your foot and lower leg? Have you been having fevers? Physical exam y o o o The doctor will likely have you disrobe to completely expose the knee. tendons. X-rays show fractures (broken bones) and dislocations of bones in the knee as well as arthritis and abnormally large or small joint spaces. at evaluating soft tissue structures of the knee such as ligaments. y o          o    o   The doctor will typically want to know the exact nature of the pain. MRI o o y . and other tests y o Depending on your particular history and exam. What makes it better or worse? Does the knee pain wake you up at night? Does the knee feel unstable? Have you been limping? The doctor will also want to know a bit about you. They both are also poor.o Swelling. and the menisci. Rarely. and menisci of the knee and evaluate the integrity of each of these. doctors rely on a detailed history and physical exam more than any single test. if you are on a blood thinner (warfarin or Coumadin) or have a bleeding disorder (such as hemophilia) Getting a Knee Pain Diagnosis History: Even in today¶s world of technology. the doctor may perform a number of maneuvers to stress the ligaments. The doctor will then inspect the knee and press around the knee to see exactly where it is tender. however. wear shorts to your appointment. CT scans. the doctor may order a CT scan (a 3-dimensional X-ray) of the knee to precisely define a fracture or deformity. Where in the knee is your pain? What does the pain feel like? How long has the pain been present? Has it happened before? Describe any injuries to the knee. Both X-rays and CT scans are excellent for diagnosing fractures. X-rays. tendons. In addition. Do you have any major medical problems? How active is your lifestyle? What are the names of the medications you are taking? The doctor will want to know about any related symptoms. the doctor may suggest X-rays of the knee. If possible.

or falls). ankle. Symptoms: Fractures may be accompanied by swelling or bruising but are almost always extremely painful and tender. contact sports. therefore. MRIs do not image bones and fractures as well. In contrast to CT scans. Acute knee pains can be caused by an acute injury or infection. lupus. Also in contrast to CT scans. y y o o o o Knee Pain Overview (continued) Types of Knee Pain The nerves that provide sensation to the knee come from the lower back and also provide hip. This is a surgical procedure where the doctor will place a fiber optic telescope within the knee joint. In general. Pain from a deeper injury (called referred pain) can be passed along the nerve to be felt on the surface. from the knee. knee pain is either immediate (acute) or long-term (chronic). Acute Knee Pain Fractures (broken bones) y o o Description: Fractures of any of the bones of the knee are traumatic injuries typically caused by moderate to high forces (such as car accidents. and diabetes. with a needle. can arise from the knee itself or be referred from conditions of the hip. leg. Crystals. Fluid removal The knee and all bursae of the knee are filled with fluid. All of the following sources of knee pain arise from the knee joint itself. . MRIs are excellent for evaluating ligaments and tendons for injuries. The arthroscope is attached to a camera that relays real-time images to a video monitor. The pain is typically so severe that people are often unable to walk or even put their full weight on the knee. your physician may remove fluid. By doing so. Chronic knee pain is often from injuries or inflammation (such as arthritis) but can also be caused by infection. such as gout.o o o y o o o o Magnetic resonance imaging (MRI) uses large magnets to create a 3-dimensional image of the knee. If your symptoms suggest infection or crystalline arthritis. and ankle sensation. which suggest crystalline arthritis. Knee pain. or lower back. Arthroscopy The orthopedic surgeon may elect to perform arthroscopy if you have chronic knee pain. Blood tests: The doctor may also elect to perform certain blood tests to evaluate for signs of infection or diseases such as rheumatoid arthritis. often can be seen under the microscope. This fluid will then be analyzed to better clarify the diagnosis. the surgeon may be able to see small particles in the knee or to look more closely at damaged menisci or cartilage. The doctor may also be able to repair damage by shaving down torn cartilage or removing particles from the knee while looking at the inside of your knee on a video monitor. Infection may also be detected under a microscope by finding bacteria and pus in the fluid.

o o . to tear. Treatment: Depending on the particular fracture. Evaluation: After a relevant history is taken and physical examination is performed and conservative treatment. The doctor may also recommend x-rays. almost always. A force from the outer (lateral) knee to the inner (medial) knee is typically responsible for this injury in contrast to the more rarely injured LCL. Symptoms: Severe MCL sprains or tears often produce a tearing or ripping sensation along the inner joint line of the knee.. and pain control medications along with an exercise regimen including a stationary bike and legstrengthening exercises may be all you need. Knee Pain Overview (continued) Acute Knee Pain continued. the doctor may suggest MRI or arthroscopy to further evaluate a torn ligament. Like all ligaments. however. Some fractures. bruises occur at the point of impact. anti-inflammatories. ice. Conservative treatment and knee braces may prove sufficient for those who do not demand quite so much from their knees. Sprained and torn collateral ligaments y o o o o Description: The medial collateral ligament (MCL) is the most commonly injured ligament in the knee. Due to these severe forces. This will. you may hear a pop. are complicated by arthritis or by injuries to arteries or nerves that can be serious.o o o Evaluation: Fractures are an emergency and should be checked by a doctor. You may also notice knee instability and swelling. A delay in evaluation can result in fracture fragments being moved and associated injuries. Symptoms: If you tear your ACL. the doctor may either recommend immobilization (with a cast or splint) or surgery to repair it. The posterior cruciate ligament (PCL) is stronger than the ACL and much less commonly torn. Prognosis: Fractures often heal with no long-term problems. A torn ligament is completely ruptured. Such an exercise regimen should be under the supervision of a doctor or physical therapist because certain exercises are to be avoided. be followed by marked knee swelling over the next couple of hours because the ACL bleeds briskly when torn. A sprained ligament may be partially ruptured. In contrast to mild sprains. early rehabilitation with compression. which is typically a result of an inner to outer force. Treatment: For a mild sprain. Sprained and torn ligaments occur opposite the point of impact. elevation. This evaluation will generally include x-rays and other relevant studies. The x-ray does not help in diagnosing ligament injuries but may help detect any bone injuries or arthritis prior to arthroscopy. this ligament may be sprained or torn. In general. Sprained and torn cruciate ligaments y o Description: An anterior cruciate ligament (ACL) injury is a common sports injury generally caused by a hard stop or a violent twisting of the knee. Both MCL and LCL injuries are common in contact sports but can also result from twisting the knee with a planted foot such as in skiing. The PCL requires strong forces. complex tears often require surgical repair for best results. such as those produced when the dashboard strikes the knee in a car accident. Treatment: Surgical repair is recommended for high-level athletes who demand optimal outcomes. PCL injury is often associated with other ligament and bone injuries.. You will also notice your knee give way or become unstable and feel pain that is bad enough that you might feel like vomiting.

This displacement stretches and frequently tears not only the ligaments of the knee but also arteries and nerves.on their own. amputation may be required. however. Those people with complete ruptures are unable to extend the knee. Swelling typically accompanies these symptoms although the swelling is much less severe than with an ACL injury. or either click or grind through its range of motion..Tendon ruptures y o Description: Both the quadriceps and patellar tendons may rupture partially or completely. Whether a dislocation reduces by itself or is put back into place in the hospital. many will report feeling a dull clunk. Nerve injuries. it requires further evaluation and care. A quadriceps tendon rupture typically occurs in recreational athletes older than 40 years (this is the injury former President Clinton suffered while jogging).. does not stop here. Symptoms: Meniscal injuries may cause the knee to lock in a particular position. Symptoms: Rupture of either the quadriceps or patellar tendon causes pain (especially when trying to kick or extend the knee). Symptoms: Knee dislocations are severely painful and produce an obvious deformity of the knee. After reduction.or put back into alignment -. Treatment: Meniscal injuries often require arthroscopic surgical repair. The patella is also often out of place either upward (with patellar tendon rupture) or downward (with quadriceps tendon rupture). Medical treatment. A locking knee or a knee that "gives" should be evaluated for arthroscopic repair. and a patellar tendon rupture typically occurs in younger people who have had previous tendonitis or steroid injections to the knee. may leave the lower leg viable but without strength or sensation. a piece of the meniscus will tear off and float in the knee joint. Many dislocations are reduced -. Meniscal injuries may also cause the knee to give way. Treatment: Tendon ruptures should be evaluated urgently. Dislocation of the knee is caused by a particularly powerful blow to the knee. it must be repaired immediately in the operating room. o o o o o Knee Pain Overview (continued) Acute Knee Pain continued. Often. the doctor will immediately reduce the dislocation. Untreated arterial injuries leave the lower leg without a blood supply. If circulation is not restored. people with these injuries are observed in the hospital where they usually do a number of tests to ensure that no arterial or nerve injury has occurred. Meniscal injuries y o o Description: Injuries to the meniscus are typically traumatic injuries but can also be due to overuse. on the other hand. Knee dislocation y o Description: Knee dislocation is a true limb-threatening emergency. As this occurs. If such an injury is found. Treatment: If the knee dislocation has not been put back into place on its own. Tendon ruptures generally require surgical repair. This is also a rare injury. The lower leg becomes completely displaced with relation to the upper leg. Dislocated kneecap (patella) y . A partial rupture may be treated with splinting alone.

either over-the-counter. Chronic Knee Pain Arthritis: Arthritis of the knee is an inflammatory disorder of the knee joint that is often painful. y o  Knee Osteoarthritis Description: Osteoarthritis (OA) is caused by degeneration of cartilage in the knee. the obese. Symptoms: If you have this injury. Anti-inflammatory medications. Treatment: The doctor will move the patella back into place (reduce the dislocation). Even if the patella goes back into place by itself. and in those with high-riding kneecaps. This injury often causes damage to the cartilage on the back of the patella. however. bone on bone. the menisci (cartilage) will be completely eroded. Symptoms: In addition to knee pain. Arthritis has many causes. knock-kneed people. the doctors will treat these injuries by splinting the knee for 3 weeks to allow the soft tissues around the patella to heal followed by strengthening exercises to keep the patella in line. or by your doctor's prescription.   o  Rheumatoid arthritis of the knee Description: Rheumatoid arthritis (RA) is a connective tissue disease of the whole body that affects many joints often including the knee. are also quite helpful. More severe OA can be treated with narcotic pain medicines or a knee joint replacement in which a synthetic joint replaces your knee joint.o o o Description: A common injury caused by direct trauma or forceful straightening of the leg. Symptoms: Osteoarthritis causes a chronically painful knee that is often more painful with activity. rheumatoid arthritis may produce morning stiffness and pain in other joints. People who have this disease often have family members who suffer from it as well. you will notice the patella being out of place and may have difficulty flexing or extending your knee. such as an injury that happens when serving in volleyball or tennis. and the femur will rub on the tibia.   o  Crystalline arthritis (gout and pseudogout) Description: These severely painful forms of arthritis are caused by sharp crystals that form in the knee and other joints. and prescription drugs (such as methotrexate [Rheumatrex]) aimed at slowing disease progression. Kneecap dislocation is more common in women. These crystals can form as a . In its extreme form. After reducing the patella and ensuring the absence of a fracture. Treatment: Treatment is aimed at pain control with over-the-counter pain relievers. anti-inflammatory medications. Treatment: Treatment includes pain medications. it needs to be x-rayed for a fracture.

however. Gonorrhea. This type of bursitis occurs in people who work on their knees. can infect the knee. people who develop such infection typically complain of fevers and chills. infection. Treatment: New swelling and pain in the knee must be evaluated for infection based on your doctor¶s opinion. Infection (or infectious arthritis) y o Description: Many organisms may infect the knee. Severe forms. Treatment: Treatment will usually include home care with PRICE therapy and NSAIDs. Bursitis y o o Description: As a result of trauma. The anserine bursa is located about two inches below the knee along the medial side of the knee. Symptoms: Infection of the knee causes painful knee swelling. Treatment usually includes intensive antibiotic therapy and may include aspiration of the joint. the various bursae of the knee may become inflamed. Less severe infections may not have associated fevers or cause this ill feeling. More commonly occurring in the overweight and in women. Symptoms: Acute or chronic trauma causes a painful and often swollen knee from the inflammation of the bursae. o o Patellofemoral syndrome and chondromalacia patella y o o Description: These 2 conditions represent a spectrum of disease caused by patellar mistracking. Treatment: Treatment is aimed at controlling inflammation with antiinflammatory medications. o Knee Pain Overview (continued) Chronic Knee Pain continued. Symptoms: The condition typically occurs in young women and also in athletes of both sexes and elderly people. In patellofemoral syndrome. but also affecting athletes and others. Another type of bursitis is anserine bursitis. A particularly common bursitis is prepatellar bursitis. In addition.. as can common organisms residing on normal skin. result of defects in the absorption or metabolism of various natural substances such as uric acid (which produces gout) and calcium pyrophosphate (pseudogout). or surgical drainage of the infection. and at aiding the metabolism of the various chemicals that may lead to crystal formation. can be treated with periodic steroid injections to the bursae. anserine bursitis often causes pain in the region of the bursa and is often worse with bending the knee or at night with sleep. the patella rubs against the inner or outer femur rather than tracking straight . or crystalline deposits.. a common sexually transmitted disease. It is often referred to as housemaid¶s knee or carpet layer¶s knee.

Particularly important are rest. Severe cases of patellofemoral syndrome or chondromalacia may be treated surgically through a variety of procedures. and exercises (such as straight leg raises) that balance the muscles around the patella work for most people. or orthotic supports that correct foot mechanics and may reduce abnormal forces on the knee. and NSAID drugs. is termed jumper¶s knee. the bump about two inches below the knee on the front side). Symptoms: Jumper¶s knee causes localized pain that is worse with activity. After controlling the pain. As a result the patellofemoral joint on either the inner or outer side may become inflamed causing pain that is worse with activity or prolonged sitting. which will help stop the pain and break the cycle of inflammation. It usually hurts more as you jump up than when you land because jumping puts more stress on tendons of the knee. Also. Others may benefit from bracing or taping of the patella. Jumper¶s knee is so named because it is typically seen in basketball players.o down the middle. commercial arch supports (for the arch of the foot). or at the place where it inserts on the tibia (called the tibial tuberosity. Treatment: Home care with PRICE therapy. you should slowly start an exercise regimen to strengthen the quadriceps and hamstring muscles and resume your sport of choice a few weeks down the line. where it inserts. Osgood-Schlatter disease y o Description: Osgood-Schlatter disease occurs in adolescent athletes where repetitive extension of the knee causes inflammation and injury of the tibial tubercle (the bony protrusion at the top of the shin. volleyball players. As the condition progresses. NSAIDs. and people doing other jumping sports. This pain is typically worse when extending the leg. softening and roughening of the articular cartilage on the underside of the patella occurs. and the syndrome is referred to as chondromalacia patella. ice. Jumper¶s knee y o Description: Tendonitis (inflammation of the tendon) of the quadriceps tendon at the upper point of the patella. Symptoms: Children suffering from this syndrome report pain at the tibial tubercle. bracing of the extensor mechanism may help remove stress from the tendons o o Knee Pain Overview (continued) Chronic Knee Pain continued. just below the kneecap). Treatment: Home therapy with the PRICE regimen together with antiinflammatory drugs is the basis of treatment.. The tibial tubercle is tender to touch and over time begins to protrude more because the chronic inflammation stimulates the bone to grow. Treatment: Osgood-Schlatter disease is a self-limited condition that usually resolves as the thetibial tubercle stops growing with the end of adolescence (at about age 17 years in males and age 15 years in o o . or tendonitis of the patellar tendon either at the lower point of the patella..

but please see a book on exercise and training for more) can help prevent knee injury. reduce osteoarthritis. Many types of pain are difficult to prevent.females)... PRICE therapy and NSAIDs may be of some help. Keep limber. When this band is tight it may rub against the bottom outer portion of the femur (the lateral femoral condyle). Then. Strengthening exercises particularly of the quadriceps (straight leg raises and leg extensions are two excellent exercises. Keeping your weight down may also reduce the number of ligament and tendon injuries for similar reasons. Symptoms: Distance runners typically suffer from this condition. In severe cases. Iliotibial band syndrome y o Description: A fibrous ligament. consider swimming or water exercises. These runners complain of outside knee pain usually at the lateral femoral condyle. the pain will typically come on 10-15 minutes into a run and improve with rest. Stretching keeps your knee from being too tight and aids in preventing both patellofemoral syndrome and iliotibial band syndrome. Stay slim y o o Staying slim reduces the forces placed on the knee during both athletics and everyday walking and may. Treatment includes PRICE and NSAID therapy. according to some medical research. Treatment: The most important aspect of treating iliotibial band syndrome is to stretch the iliotibial band. . keep fit y o o o Many knee problems are due to tight or imbalanced musculature. lean toward your left for 20-30 seconds using the wall to help you support yourself. the force of buoyancy supports some of our weight so our knees do not have to. called the iliotibial band. splinting the knee for a few weeks may help reduce the pain and halt the inflammation cycle. In water. Early on. therefore. In addition to stretching the iliotibial band. Knee Pain Overview (continued) Knee Pain Prevention continued. Exercise wisely y o o If you have chronic knee pain. o o Knee Pain Prevention Knee pain has a host of causes. but you can do some general things to reduce the likelihood of sustaining a knee injury. extends from the outside of the pelvic bone to the outside of the tibia. also help to prevent knee pain. One way to do this is to place the right leg behind the left while standing with your left side about two to three feet from a wall. Stretching and strengthening.

and leg muscles. If it hurts. consider stopping . relieving back pain. Exercises for lower back pain can strengthen back. Always ask your doctor before doing any exercises for back pain. respect and listen to your body. See which exercises can help low back pain and which you should avoid. You may find that your aching knees will act up if you play basketball or tennis every day but will not if you limit your pounding sports to twice a week.many injuries occur when people are tired. stomach. knee protection may include wearing a seatbelt to avoid the knee-versus-dashboard injuries as well as injuries to other parts of your body. or jogging. at least try to limit hard pounding and twisting activities such as basketball. If you are fatigued. Good and Bad Exercises for Low Back Pain Lower Back Pain: How Exercise Helps You may feel like resting. They help support your spine. Whatever you do. but moving is good for your back. change what you are doing. Protect the knee y o o o Wearing proper protection for the activity at hand can help avoid knee injuries. Previous page Next page . When playing volleyball or when laying carpet. When driving. protecting your knees may include kneepads. tennis.o o o o If you don¶t have access to a pool or do not enjoy water activities.

Tighten stomach muscles and raise your shoulders off the floor. Cross arms over your chest or put hands behind your neck. Don't lead with your elbows or use arms to pull your neck off the floor. Previous page Next page .Good and Bad Exercises for Low Back Pain Try: Crunches Lie with knees bent and feet flat on the floor. then slowly lower back down. Repeat 8 to 12 times. Breathe out as you raise your shoulders. Hold for a second.

Standing toe touches. Previous page Next page . put greater stress on the disks and ligaments in your spine. Some may aggravate pain. They can also overstretch lower back muscles and hamstrings. for example.Good and Bad Exercises for Low Back Pain Avoid: Toe Touches Exercise is good for low back pain ² but not all exercises are beneficial.

Do 2 to 4 times for each leg. Previous page Next page . Sit-ups may also put a lot of pressure on the discs in your spine. Hold for at least 15 to 30 seconds. Straighten your knee and slowly pull back on the towel. Previous page Next page Good and Bad Exercises for Low Back Pain Try: Hamstring Stretches Lie on your back and bend one knee. most people tend to use muscles in the hips when doing sit-ups. Loop a towel under the ball of your foot. You should feel a gentle stretch down the back of your leg.Good and Bad Exercises for Low Back Pain Avoid: Sit-ups Although you might think sit-ups can strengthen your core or abdominal muscles.

Good and Bad Exercises for Low Back Pain Avoid: Leg Lifts Leg lifts are sometimes suggested as an exercise to "strengthen your core" or abdominal muscles. try lying on your back with your right leg straight and left leg bent at the knee. Repeat 10 times. Instead. But lifting both legs together while lying on your back can make back pain worse. Slowly lift right leg up about 6 inches and hold briefly. Lower leg slowly. Previous page Next page . then switch legs.

then lean back until your back is flat against the wall.Good and Bad Exercises for Low Back Pain Try: Wall Sits Stand 10 to 12 inches from the wall. Hold for a count of 10. Previous page Next page . Repeat 8 to 12 times. pressing your lower back into the wall. then carefully slide back up the wall. Slowly slide down until your knees are slightly bent.

Lift and extend one leg behind you. and tighten your stomach muscles. Previous page Next page Good and Bad Exercises for Low Back Pain Try: Bird Dog Start on your hands and knees. If it's comfortable for you. Keep hips level. Push with your hands so your shoulders begin to lift off the floor. and then switch to the other leg. Previous page Next page . put your elbows on the floor directly under your shoulders and hold this position for several seconds. and try to lengthen the time you hold each lift. Repeat 8 to 12 times for each leg. Hold for 5 seconds.Good and Bad Exercises for Low Back Pain Try: Press-up Back Extensions Lie on your stomach with your hands under your shoulders. Try lifting and extending your opposite arm for each repetition.

Then lower your knee and repeat with the other leg. Previous page Next page .Good and Bad Exercises for Low Back Pain Try: Knee to Chest Lie on your back with knees bent and feet flat on the floor. Keep your lower back pressed to the floor. keeping the other foot flat on the floor. Do this 2 to 4 times for each leg. and hold for 15 to 30 seconds. Bring one knee to your chest.

squeeze your buttocks. Push your heels into the floor. Previous page Next page . Hold for 10 seconds while breathing in and out smoothly. Hold about 6 seconds. Repeat 8 to 12 times.Good and Bad Exercises for Low Back Pain Try: Pelvic Tilts Lie on your back with knees bent. Repeat 8 to 12 times. feet flat on floor. and your hips and pelvis rocking back. You¶ll feel your back pressing into the floor. Previous page Next page Good and Bad Exercises for Low Back Pain Try: Bridging Lie on your back with knees bent and just your heels on the floor. Tighten your stomach by pulling in and imagining your belly button moving toward your spine. and knees are in a straight line. and lift your hips off the floor until shoulders. hips. and then slowly lower hips to the floor and rest for 10 seconds.

In fact. and which exercises to avoid. Previous page Next page . it may help relieve chronic back pain.Good and Bad Exercises for Low Back Pain Lifting Weights May Help Done properly. putting extra stress on back muscles and ligaments could raise risk of further injury. Ask your doctor whether you should lift weights. But when you have acute (sudden) back pain. lifting weights doesn't usually hurt your back.

because you may need to skip some moves. where the water supports your body. Avoid any strokes that twist your body. If your back is hurting. Previous page Next page Good and Bad Exercises for Low Back Pain Try: Some Pilates Moves Pilates combines stretching. heart. strengthening. Previous page Next page . and blood vessels and can help you lose weight. and biking may all help reduce back pain. swimming. and core abdominal exercises. Under the instruction of an experienced teacher. Be sure to tell your teacher about your back pain. Walking.Good and Bad Exercises for Low Back Pain Try: Aerobic Exercise Aerobic exercise strengthens your lungs. it may help some people with back pain. Start with short sessions and build up over time. try swimming.

fracture. It can stem from a disease or medical condition.Low Back Pain: What Can You Do? The content below was selected by the WebMD Editorial staff and is solely under WebMD's editorial control. or spinal stenosis (a narrowing of the spinal canal through which the spinal cord runs). Back pain takes various forms. from a persistent dull ache to sudden sharp pain. and has many causes. making it the fifth most common reason for visiting the doctor. MD If you¶ve been sidelined by a sore back. Many people develop back pain simply because they¶re overweight or sedentary. fibromyalgia. such as arthritis. Sometimes it results from a sprain. or other accidental injury. . you¶re not alone. Four out of five people experience back pain at some point. NEXT ARTICLE: y y Low Back Pain: What Can You Do?11 Tips for Back Pain ReliefBack Pain Medications Which drugs are used to relieve lower back pain? Back Pain CausesBack Pain and Narcotic Painkiller AddictionAlternative Treatments for Back Pain11 Ways to Avoid Back Pain WebMD Medical Reference Reviewed By BrunildaNazario.

To firm up a soft mattress. Sitting on an overstuffed wallet may cause discomfort and back pain. If you have to go higher. Keep your knees a bit higher than your hips while seated. Staying within 10 pounds of your ideal weight will help control back pain. Pay attention to your posture. Experts now know that physical activity helps ease inflammation and muscle tension by keeping blood and nutrients flowing to the affected area. They can shift your center of gravity and strain your lower back. bring along a pair of low-heeled shoes and slip into them if you become uncomfortable. stop. 9. Sleeping on your stomach can be especially hard on your back. a firm mattress is probably best. If you can¶t sleep any other way. 11 Ways to Avoid Back Pain (continued) continued. 2. 6. keep your head up and your stomach pulled in. 7. Prefer to sleep on your back? Put one pillow under your knees and another under your lower back. you may think the best way to get relief is to limit exercise and to rest. sitting. rest one foot on a stool -. Be careful how you lift. you can place a half-inchthick plywood board underneath. take your wallet out of your back pocket. Sleep on your side. Bend your knees and squat. What¶s more. Prop your feet on a stool if you need to. 5.and switch feet every five to 15 minutes. Clothing so tight that it interferes with bending. If you smoke. smokers are especially vulnerable to back pain. sleep on your side with your knees pulled up slightly toward your chest. If you¶re going to be sitting for a prolonged period -. Stick to a one-inch heel.while driving. The best chair for preventing back pain is one with a straight back or low-back support. Pushing is easier on the back.. Because nicotine restricts the flow of nutrient-containing blood to spinal discs. 10. pulling in your stomach muscles and holding the object close to your body as you stand up. If you can. Watch your weight. push rather than pull heavy objects. Get more exercise. When you exercise. 8. Extra pounds. adjustable strap that¶s long enough to reach over your head. can make back pain worse by shifting your center of gravity and putting strain on your lower back. If possible. always start and end with stretches. Don't twist your body while lifting. 4. for example. If you must stand for a prolonged period. or walking can aggravate back pain by causing poor posture and misalignment of the spine. A day or two of rest may help. place a pillow under your hips. and surgery is rarely necessary. Stash the skinny jeans. Pick the right handbag or briefcase. especially in your midsection. Don¶t bend over to lift heavy objects. No matter how you sleep. If you¶re prone to back pain. Buy a bag or briefcase with a wide.. but more than that may actually increase your pain. simple self-help strategies such as these can be surprisingly effective at preventing back pain and keeping it from returning: 1. 3. A messenger bag (like the ones bike messengers wear) is made to wear this way. Lighten your wallet. If your back is hurting.The good news is that most lower back pain usually gets better within a few days or weeks. Avoid high heels. Having the .

suggest that it may. By immobilizing and thus weakening back muscles. . To lighten the load. from elastic bands to special corsets. NEXT ARTICLE: y y Low Back Pain: What Can You Do? 11 Tips for Back Pain ReliefBack Pain MedicationsBack Pain CausesBack Pain and Narcotic Painkiller AddictionAlternative Treatments for Back PainAlternative Treatments for Low Back Pain From acupuncture to biofeedback. Of course. but there is not much evidence that they help treat chronic back pain. Low Back Pain: What Can You Do? The content below was selected by the WebMD Editorial staff and is solely under WebMD's editorial control.´ says Daniel C. many different alternative treatments purport to relieve chronic back pain. The only question seems to be why this ancient healing tradition works. Various back supports are available. cases. it would be reasonable to try any of a number of alternative treatments. Which are worth trying? ³As long as you¶ve had your back pain problem checked out by a doctor to rule out a serious disease. Here are seven: Acupuncture. periodically purge bags. 11. backpacks. When carrying a heavy bag or case without straps. They can be helpful after certain kinds of surgery. experts say it¶s best to stick with the alternative treatments that are proven to be safe and potentially effective. Some scientists suggest that it works by triggering the release of natural painkillers known as endorphins. PhD.strap on the opposite shoulder of the bag distributes the weight more evenly and helps keep your shoulders even and your back pain-free. a senior investigator at Group Health Research Institute in Seattle who has conducted research on alternative medical techniques for back pain. MD From acupuncture to yoga. back braces may actually aggravate back pain. Forget about back braces. and other carriers of things you don't need. including a randomized trial of acupuncture published in the Archives of Internal Medicine. Practitioners of traditional Chinese medicine maintain that the needles affect the flow of a ³vital energy´ known as qi (pronounced chee) within the body. natural ways to relieve lower back pain. Cherkin. WebMD Feature By David Freeman Reviewed By BrunildaNazario. Can inserting needles in your body really relieve lower back pain? Recent studies. switch hands frequently to avoid putting all the stress on one side of the body.

muscle tension.´ ³We don¶t know what¶s going on in the body [during spinal manipulation]. medical director of Brigham and Women¶s Hospital¶s Osher Clinical Center for Complementary and Integrative Medical Therapies in Chestnut Hill. PhD. the chiropractor will usually take a medical history and do a physical exam that focuses closely on the spine. ³But we know that it alleviates sensations of pain and soreness and increases joint mobility. who is also an assistant clinical professor of medicine at Harvard Medical School in Boston. It requires time and application. pulling. it starts. Mass. president of Palmer College of Chiropractic in San Jose. you may be able to reduce muscle tension and relieve pain. there is evidence that it can ease chronic pain generally. DC.´ During your first visit. spinal manipulation. ³I can¶t explain how my car works.´ says Levy. at least from the patient¶s perspective. M. Alexander. but one study published in the journal BMJ showed that people given one-on-one training in the technique reduced their back pain. Cherkin says. In subsequent visits. and several sessions may be required. Chiropractic.´ Acupuncture needles typically stay in place for 20 to 30 minutes. Its name comes from an Australian actor named F. This high-tech treatment can help you learn to loosen tight muscles by using your mind to control your body. natural ways to relieve lower back pain. may help relieve back pain. breathing. Calif. told WebMD in an email. Alternative Treatments for Low Back Pain From acupuncture to biofeedback. It pays particular attention to releasing tension in the neck. The chiropractor may also use heat. (continued) continued. But "it's not a magic bullet." Biofeedback.´ says William C. Meeker.. There isn't a lot of research on the Alexander technique. Paul Little. Chiropractic¶s signature treatment. "This is an effective technique to improve pain and function in the long term. The National Center for Complementary and Alternative Medicine reports that spinal manipulation ³appears to be as effective as conventional treatments. or pushing movements to adjust the bones and joints in your spine.Donald B. electrical stimulation. . Although there¶s no compelling evidence to show that biofeedback works specifically for chronic back pain." one of the study's authors. ³I just know that if I turn the key properly in the ignition. As you become aware of the connection between the mind and the body. the chiropractor will use twisting.. or ultrasound to relax your muscles. who developed the technique. back. professor of primary care research at the University of Southampton in England. It¶s worth a try. To learn biofeedback. blood pressure. and brain wave activity. Alexander technique. A biofeedback therapist teaches you relaxation techniques so you can see how to control a specific body function. sensors are applied to your body that give continuous feedback about body functions such as heart rate. This type of physical therapy uses hands-on training to teach people to avoid specific postures and ways of moving that cause pain by placing undue strain on the musculoskeletal system. and spine. Levy. says that how acupuncture works may not matter.. MD.

A kind of meditation known as mindfulness may help ease chronic back pain. Morone. PhD. "Yoga was clearly better than self-care. and cautions that physically demanding forms of yoga could actually make back pain worse. ³The emotional component of pain cannot be overestimated. too. although they continued to have back pain. MD. but only if you're willing to practice. Karen J. Sherman. Health insurance plans often cover the cost of chiropractic care. Others said that. Yoga." She recommends finding a yoga instructor who has experience working with people who have back pain." says one of the study¶s authors. She says that the overall pain-relieving effect of mindfulness appears small. In one study.´ says Natalia E. Why would anyone wracked with pain want to try poses (asanas) with names like "Cobra Posture" and "Supine Butterfly?" But research suggests that this ancient movement-and-meditation technique can ease chronic back pain. and even some conventional medical doctors use spinal manipulation. the largest of its kind. Meditation.Physical therapists. Cherkin says all showed positive results. possibly by changing emotions that tend to make pain worse. showed that back pain sufferers treated with 10 weekly massage visits got long-lasting pain relief. and sensations without judging them. easy-to-do form of yoga known as viniyoga had pain relief that lasted at least several months. ³Mindfulness helps people become aware of thoughts. Though few studies have looked at massage as a remedy for chronic back pain. people with back pain who took 12 classes learning a gentle. Cherkin's own study. learning yoga might sound like the ultimate bad dream. senior investigator at Group Health Research Institute. . emotions. "It's certainly worth trying. For anyone with a bad back. though some people who participated in her studies experienced dramatic pain relief. Massage.´ Morone says. and massage does ease the muscle tension that often accompanies back pain. osteopaths. assistant professor of medicine at the University of Pittsburgh School of Medicine. It feels good to get a massage. it didn¶t bother them as much.

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