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DrSugar on Chronic and Nagging Knee Pain

DrSugar is keyed up about the knee and the nagging pain in that joint that can frustrate your fitness drive. Here's what he has to say.

Let's begin with a brief anatomy lesson for the knee is a complicated structure with multiple moving parts and a variety of connective tissues holding everything together. For a dedicated athlete or even the average weekend warrior, the knee joint is a minefield of potential sites of injury. Commonly injured areas prone to inflammation include: the prepatellar bursa (in front of the knee cap), patellar tendon (holds the knee cap in place), anterior cruciate ligament (criss-crosses inside the knee), meniscus (lines the bottom of the knee joint), as well as the bones and muscles making up the knee joint.

Now that you know a little more about the structure of the knee, to see how it can break down

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Chronic knee pain is usually due to inflammation of tendons or bursa around the knee, however sometimes more serious injuries such as stress fractures of the tibia (shin bone) can also start as a nagging pain. Two of the most common chronic knee problems are patellofemoral syndrome (aka runner's knee), which affects the anterior knee, and iliotibial band syndrome, which affects the lateral knee and thigh. Both are very common and usually occur as a result of overuse or poor exercise habits. To prevent these syndromes it is important to minimize high impact activities when possible. This includes always using proper running shoes that fit well, avoiding downhill running, and minimizing jumping or running on hard surfaces, such as concrete. Other ways to decrease stress on the knee include mixing exercises such as running, swimming, and biking. The idea is to avoid producing only one type or repetitive motion at the knee joint.

If it is too late for prevention, then there are a number of ways you can help treat your soft tissue knee injury. The most important first step is to slow down and avoid the activity that is causing the pain. The most common culprit is running because it is such a common high impact activity. If you are an avid runner plagued with knee pain, you might have to switch to biking or swimming until the inflammation subsides. Ice, heat, and anti-inflammatory medications can also help with pain in an acute setting, but are unlikely to provide any long term benefit. For long term results, it is important to strengthen the muscles around the knee. This can be accomplished through physical therapy or core strength training with an experienced trainer. Another important solution is to have your feet evaluated for orthotics or other shoe inserts if you suspect that you have low arches or any other foot abnormality. It is also important to see your doctor for any severe knee pain or prolonged pain that is not relieved with methods described above to rule out more significant damage to ligaments or bones.

If you have a question for DrSugar, send me a private message here and I will forward it to the good doctor.

DrSugar's posts are for informational purposes only and should not be considered medical advice, diagnosis, or treatment recommendations. Click here for more details.

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DrSugar DrSugar 8 years
Inflammation is a bit of a double edged sword. On one hand it can promote healing and on the other it can cause further damage and irritation. To my knowledge there have been no studies to indicate that NSAIDS slow the healing process for soft tissue processes. Also, they are a standard treatment among orthopedists and rheumatologists for these types of injuries. Diet wise it is always important to maintain adequate protein intake to ensure proper healing.
Arthur Arthur 8 years
Two questions. I've read stuff that says that NSAIDs may slow down or otherwise prevent recovery of soft tissue inflammation, should I give up my advil? Are there any dietary habits or foods that can help speed recovery?
nancita nancita 8 years
I have always been plagued by knee pain. Great tips and explanation...thanks, doc.
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