Angie Brown, Quinnipiac University

Knee injuries are common in athletes, accounting for 41% of all athletic injuries. But knee injuries aren’t limited to competitive athletes. In our everyday lives, an accident or a quick movement in the wrong direction can injure the knee and require medical treatment. A quarter of the adult population worldwide experiences knee pain each year

As a physical therapist and board-certified orthopedic specialist, I help patients of all ages with knee injuries and degenerative conditions.

Your knees have a huge impact on your mobility and overall quality of life, so it’s important to prevent knee problems whenever possible and address pain in these joints with appropriate treatments.

Healthy knees

The knee joint bones consist of the femur, tibia and patella. As in all healthy joints, smooth cartilage covers the surfaces of the bones, forming the joints and allowing for controlled movement.

Muscles, ligaments and tendons further support the knee joint. The anterior cruciate ligament, commonly known as the ACL, and posterior cruciate ligament, or PCL, provide internal stability to the knee. In addition, two tough pieces of fibrocartilage, called menisci, lie inside the joint, providing further stability and shock absorption.

All these structures work together to enable the knee to move smoothly and painlessly throughout everyday movement, whether bending to pick up the family cat or going for a run.

Causes of knee pain

Two major causes of knee pain are acute injury and osteoarthritis.

Ligaments such as the ACL and PCL can be stressed and torn when a shear force occurs between the femur and tibia. ACL injuries often occur when athletes land awkwardly on the knee or quickly pivot on a planted foot. Depending on the severity of the injury, these patients may undergo physical therapy, or they may require surgery for repair or replacement.

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PCL injuries are less common. They occur when the tibia experiences a posterior or backward force. This type of injury is common in car accidents when the knee hits the dashboard, or when patients fall forward when walking up stairs.

The menisci can also experience degeneration and tearing from shear and rotary forces, especially during weight-bearing activities. These types of injuries often require rehabilitation through physical therapy or surgery.

Knee pain can also result from injury or overuse of the muscles and tendons surrounding the knee, including the quadriceps, hamstrings and patella tendon.

Both injuries to and overuse of the knee can lead to degenerative changes in the joint surfaces, known as osteoarthritis. Osteoarthritis is a progressive disease that can lead to pain, swelling and stiffness. This disease affects the knees of over 300 million people worldwide, most often those 50 years of age and up. American adults have a 40% chance of developing osteoarthritis that affects their daily lives, with the knee being the most commonly affected joint.

Age is also a factor in knee pain. The structure and function of your joints change as you age. Cartilage starts to break down, your body produces less synovial fluid to lubricate your joints, and muscle strength and flexibility decrease. This can lead to painful, restricted movement in the joint.

Risk factors for knee problems

There are some risk factors for knee osteoarthritis that you cannot control, such as genetics, age, sex and your history of prior injuries.

Fortunately, there are several risk factors you can control that can predispose you to knee pain and osteoarthritis specifically. The first is excessive weight. Based on studies between 2017 and 2020, nearly 42% of all adult Americans are obese. This obesity is a significant risk factor for diabetes and osteoarthritis and can also play a role in other knee injuries.

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A lack of physical activity is another risk, with 1 in 5 U.S. adults reporting that they’re inactive outside of work duties. This can result in less muscular support for the knee and more pressure on the joint itself.

An inflammatory diet also adds to the risk of knee pain from osteoarthritis. Research shows that the average American diet, often high in sugar and fat and low in fiber, can lead to changes to the gut microbiome that contribute to osteoarthritis pain and inflammation.

Preventing knee pain

Increasing physical activity is one of the key elements to preventing knee pain. Often physical therapy intervention for patients with knee osteoarthritis focuses on strengthening the knee to decrease pain and support the joint during movement.

The U.S. Department of Health and Human Services recommends that adults spend at least 150 to 300 minutes per week on moderate-intensity, or 75 to 150 minutes per week on vigorous-intensity aerobic physical activity. These guidelines do not change for adults who already have osteoarthritis, although their exercise may require less weight-bearing activities, such as swimming, biking or walking.

The agency also recommends that all adults do some form of resistance training at least two or more days a week. Adults with knee osteoarthritis particularly benefit from quadriceps-strengthening exercises, such as straight leg raises.

Treatments for knee pain

Conservative treatment of knee pain includes anti-inflammatory and pain medications and physical therapy.

Medical treatment for knee osteoarthritis may include cortisone injections to decrease inflammation or hyaluronic acid injections, which help lubricate the joint. The relief from these interventions is often temporary, as they do not stop the progression of the disease. But they can delay the need for surgery by one to three years on average, depending on the number of injections.

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Physical therapy is generally a longer-lasting treatment option for knee pain. Physical therapy treatment leads to more sustained pain reduction and functional improvements when compared with cortisone injections treatment and some meniscal repairs.

Surgical interventions for knee pain include the repair, replacement or removal of the ACL, PCL, menisci or cartilage. When more conservative approaches fail, patients with osteoarthritis may benefit from a partial or total knee replacement to allow more pain-free movement. In these procedures, one or both sides of the knee joint are replaced by either plastic or metal components. Afterward, patients attend physical therapy to aid in the return of range of motion.

Although there are risks with any surgery, most patients who undergo knee replacement benefit from decreased pain and increased function, with 90% of all replacements lasting more than 15 years. But not all patients are candidates for such surgeries, as a successful outcome depends on the patient’s overall health and well-being.

New treatments on the horizon

New developments for knee osteoarthritis are focused on less invasive therapies. Recently, the U.S. Food and Drug Administration approved a new implant that acts as a shock absorber. This requires a much simpler procedure than a total knee replacement.

Other promising interventions include knee embolization, a procedure in which tiny particles are injected into the arteries near the knee to decrease blood flow to the area and reduce inflammation near the joint. Researchers are also looking into injectable solutions derived from human bodies, such as plasma-rich protein and fat cells, to decrease inflammation and pain from osteoarthritis. Human stem cells and their growth factors also show potential in treating knee osteoarthritis by potentially improving muscle atrophy and repairing cartilage.

Further research is needed on these novel interventions. However, any intervention that holds promise to stop or delay osteoarthritis is certainly encouraging for the millions of people afflicted with this disease.

Angie Brown, Clinical Associate Professor of Physical Therapy, Quinnipiac University

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This article is republished from The Conversation under a Creative Commons license. Read the original article.

Our Lifestyle section on STM Daily News is a hub of inspiration and practical information, offering a range of articles that touch on various aspects of daily life. From tips on family finances to guides for maintaining health and wellness, we strive to empower our readers with knowledge and resources to enhance their lifestyles. Whether you’re seeking outdoor activity ideas, fashion trends, or travel recommendations, our lifestyle section has got you covered. Visit us today at https://stmdailynews.com/category/lifestyle/ and embark on a journey of discovery and self-improvement.

Create a Heart-Healthy Holiday Menu

(Family Features) The traditions of the holidays often include family-favorite meals and seasonal sweets, but enjoying those beloved treats doesn’t always mean giving up health-conscious eating.

This year, before you decide what to prepare for holiday get-togethers, consider the benefits of recipes like this Apple Coffee Cake that follow heart-healthy eating plans. One such plan, the Dietary Approaches to Stop Hypertension (DASH) plan, offers benefits for the heart and helps prevent and treat high blood pressure, too.

Developed by the National Heart, Lung, and Blood Institute (NHLBI), DASH takes a flexible, balanced approach to eating that can help boost your health for the long haul.

• It requires no special foods and instead provides daily and weekly nutritional goals.
• It can lower two major risk factors for heart disease – high blood pressure and high LDL (bad) cholesterol levels, according to NHLBI-funded research.
• It can help you lose weight if you follow the plan and increase your physical activity, research shows.
• If combined with reductions in salt and sodium, it often provides greater health benefits than the eating plan does alone.

To learn more and find DASH-friendly recipes, visit nhlbi.nih.gov/DASH.

Watch video to see how to make this recipe!

Apple Coffee Cake
Recipe courtesy of The Heart Truth program, part of the National Heart, Lung, and Blood Institute
Prep time: 10 minutes
Cook time: 40 minutes
Servings: 20

• 5          cups tart apples, cored, peeled and chopped
• 1          cup sugar
• 1          cup dark raisins
• 1/2       cup pecans, chopped
• 1/4       cup vegetable oil
• 2          teaspoons vanilla
• 1          egg, beaten
• 2 1/2    cups sifted all-purpose flour
• 1 1/2    teaspoons baking soda
• 2          teaspoons ground cinnamon

1. Preheat oven to 350 F. Lightly oil 13-by-9-by-2-inch pan.
2. In large mixing bowl, combine apples with sugar, raisins and pecans; mix well. Let stand 30 minutes.
3. Stir in oil, vanilla and egg.
4. Sift together flour, baking soda and cinnamon. Using about 1/3 of mix at a time, add to apple mixture, stirring just enough to moisten dry ingredients.
5. Turn batter into pan. Bake 35-40 minutes until toothpick inserted in center of cake comes out clean.
6. Cool cake slightly before serving.

SOURCE:
National Heart, Lung, and Blood Institute

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(Family Features) Nearly half of all American adults have high blood pressure, or hypertension, according to the Centers for Disease Control and Prevention. Of those, about 75% don’t have it under control, and many may not even realize they have it unless they experience other complications.

In fact, high blood pressure is a leading cause and controllable risk factor for heart disease and stroke as well as other issues such as kidney failure, vision loss and sexual problems. However, the American Heart Association recommends taking these simple steps to help control your levels and manage risks.

1. Know Your Numbers
In most cases, normal blood pressure is 120/80 mm HG or less. Readings consistently higher than 130/80 are considered high blood pressure. Have your blood pressure measured at least once a year by a health care professional and regularly monitor it at home with a validated monitor then discuss the readings with your doctor. Getting accurate readings can help ensure the most appropriate treatment should any problems arise.

2. Maintain a Healthy Weight
If you’re overweight or obese, you’re at increased risk of high blood pressure. Losing just 3-5% of your body weight can help improve your numbers. There are an abundance of plans and programs available that can assist with weight loss, and taking positive steps with a friend or family member may help with motivation.

3. Get Active
To maximize health benefits and help keep blood pressure in the normal range, the American Heart Association recommends adults get at least 150 minutes per week of moderate activity, 75 minutes of vigorous activity or a combination of the two. Try activities like brisk walking, swimming, bicycling or dancing. For example, the Get Down with Your Blood Pressure campaign uses music and dance to help remember the four easy steps to self-monitor blood pressure:

• Get It – grab your self-monitoring blood pressure (SMBP) device
• Slip It – slide the SMBP cuff up your arm
• Cuff It – wrap the cuff snugly, but not too tight
• Check It – check your blood pressure on the device

4. Eat Well
Making small, simple changes to your eating habits can go a long way toward keeping you and your family healthy. Eating fruits and vegetables, such as mangos, avocados and blueberries, can lower blood pressure over time. Other smart choices include nuts and seeds, whole grains, lean proteins and fish.

5. Reduce Alcohol and Tobacco Usage
Smoking compounds risk factors for heart disease, such as high blood pressure and diabetes, and the chemicals in tobacco smoke can harm your heart and blood vessels. Similarly, consuming alcohol excessively (more than two drinks per day) is associated with high blood pressure. Limiting alcohol consumption and stopping smoking – or avoiding secondhand smoke – can help reduce your risk.

If you develop high blood pressure, work with a health care professional to manage it, and visit heart.org/hbpcontrol to find local blood pressure resources, step-by-step self-monitoring videos and more.

Monitoring Your Blood Pressure at Home

Knowing how to correctly check your blood pressure is important, especially if your doctor recommends regular self-monitoring at home.

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• Be still. Don’t smoke, drink caffeine or exercise during the 30 minutes before measuring your blood pressure. Empty your bladder and take at least 5 minutes of quiet rest time before measuring.
• Sit correctly. Sit with your back straight and supported. Keep your feet flat on the floor and your legs uncrossed. Support your arm on a flat surface, such as a table, with your bicep at heart level. Place the bottom of the cuff directly above the bend of your elbow. Never take measurements over sleeves or other clothing.
• Measure at the same time every day. For greatest consistency, take readings at the same time daily, such as a set time in the morning and evening.
• Take multiple readings and record the results. Each time you measure, take 2-3 readings approximately 1 minute apart and record the results to share with your doctor.

This project is supported by cooperative agreements (CPIMP201227 and CPIMP201228) with the Office of Minority Health (OMH) of the U.S. Department of Health and Human Services (HHS), as part of a financial assistance award totaling $14.6 million in partnership with the Health Resources and Services Administration (HRSA). The contents do not necessarily represent the official views of, nor an endorsement by OMH/OASH/HHS or the U.S. Government. For more information, please visit https://www.minorityhealth.hhs.gov/.

 

Photos courtesy of Getty Images

SOURCE:
American Heart Association

Our Lifestyle section on STM Daily News is a hub of inspiration and practical information, offering a range of articles that touch on various aspects of daily life. From tips on family finances to guides for maintaining health and wellness, we strive to empower our readers with knowledge and resources to enhance their lifestyles. Whether you’re seeking outdoor activity ideas, fashion trends, or travel recommendations, our lifestyle section has got you covered. Visit us today at https://stmdailynews.com/category/lifestyle/ and embark on a journey of discovery and self-improvement.