Knee pain

subject: Article from Arkansas Democrat-Gazette Active Style Section 2014 02 10

Halting knee pain centers on source By GRETCHEN REYNOLDS THE NEW YORK TIMES Q: How do I prevent my knees from hurting when I descend stairs? A: If it's any comfort, you have company. But before you can correct a problem, you must find out what's behind it. There are various possible causes. A doctor can help you sort through them. Pain when one walks down stairs is common among people with arthritis, but it does not necessarily mean someone has arthritis. Knee pain also can be caused by chronically weak or temporarily very tired thigh muscles that fail to keep the kneecap moving in the track it is designed to follow. Strengthen the muscles and such pain goes away. Knee pain can also be caused by irritation or stiffness in the illiotibial band, a tough band of fibrous tissue that runs from muscles at the top of the outer thigh to the side of the knee. Most people with knee arthritis - meaning some degeneration of the cushioning cartilage in the joint - experience pain when they go down stairs, even if their arthritis is mild, says Dr. Kevin J. Bozic, an orthopedic surgeon at the University of California at San Francisco. More so than climbing stairs, descending places great force on the knee and, in particular, the patello-femoral joint, the portion of the knee beneath the kneecap, he said. This discomfort is magnified if you have weak quadriceps or thigh muscles, he said, since the force that might otherwise be absorbed by those large muscles moves through the knee instead. To strengthen your quadriceps, try straight leg raises, Bozic said. Lie on your back with one leg bent. Lift the other leg, straightened, at least six inches off the ground; tighten the thigh muscles and hold for a few seconds. Lower and repeat several times. Then do the same exercise with the other leg. Your physician or an athletic trainer can suggest other safe exercises that target those muscles. Avoid prolonged sitting, too, said Dr. Freddie H. Fu, a professor and chairman of orthopedic surgery at the University of Pittsburgh Schools of the Health Sciences, since uninterrupted sitting leads to stiffness that aggravates the pain of going down stairs. And if all else fails, turn around, Bozic said. Descending stairs backwards reduces loads across the knee joint, he said. According to a 2010 motion-capture study, the forces generated when descending backward migrated toward the hip rather than the knee. Just don't fall down, Bozic said.