Joint Resolution: You Kneed to Read This

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Perhaps the only thing more annoying than being sidelined from exercise because of knee complications is to have such problems even though you don't exercise. Unfortunately, both scenarios are common. Knee ailments are among the top ten leading causes of visits to the doctor's office, affecting millions of adults -- a number that seems to be growing fast.

"As the population ages and people become more active, the amount of knee problems we see is increasing," says Dr. Jason Koh, assistant professor of orthopedic surgery at Chicago's Northwestern University Feinberg School of Medicine. Doctors saw more than 14.2 million knee complaints in 2004, nearly double the number from a decade earlier, according to the National Center for Health Statistics, part of the U.S. Centers for Disease Control and Prevention. It's not just ueberathletes and dare-devils who are suffering: Knee problems can also strike sedentary people and those who prefer a regime of, shall we say, exercise lite.

"The most common knee pain is really insidious in onset," says Dr. Susan Joy, director of women's sports health at the Cleveland Clinic, in Cleveland, Ohio. "It can be from repetitive use or increasing activity. It's not necessarily from a twist or turn or fall."

So, why is the knee, the largest joint in the body, prone to aches and pain, and what can you do about it? Imagine your knees as fulcrums, or levers, that support your upper body and absorb shock when you walk, jump, or run. "There's a tremendous amount of force pressing down on your knees when you move," says Koh. "Considering we take about one to two million steps a year, that's a lot of cumulative impact."

Our nation's collective obesity epidemic doesn't help. That's because the strain of everyday activity such as going up and down stairs puts as much as two to three times your body weight on your knees. "Even losing 10 pounds can make a significant difference," says Joy.

Repetitive stress can tear or tighten tendons and ligaments that connect muscle and bone to the kneecap and wear away the soft cartilage that cushions the bone.

The good news, says Koh, is that most knee problems are treatable without surgery. If you have persistent knee pain, the RICE rule applies: Rest your knee, apply ice and compression to reduce swelling, and keep the knees elevated. Over-the-counter ibuprofen and aspirin can reduce swelling and pain, while research shows that glucosamine and chondroitin supplements -- widely touted for their ability to ease pain and rebuild cartilage -- may have some therapeutic effects. Most importantly, leg-strengthening activities such as squats, knee presses, yoga, and Pilates will help stabilize the knee.

"If the muscles that support the joint are stronger, there'll be less stress going through the joint," explains Joy.

To prevent knee injuries, Koh suggests increasing physical activity gradually, stretching before exercising (no bouncing -- it pulls on muscles instead of stretching them), and keeping the muscles around the knees strong.

If your knee pain doesn't go away in a week or two, it's probably time to visit your doctor, Joy says. You'll most likely be referred to physical therapy, although your physician may prescribe orthotics to correct an abnormal gait or cortisone shots to reduce inflammation. In some cases, arthroscopic surgery, a minimally invasive proce-dure that repairs torn cartilage, tendons, and ligaments, may be required.

Only with a proper diagnosis, says Joy, can you be sure of getting the right treatment.