Knee health: how to prevent knee injuries

How to prevent knee injury

Throughout our lives, our knees are subject to wear and tear. What we can do is help prevent knee injury through positive lifestyle habits. If damage does occur, early physiotherapy can aid a speedy recovery.

Healthy lifestyle choices will greatly reduce the chance of joint, cartilage or ligament damage. This includes keeping to a healthy weight and exercising regularly to keep muscles strong and joints mobile.

If you do experience knee injury, physiotherapy and the right exercises will aid your recovery. They will also often make the problem less likely to reoccur, become worse, or require surgery later. While usually successful, surgery is a major undertaking.

Hila Glick, vice president for physiotherapy at Onestep, says: "The best way to take care of your knees is to keep active, to strengthen the muscles around the knees and the entire body, as well as to work on muscle flexibility and length."

Leg strength exercises

The knee is one of the largest joints in your body, connecting your upper and lower leg bones and enabling a wide range of movements and manoeuvres. The strength of these bones and of the muscles that surround them provides crucial knee support, helping to reduce the stress and weight placed on them.

Maintaining leg muscle strength throughout your life is important. Strength training exercises can improve bone density by up to 3%¹ and slow down the rate of bone and muscle loss associated with ageing.

Stretching and flexibility training

By stretching regularly, you can help prevent knee injury by keeping your supporting muscles long and flexible. This will increase the range of motion (ROM) in your knees², protect against the tightness in the surrounding muscles, and improve your balance - reducing your chance of falls and injuries.

Low-impact cardio exercises

As well as helping to build muscle, cardiovascular exercise, or cardio, keeps the circulation around your knees constant: "The ligaments around your knees don’t get as much blood flow as other parts of the body," Wills explains. "It's important to engage in activities that keep flushing oxygen and nutrients through to these spaces."

This helps to keep knee cartilage healthy and may prevent atrophy, the deterioration of protective muscle and nerve tissue. While this is true of both high-impact and low-impact activities, low-impact cardio also limits the knee-jarring impact of your feet forcefully hitting the ground. For this reason, activities such as cycling and swimming are particularly effective at maintaining knee health.

Maintaining a healthy weight

Major weight gain can add significant stress to your knees," Wills warns. "Where possible, try to keep to a regular weight through exercise and healthy eating."

The higher your body weight, the more force is exerted on your joints. Being overweight also increases your risk of injury and conditions affecting the joints, like osteoarthritis³ and gout.

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What are the most common types of knee injuries?

"There are numerous types of knee injuries. The type of injury depends on the area that was injured, the severity, and a person’s physical background," explains Glick.

Some of the most common injuries include

• Tears in the ligaments, tendons and cartilage.

• Kneecap fractures.

• Kneecap dislocations.

If you're experiencing persistent knee pain that's limiting your mobility, a physiotherapist can help diagnose the issue and create a tailored treatment plan.

How do you recover from a knee injury?

Recovering from a knee injury will typically involve exercises to improve strength and flexibility - delivered in a way that protects against further damage. In many cases, physiotherapy exercises can restore range of motion and help to prevent the need for knee surgery.

How to avoid making a knee injury worse

If you want to make sure you don't make your knee injury worse, Glick advises the following:

1. Don't ignore knee pain and continue with your existing routine.

2. Do stay active - movement helps prevent your joints from stiffening up, gets your blood flowing and may ensure that no further damage is done to other body parts due to compensation.

The rise of online physiotherapy

Depending on your knee injury, physiotherapy may help you to recover, delay or avoid knee surgery, prepare your body for a procedure, or recover post-operation. However, knee injuries are often debilitating and could make visiting a physiotherapist physically awkward and uncomfortable.

You may prefer to use an online physiotherapy platform from the comfort of your home. They may offer you more flexibility and convenience.

Glick says: "Once you have the list of exercises and you feel comfortable performing them, you can then practise several times a day according to your schedule and routine."

Can you avoid knee surgery?

While knee problems and knee injury can occur at any age, the vast majority of people requiring knee replacement surgery - the main type of knee operation - are aged 50 years and above, and around half are over 70 years. Age is a common risk factor because over the course of your life your knees are subject to deterioration from wear and tear.

Looking after your knees is important at all ages, as placing them under excessive stress or incurring injuries can add to cumulative wear and tear in later life. As you get older your risk of developing conditions that affect your joints also increases. For example, osteoarthritis - the degeneration and inflammation of joint cartilage and surrounding bone tissue - is the most common cause of knee surgery.

Wills advises: "It's natural to be concerned about the potential of knee surgery, but it's also important to put this into perspective and remember that genetics do play a big part."

This is not to say that knee surgery may be inevitable. Healthy lifestyle habits can help protect against excessive damage.

What does it mean if you do need knee surgery?

If your knee becomes too worn, damaged or injured to the point that physiotherapy alone is unable to rehabilitate it, then knee surgery can significantly improve your quality of life. It's one of the most common elective orthopaedic procedures, contributing to around 160,000 total knee and hip replacements taking place in England and Wales every year.

Glick advises: "It's important to note that while there are ways to help prevent knee surgery, in some cases surgery is the right thing to do. I believe that this should be a mutual decision, made by both the patient and the surgeon."

While knee surgery can cure your knee pain and give you a better range of motion, like all operations it carries risks and considerations. These risks can include infection and complications such as deep vein thrombosis like any surgery⁴.

These days, knee replacements usually provide benefits for decades. Dr Sarah Jarvis, GP and TV doctor, says: "When I first became a GP 31 years ago, we had to counsel patients that they might need further surgery after a decade or so.

"That was a major consideration because the revision of knee replacement surgery carries a higher risk of complications than the original procedure. Today, by contrast, I can reassure my patients that more than 4 in 5 total knee replacements and 7 in 10 unicondylar knee replacements - where only a portion of the knee is resurfaced with plastic and metal components - last for 25 years⁵."

Just as physiotherapy can help you recover from knee injuries, it can make a huge difference to your outcomes following surgery. Expert physiotherapy input, and doing recommended exercises regularly, can speed recovery, get you back to normal, and help protect your new knee for years to come.

Further reading

1. Westcott: Resistance training is medicine: effects of strength training on health.

2. Page: Current concepts in muscle stretching for exercise and rehabilitation.

3. Bliddal et al: Osteoarthritis, obesity and weight loss: evidence, hypotheses and horizons - a scoping review.

4. Bawa et al: Trends in deep vein thrombosis prophylaxis and deep vein thrombosis rates after total hip and knee arthroplasty.

5. Evans et al: How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up.