Knee Pain: Caught in the Middle!

Last week Dr. Oz and I discussed joint pain. The aching, tightness, popping, and swelling that can make everyday activities a chore. Your knees are often your most aching joint. This is because they are literally caught in the middle of the leg and not only experience their own pain, but can be painful because of referred injury from the feet and hips. 

There are many reasons for your joints to ache, including weakness, injury, excess body weight, but many people have joint pain because of cartilage damage.  When people are diagnosed with arthritis this means their cartilage is damaged.

Cartilage is normally the glistening…smoother than ice…biomechanical wonder….that lines the ends of our bones….until it starts to break down. Technically, the definition of cartilage wear is osteoarthritis…yes, I said the awful word. For most of you this cartilage break down is most problematic in the knees and hips.

Aging cartilage and damage is a big problem in the general population just trying to get moving, but can be especially vexing for the master athletes and weekend warrior who neither have the time or inclination to be slowed down by the pain or swelling that often accompanies cartilage that is “running out.”

Over the next several weeks I am going to talk to you, as I do everyday with my patients, about cartilage care and your options for remaining active even with aching knees.

These cartilage care blogs are going to cover the following topics: 

Do it yourself cartilage care.Help from a friend…your doctor.Surgical interventions for cartilage gone bad:MicrofractureCartilage transplantationNatural and synthetic plugsJoint replacement

Do-It-Yourself Cartilage Care

Caring for your knees and hips begins at home. The following is a short list of treatments you can try on your own.



In the morning or prior to exercise when you are trying to loosen your tight joints heat is a good fix. A slow steady application is the best way to get your circulation going, relax your tight joints and get ready for activity. There are a variety of ways to accomplish this including heating pads, hot water bottles and thermal wraps. In general I prefer the thermal wraps.  Several companies make these but the concept is the constant application of approximately 104 degrees of heat over time.  Some of these wraps last up to 12 hours and are perfect for getting on the go (versus a heating pad that leaves you plugged into the wall). Although they may feel warm and definitely smell funny, the heating gels that you rub into your skin do not reach deep enough to increase the circulation around your joint.


After activity, at the end of a long day or anytime your joints ache, ice is an excellent remedy.  Not only does this simple solution calm the inflammatory process going on in your knees, but it confuses the pain pathways and decreases pain. A minimum of 20-30 minutes is necessary.  Apply the ice pack or simply a bag with ice onto a thin towel over your joint.  Our skin gets thinner with age and this will prevent damage.

NSAIDS, non-steroidal anti-inflammatories

Now I know most of you will say that you are not “pill people” but this class of drugs does not simply mask the pain – it actually treats the source. Before you take these suggestion you should make sure with your doctor that this class of drugs is all right for you. This is especially key if you have stomach problems. In general, these medications are taken several times a day and take several days to build up a therapeutic level in your blood.

Do resistance training!

The key to healthy knees are strong quads and the key to healthy hips are strong cores and buttocks. If you are a typical masters athlete…or at least like the many I see each day in my practice…you do your sport and little cross training or resistance work.  All…yes ALL…my patients with cartilage wear are sent to the gym to lift with their quads, cores and butts. This will improve your game and keep your joints healthy. Just a note…if your knees hurt…especially in the front…NEVER…do another knee extension. This loads your knee cap 10 times whatever the weight is you are lifting.

Active Rest

If you have pounded out an intense workout and your joints are sore…rest them. This does not mean sitting on the couch for several days. Instead get on a bike and spin, row, use the elliptical, workout your upper body alone one day. Rest is great…when it is active.

Next time:  A little help from your friend…your doctor