Looking After Your Knees

As the years go by we all begin to experience occasional knee pain and discomfort. What sorts of things can happen to your knees and when might knee pain be a cause for concern?

Injuries to your knees and the resulting pain can be worrying, especially if you haven’t any trouble in that area before. A sudden pain in your knee after a jolt or fall is alarming, but the good news is that most of the time, it might not mean you need to see a doctor.

Your knee joint is open to injury and pain simply because all day, while you are standing, it takes the full weight of your body. When you move, especially during exercise or sport of some kind, when you fall or twist or get knocked, your knees bear the brunt of it. All this is made worse when you’re advancing in years. Let’s look at the most frequent causes of knee pain.

Knee Strains

Sudden pain after activity? It probably means you just did more than you are used to, and what you have is a strain. The tissues of your knee have stretched and if you give them time they will stretch right back to where they were.

Simply rest at home and try to not use the knee for a while. Elevate it to keep the blood flow even and be very gentle with it, so no running about or lifting things. To ease the pain, ice it. The pain should subside on its own.

Remember, to treat a strain at home you use the R.I.C.E. method:

  • Rest the knee.
  • Ice the area. (use cooling for first 48 hours and avoid heat)
  • Compress with a wrap or elastic sleeve.
  • Elevate the knee as much as possible.

After 48 hours stop icing your injury and start to apply heat and gentle exercise. If an injury you think is a strain doesn’t get any better after three days, you should probably get it checked by a doctor.


Another kind of knee pain you can probably deal with yourself is inflammation of the tendon or tendonitis. You can inflame your tendons by doing too much strenuous activity without preparation.

Patellar tendonitis (or inflammation of the tendon) is also known as “jumper’s knee”, a common complaint of basketball or volleyball players. You jump repeatedly and land awkwardly time after time, tendonitis may well be the result.

You know you possibly have tendonitis if your knee is swollen, red and warm. You can treat this yourself easily at home. Use the same R.I.C.E. method as above for a strain.

Menisci damage

More serious is damage to the menisci. The menisci are rubbery pads in your knee that cushion the bones, acting like little shock absorbers. The menisci become worn as you age and this is a very common reason for knee pain in middle-age.

But the meniscus can also be torn by twisting the knee. If after twisting your knee painfully you have not only pain and swelling but also a locking of the knee you might have torn the meniscus. A tear like this may go away on its own if you take it easy. In cases where it doesn’t improve at home using the R.I.C.E. method you may need to see a doctor, who might suggest an operation to repair the tear.


If you are a senior and you get frequent attacks of knee pain, it could be osteoarthritis. This is a common type of arthritis that causes damage to the articular cartilage (the protective surface of the knee bone). This creates swelling of the tissues around the joints.

Although osteoarthritis can sometimes occur in younger people, it is rare in the young unless the person is overweight. Young or old, osteoarthritis is a serious matter and needs care. If you suspect the cause of your knee pain may be osteoarthritis you should consult your doctor.

Torn ligaments

Another serious matter is torn ligaments or tendons. Ligaments are bands of tissue that connect the bones at the knee. If you have injured the ligaments or tendons of your knee, you will feel it at the side.

You will probably still feel the pain even when your knee is perfectly still. It hurts to bend the knee or put weight on it. There will be warmth and swelling around the knee and be unstable; your knee keeps giving way, or it bends sideways unexpectedly making you stumble.

This might mean you’ve torn your anterior cruciate ligament. This happens when you suddenly change direction or perhaps do a rapid twisting motion of the leg and knee. It’s easy to do this by accident if you play badminton or tennis; you switch directions suddenly and you hear a pop from your knee. Even if you don’t hear it, you’ll certainly feel it.

If you think you’ve torn a ligament you should definitely go to see your doctor, or an orthopaedic specialist, for further treatment.

When You Should See Your Doctor – Checklist

  • Pain is still severe after three days of treating yourself
  • Can’t put any weight on your knee
  • Have pain even when not moving or standing
  • Knee locks or clicks with pain or keeps giving way
  • Pain, swelling, numbness or tingling of the calf muscle

Look After Your Knees

The best way to make sure your knees are up to the job of your life and leisure is to exercise regularly. Always use support clothing to protect and support your knee joints if you have a prior injury.

Try to commit to a low impact exercise like swimming once or twice a week, just for the health of your tendons, ligaments, cartilage, menisci, muscles and bones. Make your whole body stronger with gentle regular exercise and injuries will be less frequent, recovery quicker and disease and weakness less likely.

Further Reading

Elbow Health

Your elbow is a body joint that is in constant use over your life. How can you protect it from the effects of time and being in use?

Your elbows take a lot of punishment. As a major joint of the body, they are designed to be in use for a lifetime, but even the most efficiently designed joint wears out over time. Add to that the various types of injury and diseases that affect the joints and it’s clear that during your life you have to take steps to protect your elbows.

To start with, your elbows stick out. When you fall you tend to protect your body with them, making them prone to injury. They are also the main pivot point of your arm, taking the strain of all the lifting and manual work you do with your hands. Overuse and injury gradually take their toll.

Elbow Injuries

In young people, elbow injuries are mostly sport or activity related. Falls that involve landing on the hand or the elbow directly result in fractures, usually to the point (or the olecranon process) of the elbow. Landing flat on the extended elbow usually results in dislocation of the joint.

In later life, the potential for fractures increases as your bones become more brittle, and minor injuries resulting from pulling or falling can now have unexpected and serious results. For example in the elderly, a fracture of the point (olecranon) of the elbow can result from a simple pull of the triceps and brachioradialis muscles that flex the arm.

Some of the more common injuries are muscular in nature. Lateral and medial epicondylitis (better known as tennis elbow and golfers elbow) are what is called muscular overload injuries. These can occur after relatively minor trauma to the muscles that extend (tennis) or bend (golfer’s) the elbow.

Elbow Disease

As far as disease goes, the elbow is prey to anything that affects the joints, arthritis being the main culprit. Arthritis is any one of a number of diseases that cause painful inflammation of the joints. For example, osteoarthritis is caused by injury or aging but a related disease, rheumatoid arthritis, is caused by a weakened immune system.

Or perhaps you may suffer from bursitis. This is caused by trauma or overuse of the elbow that damages the bursa, a small fluid filled cushion that sits in the joint. Another painful condition is tendonitis; an inflammation of the tendons, again often caused by overuse or aging but there can be other reasons. As you can see the majority of elbow pain conditions are a product of repetitive use or use over time.


The treatments for elbow pain vary depending on the cause. If there is inflammation to the elbow then you may be taking some kind of anti-inflammatory medication, or perhaps applying it to the skin. You may also need to support your arm while the medication takes effect.

If the problem is temporary or minor it may be as simple as applying an ice pack. But in extreme cases you may have to have physiotherapy, corticosteroid injections into the joint or shock wave therapy to bring any kind of relief. If that doesn’t help then the only answer may be surgery, but these days that’s a last resort.

It’s well known to doctors that helping the body heal itself is the best option, especially with complicated structures like elbow joints. All in all, it’s best to avoid elbow pain in the first place by taking action to prevent it.


If you are a sports person then you will already know it’s a good thing to wear protective clothing while playing. If you have former injuries it’s especially vital that you wear support clothing to prevent a relapse and boost your confidence so you can play in safety.

Your doctor will tell you that to avoid elbow pain you should strengthen and exercise your arms, but also make lifestyle adjustments too. As with all bone and muscle pain prevention, regular, if possible daily, exercise is to be recommended.

Do exercises that strengthen your wrist, arm, shoulder, and back muscles. All areas of your torso are connected and support each other. If the whole system is strong then the joints will be protected and strong too.

Your exercise regime should involve exercises that improve your range of motion, stretching your tendons and preventing stiffness. For strengthening muscles and tendons all over your body, it’s hard to beat yoga as regular exercise. You should however consult your doctor if you already have severe elbow injuries before embarking on a course of yoga.

Exercise and Lifestyle

During your daily exercise, especially if using gym equipment, make sure you are using correct technique to reduce strain. Make sure you are trained in the use of gym machines before you exercise, and also ensure the machines are the right size for you and are adjusted to your height where necessary.

In your daily life, avoid leaning on your elbow for extended periods. It’s easy to get into habits, like leaning your face on your hand and planting your elbow on your desk while looking at a computer screen. These are not good habits to get into. When you notice yourself doing them, adjust your position or take a break.

Similarly, avoid repetitive movements over long periods of time. Change your pace or your angle, or alternate hands when gardening or doing chores. Repetition can cause overuse injuries to the bursa and tendons.

Support clothing

Talk to your doctor about support clothing, like elbow sleeves and slings, both to protect  existing injuries or to prevent new ones. If you include a sport in your regular exercise, use elbow support sleeves and straps to protect and cushion your elbow during strenuous activity.

You must be guided by your doctor as to the use and duration of using such appliances, but used correctly they can speed your recovery and protect you from further injury.

Further Reading

Shoe Therapy

For conditions like diabetes and plantar facilitis, or just plain orthopedic comfort, therapeutic shoes can offer your feet much needed relief.

If you have any foot problems, these two articles are informational, not intended as diagnostic or presenting any cures. If you do have any foot pain, aches or other foot problems you should consult your doctor. After a proper diagnosis you can be sure you are buying the right shoes for you.

Choosing the right shoes, as we said in part 1 of this article, Choosing The Right Work Shoes, is important for everyone’s foot health. It’s also crucial for your overall bodily health. But what if your shoe needs are complicated by a medical condition? If careful choice of shoes is not enough to help with your foot problems, there are also specialist therapeutic shoes. These go further to soothe the symptoms of a variety of common foot health conditions.

From arthritis, diabetes and plantar facilitis (inflammation or injury of the tissue of the sole) to more general mechanical problems like back pain, adapted shoes can help and even heal. In this second part we look at the ways that specially adapted shoes can assist with existing foot problems or even prevent them from developing.


In the United States we currently have an estimated 25 million diabetes sufferers, consisting of 18.8 million diagnosed cases and an estimated 7 million undiagnosed. Diabetes disrupts the circulatory system affecting the extremities; this includes the eyes, the limbs and of course the feet. Problems with circulation are made much worse if you have ill fitting or unsupportive shoes. A tight shoe will compress the foot. An unsupportive shoe will bend the foot in uncomfortable directions.

The enlarged toe box at the front of diabetic shoes give the toes room to move, but the rest of the shoe fits normally. This is much better for you than buying bigger shoes than your normal size. The steel shank underneath the shoe stiffens the area between the heel and the arch making it impossible to bend in an uncomfortable direction. The insole can be exchanged for a doctor prescribed orthotic appliance (shaped supportive insert), distributing the weight and supporting the foot for better blood flow.

Plantar Facilitis

Over two million Americans suffer from plantar facilitis every year. The plantar fascia is a fibrous, tendon-like plane that runs the length of the bottom of the foot. With excessive activity the plantar fascia can become irritated, inflamed and even in extreme cases tear. Shoe selection for sufferers is very important and old and worn shoes can cause the injury.

The worst are stiff-soled shoes that stretch the sole or worn shoes that allow the foot to “pronate” or slant inwards pressing the arch to the floor. Specialist shoes that guard against pronation by supporting the arch protect against damage. They also help support an already damaged sole.


Arthritis is not a single disease, but a patient may suffer from one or more of over 100 diseases

that affect the bones, muscles and joints. So arthritis describes inflammation of a bone joint resulting from any number of different causes. Pain and swelling in the joints of hands and feet results in limited movement and mobility.

Specialist footwear can help to promote an active life and foot comfort. The arthritic foot is sensitive and swollen and painful joints require extra room to move. Shoes must be made of soft leather materials and have no rough edges inside. Arthritic feet have no real padding, the fatty pads that most people take for granted in their feet to cushion the bones are absent.

Shoes that help with arthritis have extra cushioning in key areas and shock absorbing insoles. They also have room inside to accommodate doctor prescribed orthotics or lifts. Also bearing in mind that arthritis affects the fingers as well as the feet, arthritis shoes also have easy to grip and operate fastenings.


Bunions can form on any part of the foot, but occur most commonly at the big toe joint. They are made when friction creates inflammation, resulting in excess fluid. If the pressure continues the fluid area hardens and you get rigidity of the bones, which is very painful. The pressure on the big toe often forces it into an inward facing position, and that’s a bunion. Once again badly fitting shoes cause bunions and high heels are the main culprits. Again, specialist shoes with enlarged toe boxes that reduce cramping and allow toes to move about make them more comfortable for bunion sufferers.

Adequate toe room is important, but as with other types of specialist shoe, it’s important that the rest of the shoe fits. You have to keep the heel snug in the shoe so the shoe stays on. Also as with arthritis shoes, the material must be soft and seamless inside to protect the protruding bones from additional harm and discomfort.

Back and Leg


Badly fitting shoes can give you back problems, but you can also get shoes which help with back strain. As with the other types of shoe for medical purposes, back pain reduction is all about posture. Specialist orthotic inserts in your shoes can modify your posture, reducing posture flaws like pronation (knees coming together and feet tilting inwards) and reduce your pain.

Further Reading

Your Happy Feet Part 1: Choosing The Right Work Shoes

The Right Work Shoes

Wearing the right shoes for work is not just a question of fashion or age appropriateness. It’s also a matter of taking care of your feet, posture and leg health. But what are the right shoes for your job? We’ve got five tips for helping you choose the right footwear.

We all take great care with choosing our shoes, and it’s natural to choose shoes we like the look of. But there is another side to this choice – comfort and health. Be honest – how often do you consider the former and not the latter? Shoe choice is important, and not for reasons which might be immediately obvious. Your shoes have an impact on your health like no other piece of clothing you wear every day, so it’s essential you choose the right shoes, especially for work.

Naturally your perfect shoe depends to a large extent on the kind of work you do, whether you are mostly standing or sitting, for how long and in what kind of environment. Obviously if you have officially sanctioned footwear that you must wear by law, such as metal capped shoes for toe protection in construction or workshop environments, then this choice is to a large extent taken out of your hands. But what if you do have a choice? What shoes are right for your work?

Stand up for Health

Standing for long periods can be injurious to your health over time, for your feet themselves, the ankles, the calves and knees and the hips that balance on top of your legs. The veins and arteries running through your legs are also affected by your stance. Your shoes affect your posture and this can also have a pronounced effect on your neck and shoulders resulting in pain and discomfort.

Once you stop and think about it, it’s immediately obvious that shoe choice is an important decision. Most of this will seem common sense, but how many of us put much thought into the health consequences of inappropriate footwear?

Here’s our quick guide to choosing shoes that will serve you well.

1. It’s All In The Heel

High heeled shoes look fabulous, but high heels present the foot at an attractive but stressful angle. The angle of the foot translates to stress in the ankle and calf, putting everything else under strain all the way up the leg. Wearing heels all day can cause long-term damage. If you need a heel for whatever reason, looking dressy or taller, perhaps a compromise of a short heel would be better? Heels should have a broad base rather than a point, as that will reduce strain by limiting the side to side motion of the ankle.

2. Best Fit

Above all your shoes must fit. It’s tempting, especially if you are intoxicated by the allure of a certain glossy pump, but you should always strike a balance between good looking and good for you. Shoes must fit perfectly, and they must support your foot for the punishment it takes in a day.

Choose shoes that support the arch of your foot and make sure the fit is correct, and take the advice of your shoe store to make sure this is correct. Nothing is more stressful for the muscles and bones of your feet than a having to keep your foot tense all day to keep a shoe on.

3. Get Sole

In studies with NYC police the benefits of insoles – rubber inserts that cushion the sole while standing and walking – became very clear. Adding insoles led to an immediate and significant reduction in foot conditions and soreness. Insoles basically turn any normal shoe into a training shoe. You can also get insoles that support the arch of the foot for extra comfort and strain relief.

4. Sturdier Is Healthier

The question of shoe weight is also crucial. The reason hikers and walkers have solid shoes when they walk over rough terrain all day is that a heavier shoe supports the foot. It prevents it from muscle strain and injury from the constant impacts on the ground at varying angles. These shoes also tend to lace up high providing additional ankle support. Even if your work doesn’t involve trekking across variable terrain, a sturdier, better quality shoe is healthier for your feet than a light flimsy one.

5. Socks Matter Too

And of course, we also recommend that to support your long-term leg health you invest in support socks or stockings, especially if you are standing up in your shoes all day. Calf muscles and leg veins need support throughout your working life to prevent the formation of varicose veins and deep vein thrombosis. Therapeutic shoes can also be a boon, but we’ll talk about that in the next part of this article.

We hope you have enjoyed this walk through the world of good work shoes. Join us in part 2, later this week, for some tips about specially made therapeutic shoes and how they can help you stand up to your busy life