Knee problems are among the most common Health Issues experienced by middle aged men.
Especially if you've had an active youth...
The most common causes of knee pain in middle aged men...
Worn or injured Cartilage
Cartilage becomes brittle due to a lower water content as you get older so it's more likely to tear
Ligaments and tendons
Also become less flexible and stretchy, and liable to tear.
Particularly the tendon that holds your kneecap in place
Weaker thigh muscles
Can cause your kneecap to be pulled unequally as your knee flexes
A fold in the membrane that surrounds the knee gets caught under your kneecap, and eventually forms painful scar tissue
Is a cyst at the back of the knee and is usually caused by
Is a swelling of the fluid filled sack around the joint.
Can also be a cause of severe knee pain
All of these can lead to our old friend
Knee Arthritis is the number one most common cause of knee pain in middle aged men
Old injuries can return to haunt you
Post traumatic Arthritis often develops after an injury. Similar to Osteoarthritis It can occur years after injuries are thought to have healed.
All this in a joint that flexes and bears weight every moment we are on our feet.
I never fail to be amazed when I think about the stresses our knees take on a daily basis. Think about the pressure on the bearing surfaces, the strain on the ligaments. Times that by the years you have had your knees.
Its hardly a surprising that we develop knee problems is it?
Basic Knee Anatomy
If you have look at these two diagrams' you'll have a good idea of how your knee works
Firstly you'll see that the balled end of the femur sits in the dished top of the Tibea
(ya thigh bone connected to ya Shin Bone)
In between sits two discs of Cartilage Called Meniscus The one on the inside Is called the Medial Meniscus and the one on the outside is called the lateral meniscus.
These Cartilage disks act like shock absorbing bearings which allow the smooth ball-like ends of the humerus to slide smoothly when you bend your knee
The two bones are connected directly by the two Cruciate Ligaments in the middle. One in front of the other
The front one is called the anterior Cruciate and the back one the Posterior Cruciate
These are elastic and stretch as you flex your knee.
Down each side are the Collateral Ligaments.
The one on the inside again, is called the medial, and the one on the outside is your lateral.
These stabilize your knee against side to side movement
Your Kneecap or Patella is a disc shaped bone enclosed in the tendons of your thigh, which attach to the top of your shin.
When you straighten your leg your thigh muscles pull on this tendon which then pulls your shin straight.
As your leg straightens your patella slides in the groove of your femur and acts like another bearing surface.
This fantastic piece of engineering works beautifully all the time its components are in good shape.
But it doesn't take much for it to start going wrong.
If, for instance the meniscus wear out, or crack and break up, the bone ends will start rubbing together, the smooth surfaces will start to break up and you will have
If the muscles of your thigh which control your patella, don't pull equally, or become weak. It can wear through and become rough and arthritic.
Strain, or weakness to ligaments, will result in your knee joint becoming unstable, which will increase wear.
Common symptoms of Knee problems in middle aged men
Grinding Knees Grinding and crunching as you move your knees is quite common and usually nothing to worry about'But if it's accompanied by pain in the joint then it could be worn meniscus. If the pain feels like it's under your kneecap then its probably patella problems.
Popping sounds Are quite common again if you've got no pain then don't worry but when these sounds are associated with pain. It's more serious. A pop or snap is often felt when a ligament is damaged.
Giving way or Instability of the knee Is another sign of ligament damage
Locking or catching Is often felt in your knee when you've got a tear in the meniscus cartilage. A small flap can lift up and get caught in the joint. You will often feel like you need to straighten and 'click' your leg
Diagnosing Knee Problems
Your doctor will probably start by asking you questions on your knee symptoms, and lifestyle. Depending on the answers you give. He/She will probably be able to make a provisional Diagnosis of your knee problem.
But further tests will probably be needed like;
X-rays which will show up major bone problems like Arthritis CT scans and MRI scans will show up damage or abnormalities to your softer tissues, like cartilage, tendons, and ligaments.
Treatments for Knee Problems
Soft tissue problems especially knee injuries are usually treated at first by a procedure known by the acronym R.I.C.E. Which stands for
For two or three days then slowly re-introduce movement to prevent loss of strength and mobility.
Applying a cold compress or ice-bag (or even a bag of frozen peas) will reduce swelling
By bandaging the knee also helps to reduce swelling
keeping your knee elevated above the level of your heart reduces the pressure of the blood in the knee, which helps soft tissues to repair
Non-Steroidal anti inflammatory drugs are also used to keep swelling down
Physical Therapy (Physiotherapy) Is very important, once the healing process is underway, to ensure any strength loss in the muscles is properly regained. This is very important to us in our middle ages because we are already suffering from muscle loss, and it takes longer to rebuild.
For more serious knee problems There is of course the surgical solution...
Nowadays most Knee problems can be repaired surgically, mainly by Arthroscopy, often known as Keyhole Surgery.
Involves making two or more small incisions. One is used to insert a fiber optic camera, the other is used for the various instruments Fluid is pumped into the joint to inflate the space so the surgeon can see. Recovery from knee Arthroscopy is usually pretty rapid, with most people being up and active within a couple of weeks.
In the worst cases of damage to the knee joint itself. The components can be replaced by man made parts. Depending on the extent of the damage these can be either partial knee replacement or total knee replacement.
Partial Knee Replacement
Known as Unicompartmental replacement procedures. If only one side of your knee is damaged the surgeons can remove the damaged part and relace it.Partial Knee Replacement, is much less serious than a full knee replacement.
Its done with minimal invasive procedures, and it generally leaves quite a small scar. The recovery time is not much more than an Arthroscopy.
With partial knee replacement, you tend to keep your 'natural' knee movement, because you retain your Cruciate ligaments Present figures suggest that with care they have a life expectancy in excess of ten years. and, because bone removal is minimal they can be replaced if necessary. Making them suitable for younger patients
Full knee replacement This is a very serious operation. In total knee replacement the whole knee joint is removed...
Your kneecap is pulled over to one side. The damaged ends of your thigh and shinbone are cut away. The new Knee joint which usually comes in three components a flat piece goes over your Tibia, and a rounded component is fitted to the end of your femur. These are carefully lined up and fitted, using a chemical cement. A plastic spacer is inserted between the two metal components to act as replacement cartilage.. The wound is then closed
Because the components used in total knee replacement surgery are at present expected to have a life exceeding fifteen years, and replacement while not impossible, is very difficult, due to the amount of bone loss. Surgeons prefer to restrict total knee replacement to older patients.
The good news is... There is a new generation of Knee joints coming on stream, which require much less bone loss. Making replacement a much less serious business, They also have replaceable bearings which extend the life of the joint.
Whether you have mild or acute knee problems you need to look after your knees during middle age so as to preserve them into old age. You need to...
Build and maintain strong muscles to support your knees.
Avoid activities which inflict shock or major deceleration on them.
You also need to watch the weight. The more weight the more stress (simple)
Have a look through the pages on Exercise and Losing Weight on this site, to help form a strategy to cope with your knee problems.
Be kind to your knees
Even if you don't have knee problems now you dont know what's over the horizon
As medical science and technology advance, it gets harder to keep on top of the latest developments. So, we've set up an automatic news update system for you that will regularly update with the latest information.