Weak in the Knees
Women are up to six times more likely than men to suffer from knee problems.

By Jeanette Moninger

It’s easy to take your knees for granted–that is until every step makes you wince with pain. Years of running, stooping and kneeling can really take a toll on your joints, but women have it especially bad: Knee pain sends millions of us to a doctor every year, and studies show we are the weaker-kneed sex with women up to six times more likely than men to suffer from knee problems. Still, achy knees needn’t keep you sidelined. No matter what your knee problem, we’ll help you pinpoint the cause–and we’ve got ways to fix your bad knees for good.

RUNNER’S KNEE
The Symptoms: Your knees pop, grind, and ache while climbing up and down stairs or after prolonged periods of sitting.

The Cause: Though it’s commonly called “runner’s knee,” patellofemoral syndrome—the most common cause of chronic knee pain—afflicts even couch potatoes. The creaking, popping sensation you feel is a result of a misaligned kneecap grating over the lower end of your thigh bone. Women are particularly susceptible to this syndrome because our naturally wide pelvises cause our thighs to slant inward thereby pulling our knees inward, too (this is known as the quadriceps or “Q” angle). “This knock-kneed posture places extra pressure on a woman’s knees,” says Kathy Weber, M.D., director of women’s sports medicine at Rush University Medical Center in Chicago.

The Fix: Cut back on some of your high-impact workouts that likely trigger the pain such as running and tennis (but don’t stop altogether or the muscles that surround and support your knees will weaken). And add in knee-friendly activities such as swimming and yoga. Also be sure to regularly replace your workout shoes after 300 miles or when your shoes’ soles are worn so your arches and joints are adequately cushioned and supported.

TENDINITIS
The Symptoms: During physical activity, you feel a sharp pain between your knee cap and shin bone. Afterwards, the pain persists as a constant, dull ache.

The Cause: Tendinitis, which occurs when the tendons connecting your kneecap to the shinbone become inflamed due to repeated stress and overuse. Symptoms often flare up when you suddenly increase the frequency or intensity of your workouts or longer periods of standing up. Your odds of developing tendinitis also increase with age as muscles and tendons lose their elasticity over time.

The Fix: To ease pain and reduce swelling, take a nonsteroidal anti-inflammatory medication (NSAIDs) like ibuprofen, and ice, rest, and elevate your throbbing knee (do this especially following a workout). Patellar tendon straps, available in drugstores, also help to relieve pain by taking pressure off the tendon. If the pain worsens or persists after three days, see your doctor. She’ll likely refer you to a physical therapist who can show you the best exercises to stretch and strengthen the area.

WATER ON THE KNEE
The Symptoms: Your knee is swollen and puffy, and you have trouble straightening or bending it. It also gets stiff and hurts worse in the mornings or when the weather changes.

The Cause: Water on the knee (it’s actually excess joint fluid that accumulates in and around the knee joint) is typically caused by osteoarthritis, the most common form of arthritis. “As the cartilage that cushions your joints breaks down (due to use, age, or excess weight), your body produces more joint fluid,” says Kamala Littleton, M.D., director of the Orthopedic Program for Women at Mercy Medical Center in Baltimore. When the cartilage wears down completely, you’re left with bone rubbing on bone and painfully arthritic, swollen joints.

The Fix: Extra pounds place extra pressure on your knees, but a weight loss of 11 pounds can reduce knee pain due to arthritis by 50 percent, according to a study published in the journal Arthritis & Rheumatism. In addition, taking NSAIDs, resting and using ice compresses can alleviate pain and swelling—but if your knee becomes red or feels warm to the touch, see your doctor. She’ll likely drain the excess joint fluid with a needle and inject cortisone, a synthetic steroid, into the joint to alleviate pain and inflammation. About 25 percent of people with osteoarthritis need knee replacement surgery.

LIGAMENT INJURY
The Symptoms: After feeling (and sometimes hearing) a “pop,” your knee gives out from under you and starts to swell. The pain is intense. The injury usually occurs as the result of a hard knee twist, a sudden stop or change in direction, or an improper landing after a jump while playing a stop-and-go sport such as tennis or basketball.

The Cause: The anterior cruciate ligament (ACL), an elastic band of tissue that stabilizes the knee and keeps it from dislocating, tears. Once again, a woman’s “Q” angle comes into play. “A man’s kneecap moves straight up and down, but a woman’s pulls slightly to the side due to her wider pelvis,” says Tamara Martin, M.D., an orthopedic surgeon at Brigham and Women’s Hospital in Boston. As a result, the quadriceps (the large muscles in the front of your thighs) pull harder on the knee ligaments when we run, twist and jump. High estrogen levels (particularly from the middle to latter part of the menstrual cycle) also play a factor by loosening ligaments and weakening their ability to protect joints.

The Fix: See your doctor immediately. About a third of those who injure their ACL regain strength and motion after six to eight weeks of rest and physical therapy; the remainder need arthroscopic surgery. Because strong leg muscles–namely quadriceps and hamstrings (the muscles in the back of your thighs)–help stabilize and support your knees while also absorbing some of the pressure exerted on them, you can decrease your odds of incurring an ACL injury by strengthening them with lunges and squats.

Jeannette Moninger in magazines including Parents magazine, Redbook, Prevention and Women’s Health.