Knee care tips for Kiwis: How to keep your knees healthy

Knee problems

Your knees are essential for mobility and everyday function, and are two of the most vulnerable joints in the body. They’re susceptible to several common problems caused by overuse, age-related wear and tear, and injuries. Here are a few of them: 

• Sprains and strains: Pulled or torn ligaments, tendons, and muscles, often due to overuse, sudden movements, hyperextension, or direct impact. These injuries can involve any of the ligaments in the knee joint: the posterior cruciate ligament (PCL), anterior cruciate ligament (ACL), lateral collateral ligament (LCL), and medial collateral ligament (MCL). 
• Cartilage injuries: Damage to the cartilage cushioning the knee, usually from sudden twisting, impact, overuse, or degeneration. This includes damage to the articular or meniscus cartilage (meniscus tears). 
• Knee tendon injuries: Partial or complete tear of the patellar or quadriceps tendons, caused by overuse or repetitive stress on the knee, sudden force, a fall, an awkward landing after a jump, or medical issues that result in tendon weakness or damage.
• Osteoarthritis: A common type of arthritis that causes joint pain and stiffness. It primarily affects older people, but younger individuals may be impacted, too. Infections, being overweight, and joint injury can also contribute to the development of osteoarthritis.
• Rheumatoid arthritis: A long-term autoimmune condition that causes joint pain, swelling, stiffness, and damage.
• Fractures and dislocations: Usually due to high-impact trauma, such as falls, car accidents, or sports collisions.

Risk factors

While anyone can experience knee problems, certain factors can increase your risk. 

• Being overweight: Excess body weight places added stress on the knee joints, accelerating wear and tear over time.
• Age: Our natural ageing process leads to the gradual degeneration of cartilage and weakened joint health.
• Sedentary lifestyle: Lack of regular physical activity results in weaker and tighter muscles and potential weight gain; both increase stress on your knees and your risk of injuries.
• High-impact activities: Some sports and jobs involve repetitive movements that are hard on the knees, especially without proper conditioning.
• Prior knee injury: Previous injuries may increase your risk of experiencing new knee injuries or conditions.

Doing your best to avoid injury and consulting a healthcare professional for prompt diagnosis and treatment of knee pain can help prevent further damage and get you back on your feet faster.

How to look after your knees

If you’re looking to keep your knees in good shape or are trying to cope with discomfort, here are some helpful strategies you can take on board: 

Maintain a healthy weight

Every extra kilogram of body weight adds pressure on your knees as well as other parts of your body, accelerating cartilage wear and joint degeneration. Fat cells also promote inflammation, contributing to the development or worsening of arthritis. By maintaining a healthy weight, you reduce this added stress and your risk of developing joint issues.

Stay active

Physical activity strengthens muscles around your joints, improves balance and flexibility, reduces injuries, and helps you maintain a healthy weight. Consider exercises and stretches that strengthen your upper leg muscles and lower body. Ageing individuals can also consider low-impact activities, like walking, swimming, yoga, and tai chi.

Be sure to check with a physical therapist or medical professional before engaging in these activities, especially if you’re experiencing knee pain due to medical conditions or injuries.

Wear supportive footwear

Shoes with proper arch support and adequate cushioning promote better posture, foot alignment, and weight distribution, reducing strain on the knees.

Prevent knee injury

Various activities can damage your knees, such as high-impact sports and work or daily tasks requiring heavy lifting or kneeling. Lower your risk of injury by:

• using correct techniques when lifting, running, or jumping to avoid unnecessary strain
• avoiding frequent kneeling. Tip: Use pads to cushion your knees
• using protective gear, like knee braces or supports (as recommended by a health professional), if you play contact sports or have a past injury. These can help stabilise your knee and reduce the risk of re-injury
• doing proper warm-ups before physical activity to prepare your muscles and joints
• avoiding overexertion and getting enough rest between repetitive tasks and intensive physical activities.

Eat a healthy diet

Choose foods that can help reduce inflammation and support bone and joint health. For instance, a Mediterranean diet, rich in vegetables, fruits, wholegrains, nuts and seeds, legumes, and olive oil, can lower the risk of knee osteoarthritis. To strengthen your bones, add foods rich in calcium and vitamin D, such as salmon, dairy, and fortified foods. 

At the same time, avoid foods that can worsen inflammation, such as those high in sugar, trans and saturated fats, and refined carbohydrates.  

Avoid prolonged sitting

Staying seated for hours on end can cause stiffness and pain in the knees. Incorporate regular movements throughout your day. If you need to sit for extended periods, try to walk or stretch every 20-60 minutes.

Knee care after injury

Even the most careful Kiwis can experience knee injuries from time to time. Regardless of whether it’s a sprain, strain, or a more serious tear, timely and appropriate care right after an injury is essential for effective healing and to avoid long-term issues. Here are some important steps to follow after a knee injury:

Apply RICE (Rest, Ice, Compression, Elevation) 

This first-aid approach is highly effective for managing swelling and alleviating pain associated with minor injuries. 

• Rest: Allow the injured area to recover by minimising movement and avoiding any activities that may place additional strain on the injury. 
• Ice: Applying ice wrapped in cloth or a cold pack to the injured area helps to minimise inflammation and pain. The cold constricts blood vessels, which reduces blood flow to the site of the injury, decreasing swelling and also numbing the area to relieve pain. To avoid skin and tissue damage, avoid putting ice directly on the skin and use cold therapy for no more than 20 minutes at a time. 
• Compression: Using a compression bandage around the injured area provides stability and support. Compression also helps limit swelling and reduce pain. 
• Elevation: Keep the injured area elevated above heart level. Elevation helps reduce pain and swelling. 

Pain management 

Over-the-counter pain medication, like paracetamol or ibuprofen, can help manage discomfort and inflammation. Be sure to consult a medical professional, especially if you need to take these medications regularly. They can advise you on the correct dose and monitor potential side effects.

Consult a health professional

Early diagnosis and treatment are essential for a proper recovery. Depending on your injury or condition, you may need to see a GP or a specialist. You can also consult an allied health professional, such as a physiotherapist, who can create a personalised rehabilitation plan for you to regain strength, flexibility, and range of motion in your knee.

When to see a health professional 

While some knee injuries can be managed with simple home care, it's essential to listen to your body and know when to seek medical attention. Consult a health professional if you experience any of the following symptoms:

• Severe pain or swelling: Especially if the pain is unrelenting or worsens with time
• Deformity: If your knee appears visibly deformed or out of alignment
• Inability to bear weight: If you can't put any weight on your injured leg or walk without significant difficulty
• Numbness or tingling: Loss of feeling or tingling sensations in your leg or foot can indicate nerve damage, acute injury, arthritis, or other conditions
• Locking or catching: If your knee seems to lock in place or catch during movement
• A popping or snapping sound: This could signal a ligament or tendon tear.

Treatment for knee issues 

Knee problems limit your mobility and can be frustrating. However, there are several treatment options to help manage pain, improve function, and restore your active lifestyle.

Non-surgical treatments

These are often the first line of defence for knee issues.

• Braces: Knee braces provide support and help treat a range of knee issues, from mild to severe injuries to degenerative conditions like osteoarthritis.
• Injections: Medications can be injected to reduce inflammation and pain in the knee joint.
• Physical therapy: Physical therapy can be customised depending on the patient’s needs. It can help strengthen muscles around the knees, relieve pain, enhance flexibility, range of motion, and overall knee function, and help prevent future injuries.

Surgical options

In some cases, surgery may be necessary to repair or replace damaged structures in the knee, especially if you’re experiencing severe pain and mobility issues, and other treatment options aren’t effective. 

• Partial or total knee replacement surgery (knee arthroplasty): This surgery involves replacing damaged portions of the knee joint with artificial implants made of metal and plastic. 
• Arthroscopic surgery: A minimally invasive technique that uses a small camera to diagnose and treat knee problems.
• Osteotomy: This surgery involves cutting bone from either the tibia or femur and realigning it to relieve pressure on a specific part of the knee joint. It is often used if arthritic conditions have damaged only one side of the knee.

When insurance can help

Cost of private treatments

The cost of knee treatments can vary significantly depending on the procedure, facility, and surgeon's fees. In New Zealand, surgeries like private knee replacements typically cost around $25,000 to $33,300. 

Challenges in public healthcare

While publicly funded knee replacement surgeries are available to eligible patients, some are forced to go private due to long wait times for first specialist assessments and treatment. 

Other patients struggle to get on the waitlist, with their referrals for an appointment being declined even if their condition is severely affecting their work and quality of life. This forces them to endure chronic pain, rely on painkillers with potential side effects, or self-fund their private healthcare costs.

ACC limitations and other insurance solutions

ACC is not an option for all knee cases. While ACC covers knee injuries caused by accidents, it does not cover knee problems related to ageing or illnesses. For situations like these, comprehensive health insurance can be invaluable, covering hospital, surgical, specialist, and other costs. 

Other types of insurance can also be beneficial, especially if a knee injury or condition leaves you partially or totally disabled and unable to work. 

For those unable to work due to severe knee conditions, income protection or mortgage insurance can provide monthly benefits, replacing a portion of your lost income. This helps you meet daily expenses, so you can focus on healing without financial stress. 

In cases where knee conditions result in permanent disability, disablement insurance provides a lump sum payment. This financial support can be used for long-term care, home modifications, and living costs.

Note: If your knee pain is due to a pre-existing health condition, there may be restrictions or exclusions on what your insurer can cover. By investing in the right insurance policies before you develop serious health conditions, you create a financial safety net that safeguards you and your family from unforeseen hardships. A reliable insurance broker, like Policywise, can help by looking at various options and personalising cover to suit your needs.

RECOMMENDED READINGS

Health cover for those with pre-existing conditions

Cost of private surgery in NZ

Long waiting lists in NZ's public health system: Causes and impacts on patients

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