Kneed to Know

February 10, 2021

With the gradually lengthening days and spring just starting to ease into view, most of us will have a desire to achieve new fitness goals for 2021. Leading Yorkshire consultant knee surgeon Mr Owen Wall explores how you can make this happen safely.

The most recent lockdown restrictions, which have seen further closure of gyms and outdoor fitness clubs have once again turned people’s attention towards running and cycling. Running had already gained popularity over the summer, while the UK also saw the biggest rise in new bicycle purchases since 2014. As the weather improves through the spring, many will once again don their trainers and dust down their bikes to enjoy the great outdoors. If you are keen to either start or restart these activities, what are the best things to do in order to protect your knee health and prevent injuries?

Hit the Ground Running

A new pair of running shoes enables both young and old to easily consider the “couch to 5k” as an achievable goal. However, running can often be associated with knee problems. Those who already have advanced ‘wear and tear’ changes within their joints will have been advised not to run by their GP or specialist surgeon, and this advice holds true. For those of us with good joints however, running can increase the ability of the cartilage surfaces to withstand increasing loads and therefore become less susceptible to sustaining long term damage.

So, how does one maximise the benefits of running while avoiding injury? Most ‘injuries’ suffered by runners are in fact overuse injuries and relate to the tendons which connect the various muscles to the bones of the knee joint. For example, Runners Knee is inflammation of the thick band of stabilising tissue on the outside of the knee joint, the symptoms can be near the knee or also commonly near the outside of the hip. This and patella tendon inflammation are the two most common problems suffered by runners. There are less common problems that may also affect the internal structures of the joint – but these are rare.

To minimise the occurrence of these problems, ensure you always do the following:

Ensure you have a good pair of well-cushioned running shoes, fitted by an expert, who has studied your gait pattern.
Stretch and warm up prior to your run.
If you are a novice, always start slowly and build gradually - no more than 10% gain in intensity or distance per workout.
Stretch and cool down after your activity.
Maintain good muscle strength and balance to the core, hip and knee.
Try not to use a new pair of trainers for a big event, ensuring you break them in beforehand.
If you develop niggles around the knee, rest your running for a week to see if they resolve.
Should you develop problems with your knee joints, seek help from an expert.

In the Saddle

Cycling in the UK has witnessed a steady rise in popularity since Le Grand Depart and the next two stages of the Tour de France were hosted by Yorkshire in 2014. It is a great way of keeping healthy and active and also seeing the countryside. In Yorkshire we are blessed with having some of the best countryside, quiet roads and challenging terrain (if you choose to look for it) for cyclists in the UK.

Cycling is an easy sport to start – a roadworthy bike, a helmet and some hi-visibility clothing is enough to get pedalling. One of the big advantages of this particular exercise is that it affords protection for the knees and hips and this thankfully means that internal joint injuries are rare. However, even experienced cyclists can develop injuries. Most of these relate to overuse issues and effect the tendons which attach the muscles around the knee to the thigh and shin bone. There are occasionally issues within the knee joint too such as an exacerbation of wear and tear to the knee articular cartilage surfaces, which may cause swelling and pain. Obviously, if a cyclist were to experience such problems, they should rest and ice the joint, apply compression and seek expert opinion if the symptoms persist.

To minimise the likelihood of developing such issues, it’s important to remember the following:

Make sure your bike is roadworthy, has working brakes, correct tyre pressures and smoothly working gears.
If you are new to cycling, make sure your seat height is set correctly. Too low and your knees may suffer, too high and your hips and ankles will suffer.
If you are starting out (or restarting following a break), try not to overdo your distance – aim to ride steadily for 30 to 45 mins and build from there.
If you are using clip-in pedals, ensure these have been set correctly and allow your foot to attain its natural angle in the pedal.
Practice exiting clip-in pedals smoothly to avoid falls at traffic lights or junctions.
If you develop soreness, swelling or stiffness in the tendons or muscles around the knee or within the knee itself, take some time off to recover.
If these symptoms persist, seek expert help

Hopefully, as spring becomes summer, those of you who have chosen running and cycling as a way to keep active and healthy into 2021 will find that your efforts are rewarded with a new-found wellbeing that continues for the rest of this year.

If you do find that you are having persistent issues with your knees, make sure you seek help and guidance from an expert who can diagnose, treat and help you return to an active lifestyle as quickly as possible.

Call Owen’s secretary, Elaine, on 0113 3882009 or email elaine.ingham@nuffieldhealthcare.com to arrange a consultation at Nuffield Hospital Leeds or Spire Hospital Leeds or fill out our contact form using the button below.

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March 11, 2025

Skiing is an exhilarating sport that demands agility, strength, and endurance. However, for those suffering from Jumper's Knee, also known as patellar tendinopathy, skiing can present unique challenges. This condition, characterised by pain and inflammation in the patellar tendon, often affects athletes who engage in repetitive jumping and high-impact activities. If not managed properly, Jumper's Knee can hinder performance and lead to long-term issues. Here’s how skiers can effectively deal with Jumper’s Knee while hitting the slopes. Understanding Jumper’s Knee Jumper’s Knee occurs due to overuse and repetitive stress on the patellar tendon, which connects the kneecap to the shinbone. This stress can cause micro tears, leading to pain, swelling, and reduced mobility. Skiing, with its constant knee flexion, sudden jumps, and landings, can exacerbate this condition, making it crucial to take preventive and management measures. Prevention Strategies Strength Training – Building strong quadriceps, hamstrings, and glutes can help reduce the strain on the patellar tendon. Exercises like squats, leg presses, and step-ups can provide support to the knee. Proper Warm-up and Stretching – Before hitting the slopes, engage in dynamic stretching and warm-up exercises such as leg swings, lunges, and knee bends to increase blood flow and flexibility. Using Proper Ski Gear – Investing in well-fitted ski boots and knee braces can provide additional support and reduce strain on the knees. Maintaining Good Technique – Avoid excessive strain on the knees by keeping a proper skiing posture, with knees slightly bent and body weight evenly distributed. Gradual Progression – If you are recovering from Jumper’s Knee, gradually increase your skiing intensity rather than jumping into aggressive slopes immediately. If the pain persists despite taking preventive measures and modifying your skiing routine, seek support from a professional and stop skiing. Persistent or severe pain might indicate a more serious injury requiring advanced treatments such as physical therapy, injections, or, in rare cases, surgery. Skiing with Jumper’s Knee is possible with proper management and precautions. By strengthening the surrounding muscles, using the right equipment, and listening to your body, you can continue to enjoy the slopes while minimising discomfort and preventing further injury. While skiing with jumper's knee is possible under the right conditions, it's still not generally recommended and seeking support for knee pain is always the preferred route. If symptoms persist, professional medical advice is essential to ensure a safe and enjoyable skiing experience. We are available for knee consultations if you feel you need to address your knee pain or concerns. It may be that a simple lifestyle change will make all the difference but you can't know if you keep it hidden. The longer the pain goes unchecked, the more serious it can become.