Exercise and “Water on the Knee”

Knee in PainHi Chris,

I’m a youthful, energetic senior – 66 years of age. I certainly enjoy your articles and responses. I love to jog, walk and am an avid gardener. Lately, however, I have developed “water on the knee”. It sure is curtailing the above activities. My doctor has advised “wrapping it”, applying ice, and I take anti-inflammatories when it is really bothering me. X-rays were done and no arthritis is present. I realize positions and activities which place pressure on the knee joint should be avoided. I cannot recall any trauma to the knee-maybe the repetitious “up and down” motion involved in gardening is the culprit.

Can you suggest some activities or exercises that may be helpful with this problem ? My doctor tells me there is no quick fix and no doubt she is right. Come spring, would love to be able to continue with my gardening hobby. Can you offer some feedback on this problem? Thanks in advance.

Bev in Nova Scotia

Hello Bev

Sorry to hear about your “water on the knee”. It’s good that no arthritis is present as that can often be the case. “Water on the knee” is a phrase applied to a whole host of conditions which cause fluid build-up and inflammation around the knee joint. As a term, it is only descriptive and does not tell you the cause, much like saying you have “dermatitis” or “inflammation of the skin”. The question then is what caused the condition? The answer to the question will not only help you treat it but will also help you know what to do to avoid it in the future. Your doctor has given you good advice about wrapping and icing the joint. You may also try elevating it when there is new inflammation present. Following the RICE principle (Rest, Ice, Compression, and Elevation) will help reduce inflammation.

As to the cause of the condition, you may have torn one of the menisci in the knee or damaged a ligament. Also there can be inflammation of the busa (bursitis) which can also cause fluid to build up around the knee. Since you don’t recall having injured the knee, it may be more of a “wear and tear” problem, perhaps from gardening or quite possibly jogging. Does jogging irritate your knees at this point? The pounding of the foot onto the pavement, especially if you do not have supportive footwear or have weak ankles, can cause a ripple effect up through the shin and into the knee. It’s something you might want to think about. It may be time to give the jogging a break and try something with lower impact such as using an elliptical trainer or recumbent bike. Another good aerobic exercise which is very forgiving on the joints is aqua-fit.

I suggest that you consider visiting a sports medicine clinic. Your insurance may cover this if you have a referral from your family doctor. Either way, it’s good to keep your doctor informed. A sports medicine clinic will have practitioners such as physiotherapists who may be able to help you determine what has caused the condition and more importantly what you can do to avoid a recurrence. They will be able to prescribe specific exercises you can do that involve stretching to increase mobility about the joint and resistance exercises which will increase the muscular strength supporting the joint, for example the thigh and calf muscles. It is important to progress slowly. Employing light resistance with bands or tubing is a good idea but a good sports medicine clinic should be able to prescribe a set of exercises you can follow.

Your doctor may suggest having the knee drained or other surgeries, which can bring relief. The main thing is that if you choose to have the area drained of the fluid, get to the root of the problem so that you won’t just get a recurrence afterwards. Where there is inflammation, there is protection from stress and strain. You will want to find the source of that stress and strain, try to eliminate it or mitigate it, and develop a strategy to support your joint for the future.

Talk to your doctor again or see a physiotherapist and tell him or her that you want to continue being active but want to find out how to treat the area effectively and keep it from coming back.

Good luck and let me know how you’re progressing.

Chris


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