If you are over 40, you probably know the feeling or the sound - that crunching popping noise you hear when you bend your knees.

The knees can be a focal point for injury and by middle age show signs of simple wear and tear . It's important to keep your knees healthy.

Without them, it's tough to get around or keep your cardiovascular system strong and healthy. Although knee injuries can be painful and temporarily disabling, they are nearly always fixable.

Here's a brief explanation of some common knee ailments and the standard treatment.

Bursitis is an inflammation of the protective fluid-filled sacs or bursae around the knee. It can be caused by a blow to the knee, repetitive kneeling or other movement, or carrying excess weight. The best treatment is rest, ice, compression with an elastic bandage and over-the-counter anti-inflammatory drugs, such aspirin, ibuprofen, or naproxen. Bursitis is usually not very serious; however, the swelling and redness could mean a more serious infection in the knee. A doctor can check for infection by draining the knee.

Tendonitis: Tendons connect muscle to bone. They are tough cords of tissue that can become inflamed when you overwork muscles. If you are physically active, you can get knee tendonitis. But it's more common in athletes who do a lot of jumping.

Knee tendonitis causes pain during faster movements such as running and jumping but not as much with leisurely walking. Prompt treatment with rest, ice and over-the-counter anti-inflammatory drugs helps with the pain.


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To prevent recurrence, I often recommend physical therapy to strengthen and stretch the muscles and tendons.

Ligament Injuries: Ligaments attach bone to bone. They can be stretched or torn by a sudden twisting motion or direct impact. Strains and partial tears of a ligament usually respond to rest, physical therapy, and protective knee braces. More severe tears usually require surgery followed by physical therapy, particularly if the person wants to resume sports.

Cartilage Injuries: The knee has two pieces of crucial, shock-absorbing cartilage called "menisci." They are crescent-shaped and lie one on each side, sandwiched between the thigh and shin bones.

They stabilize the knee, spread out weight, and keep the bones from rubbing together. This cartilage can tear in sports or everyday activities that twist or rotate the knee.

Minor tears can be treated with rest and physical therapy. More serious tears often need surgery to remove damaged tissue and preserve as much cartilage as possible.

Arthritis: Age plus wear and tear make cartilage soften, deteriorate and develop cracks and holes. This is osteoarthritis. Mild arthritis can be treated with anti-inflammatory medication or injections. Severe arthritis can lead to significant pain and disability and the need for a knee replacement.

Human knees are built to last no matter how much you work them. But use them with good sense.

Stretch and warm up before and after exercise.

Vary your activities and avoid a sudden change in intensity or duration.

Wear shoes that fit well and are in good condition.

Keep your weight down. Every pound of body weight is like four pounds on your knees.

And treat little injuries early before they become big problems.

The kinder you are to your knees, the kinder they'll be to you.

Matt Nofziger, MD, is a board-certified orthopedic surgeon with SVMC Orthopaedics. Join Dr. Nofziger for a talk on knee and shoulder injuries on Oct. 18 at the Inn at Willow Pond in Manchester. Call 802-447-5190 to reserve your seat. To learn more about SVMC, visit www.svhealthcare.org. "Health Matters" is a weekly column meant to educate readers about their personal health, public matters and public policy as it affects health care.