If you work your knees hard every day—laying tile, for example, or plumbing pipes—you probably already feel some pain. All that pressure on your knees may have even taken a toll. And almost all construction jobs involve tripping hazards and the occasional quick footwork, which can easily lead to a twisted knee.
In short, your knees’ complexity allows them to do a lot, but also means a greater chance of injury.
Erica Fritz, DPT OCS, manager of the Orthopedic Physical Therapy Center at the Hospital for Special Surgery in New York, says that although most of her patients have hip or knee injuries, their causes are widespread. “I can have 20 people come in from the construction industry with the same knee issue, but they need 20 separate treatments, because the cause of injury is different for everyone.”
Preventing Knee Injury 101
The first thing to remember, says Fritz, is that too much of one thing is never a good thing, especially for the knees. “Repetitive kneeling and squatting can affect the joint itself.”
She compares the cartilage in the joint to an eraser: if you rub it and rub it, it wears away. This wearing down of the joint can eventually result in knee arthritis.
Repetitive activities can also cause muscle wear and tear. “Whereas a baseball pitcher gets shoulder tendonitis, a construction worker could get hamstring or patellar tendonitis from using other muscles in the same motion over and over again.”
Fritz urges trade workers who squat or spend long periods of time on their knees, such as tile layers and plumbers, to take frequent breaks.
Though it sounds like common sense, Fritz urges trade workers who squat or spend long periods of time on their knees, such as tile layers and plumbers, to take frequent breaks. “Even standing up for 30 seconds every hour before you get back down to the task you’re doing is important.”
The other obvious but essential preventive measure: adaptive equipment like good knee pads. If you hate wearing knee pads or don’t have any at hand, and you’re kneeling all day, Fritz suggests at least grabbing a piece of foam to soften the weight on your knee caps.
Squatting Wrong and Other Pitfalls
“People always talk about lifting from your legs to promote a healthy back,” says Fritz. “But there’s a proper and improper squat form.” She explains that sticking out your rear-end when squatting is better than simply bending your knees, which puts a lot of stress on the patellofemoral (knee cap and shin bone) joint—and can cause Patellofemoral Syndrome.
Correct squatting takes glute and and quad strength, Fritz points out, so it’s important to stay strong and flexible. “If you’re weak, you’re going to find these compensation patterns which aren’t good for your knees.”
Vibrating power tools also take a toll on the knees (not to mention the nerves in the hand). Hence tools such as jackhammers shouldn’t be used all day by the same person.
Vibrating power tools also take a toll on the knees (not to mention the nerves in the hand).
Finally, sudden knee twists can occur all too easily and may lead to traumatic injuries, such as a torn meniscus (the C-shaped cartilage pieces found on each side of your knees) or a tear of the anterior cruciate ligament (ACL), which holds your femur in place behind your thigh bone. Fritz recommends making sure you have sturdy and comfortable footwear and being always alert to tripping hazards.
Got Knee Pain—Now What?
A minor knee injury should typically heal itself in 14 days. In other words, if you feel just a minor ache, common sense says to take some ibuprofen and give it two weeks.
If it still hurts after two weeks, Fritz recommends seeking medical attention. “See your primary care doctor, an orthopedist, or a physical therapist, but definitely seek medical consultation.”
Fritz explains that not everyone will receive the same medical advice, as not everyone with knee pain will have the same diagnosis. “Maybe the muscles around your knee are weak and you need to strengthen them, or maybe you should have an ergonomic consultation to learn how to move better and improve your work space.”
If you hear a loud pop or feel you’ve had a traumatic injury, “go see someone right away.”
On the other hand, if you hear a loud pop or feel you’ve had a traumatic injury, don’t wait 14 days. “Go see someone right away.”
You May Need Surgery
When you have a cumulative trauma disorder (CTD) from repetitive overuse of any muscle or joint, it doesn’t change overnight. “People will go from, ‘I used to have some twinges in my knee, but they would go away’ to ‘Now it’s happening more frequently and doesn’t resolve as quickly’,” says Fritz.
Nip it before it gets to the ‘hurting all the time’ point, she advises. If an injury goes on long enough, permanent anatomical damage may occur (e.g., the loss of all cartilage under the kneecap) that can’t be fixed without surgery.
“Surgery becomes an option when all conservative measures—like physical therapy, acupuncture, pain medication, and cortisone injections—fail,” says Fritz. “But if it’s something traumatic like a massive ACL tear or broken bone, you’re in for surgery.”