1. Ignoring knee pain.
An occasional ache here and there is common. “But knowing when you can and can’t ignore pain is key,” says sports medicine specialist Jordan Metzl, MD, from the Hospital for Special Surgery in New York City.
Metzl’s rule of thumb: When the pain limits your ability to do what you normally do, you need to have it checked out.
“If your body is sending you signals, you need to listen to them. If they persist, you need to have it checked out,” he tells WebMD.
For Piplica, exploratory surgery revealed a torn meniscus she had endured in the past — unbeknownst to her — followed by the more recent ACL tear.
“In hindsight, maybe that first injury could have been repaired earlier, although I don’t know if I could have avoided this one altogether,” she says. “At least I would have been more careful.”
2. Being overweight.
Every pound of body weight yields five pounds of force on the knee, so even 10 extra pounds can put a considerable load on those joints.
Being overweight also increases your chances of osteoarthritis in the knee, a common and often disabling form of arthritis that wears away the knee’s cushiony cartilage. Excess pounds also cause existing arthritis to worsen more rapidly. According to the CDC, two out of three obese adults suffer from knee osteoarthritis at some time in their life.
Although diet and exercise are critical for weight loss, it’s a double-edged sword.
“If your knees hurt, it’s harder to lose weight through exercise,” says Metzl. So he recommends activities that go easy on the knee.
For example, opt for a stationary bike over running on the treadmill, and walk on a flat surface instead of hilly turf. If you’re a die-hard treadmill fan, then go for longer sessions of walking punched with brief intervals of brisk walking or running every three to five minutes, DiNubile says.
3. Not following through with rehab and rest.
The rest and rehabilitation period after a knee injury is critical to avoiding future pain or reinjury. Depending on the type of damage and treatment, recovery could last anywhere from a couple of weeks to several months.
“During the rehab period, you need someone to help you tell the difference between something that just hurts, and something that’s going to do you harm,” says DiNubile.
He tells WebMD that many of his young athlete patients are too eager to return to regular play as soon as they stop limping. He advises patients to work with an orthopedic surgeon, a sports medicine physician, a physical therapist, an athletic trainer, or some combination of these pros, in order to ensure proper focus is placed on gradually strengthening the knees.
4. Neglecting your ACL.
One of the most commonly injured ligaments in the knee, the anterior cruciate ligament (ACL) is responsible for about 150,000 injuries in the U.S. every year.
As Piplica learned firsthand, sports like roller derby that involve quick cuts, twists, and jumping, put the ACL at higher risk for rupturing. More traditional high-risk sports include soccer, basketball, football, and volleyball.
Women in particular have a two- to eight-times higher risk for ACL tears compared to men, mainly because the way women naturally jump, land, and turn puts greater strain on the ACL.
However, male and female athletes alike can be trained to “rewire” themselves and thus lower risks of knee injury. That’s done through neuromuscular training, which involves supervised practice in improving agility, leg strength, and jump-landing techniques for better knee joint stability.
These specialized techniques are effective in reducing risks of knee injury by almost one-half, according to a 2010 review of seven neuromuscular training studies.
“Given what we know in how useful it can be in reducing ACL tears, it’s irresponsible of coaches and parents to not require athletes to undergo neuromuscular training,” says DiNubile.
He recommends that athletes of any age who play ACL risk-prone sports should seek help from an athletic trainer or other trained professional to help avoid this debilitating injury.
5. Overdoing it.
“You make gains in fitness when you work hard and then allow your body to recover. You can’t do a hard workout every day,” Metzl says.
A sudden increase in intensity or duration of exercise can cause overuse injuries from repetitive strain. Tendonitis and kneecap pain are common symptoms in the knee.
Pushing too hard is also related to overtraining syndrome, a physiological and psychological condition among athletes in which they exceed their ability to perform and recover from physical exertion, often leading to injury or lowered performance.
Be sure to include stretching exercises before and after working out. And follow hard training days with easy ones so your body can recover.
6. Overlooking other muscles around the knees.
Weak muscles and lack of flexibility are primary causes of knee injuries, according to the Mayo Clinic. When the muscles around the kneecap, hip, and pelvis are strong, it keeps the knee stable and balanced, providing support by absorbing some of the stress exerted on the joint.
DiNubile stresses the importance of building the quadriceps and hamstring muscles, as well as proper strengthening of the body’s core muscles, including the obliques, lower back muscles, and upper thigh.
His favorite tool to help accomplish this strengthening is a Swiss medicine ball. Other exercises to try are knee extensions, hamstring curls, leg presses, and flexibility exercises.
Piplica recalls realizing just how weak some of her leg muscles were.
“Roller girls are striding out so much with their outer leg muscles, but we aren’t necessarily working our inner knees,” she says. “I remember when I would run for exercise, my calves and shins would hurt so bad. That surprised me, because I thought if anything was strong, it was my legs.”