Knee health for women: a guide through every stage of life

Why women's knees deserve their own guide

Most knee problems affect men and women alike, and a torn meniscus or a twisted ligament is treated on the same principles whoever the patient is. But a woman's knee often meets different pressures at different times of life. Hip and pelvis shape, ligament flexibility, muscle strength, hormones, pregnancy and the bone changes that follow menopause all play a part.

In Qatar, more girls and women now play football, padel, basketball and netball, train at the gym and run, often indoors or late in the evening to avoid the heat. That is good for long-term health, and it also means knee injuries in women are seen more often than they once were. Knowing which problems are common at each stage helps you prevent some of them and recognise others early.

ACL injuries in female athletes

Research consistently shows that girls and women who play pivoting and jumping sports tear the anterior cruciate ligament (ACL) more often than men in the same sports. The reasons are combined rather than single: landing with the knee drifting inwards, relatively weaker hip and hamstring muscles compared with the quadriceps, greater joint flexibility, and differences in the shape of the knee.

The encouraging part is that the way you move can be trained. Structured warm-up programmes that teach landing with the knee over the toes, controlled cutting, and hip and hamstring strength reduce the risk of ACL injury in many players. A typical tear happens without contact, on landing or changing direction, often with a pop, swelling within a few hours and a knee that feels loose afterwards. That pattern should be examined rather than treated as a simple sprain.

Kneecap pain and flexible joints

Pain around or behind the kneecap is one of the most common knee complaints in teenage girls and young women. It is usually worse on stairs, in deep squats, after kneeling or after sitting for a long time with the knee bent. In most cases the structure of the knee is healthy and the pain reflects load and muscle control rather than damage.

Physiotherapy focused on hip and thigh strength, sensible changes to training volume, and time usually settle it. Women with very flexible joints are also more prone to the kneecap slipping out of its groove. A kneecap that has dislocated, even once, deserves an examination, because the risk of it happening again depends on the shape of the knee and the tissues that hold the kneecap in place.

Pregnancy and the months after birth

Weight gain, a shifting centre of gravity, fluid retention and looser ligaments can all make knees ache during pregnancy, especially on stairs and when rising from the floor. Many of these aches ease in the months after birth as strength returns. Check with your obstetrician before taking any painkiller, because some common anti-inflammatory tablets are usually avoided in pregnancy, and ask which exercise suits your stage of pregnancy. Seek prompt medical attention for a swollen, painful calf, or for a knee that becomes hot, red and swollen. A separate guide on knee pain in pregnancy covers this stage in more detail.

Menopause, bone health and arthritis

After menopause, falling oestrogen speeds up bone loss and many women lose muscle strength more quickly. Knee osteoarthritis is more common in women than in men, and it often becomes noticeable from the fifties onwards as stiffness in the morning, pain on stairs and swelling after a long day.

Osteoporosis itself does not cause knee pain, but it matters for the knee in two ways. It raises the risk of fractures around the knee after a fall, and it is taken into account when planning surgery such as a knee replacement. Things that help both bones and joints include:

• Regular strength training two or three times a week.
• Walking, cycling or swimming for general fitness.
• Keeping body weight in a healthy range.
• Asking your family doctor whether a bone density scan, vitamin D or calcium check suits you.
• Treating knee pain early so that it does not stop you exercising.

Your consultation at Aman Hospital

A knee consultation usually involves talking through your symptoms, examining both knees standing and lying down, and reviewing any X-rays or MRI scans. You will normally be asked to expose the knee, so loose trousers or a skirt that can be raised make the examination easier and more comfortable.

If you would feel more comfortable with a female chaperone present, or have other preferences about the examination, you can ask the clinic when you book on +974 4400 4400 or by WhatsApp. You are also welcome to bring a family member. Aman Hospital is on Airport Street in the Old Airport area of Doha.