Monday, November 30, 2009

The Rider's Knee

The Riders Knee
I’ve just gotten around to reading my latest Equus magazine and found a very interesting article by Dr. James Warson. Dr. Warson is a retired neurosurgeon who is the leading authority on equine-related spinal injuries and author of The Rider’s Pain Free Back. His article this month in Equus addresses rider’s knee problems.  I’m sure a lot of you receive this magazine but if you don’t I thought I might relate what Dr.Warson had to say;
Your knees are designed to move in one direction only, front to back. It is not meant to move side to side or rotate. When we ride, we compress this straight structure against the apex of a round surface, the horse’s barrel. This creates a side-to-side stress on the joint it was not meant to endure. Over the years, this pressure causes the medial collateral ligament to tighten and the lateral ligament to weaken and stretch.  Disruption of either ligament shifts the tibia in the opposite direction, so lateral-ligament weakness results in deviation of the tibia inward (medially) to produce a bowed leg. Once the knee starts to bow, the stresses on the joint accelerate. When standing and walking the body presses down on the knee unevenly, with more weight borne on the medial surface of the tibia. The resulting compression of the medial meniscus  causes inflammation in the joint and degradation of the cartilage that can eventually lead to osteoarthritis. Add hook like arthritic bone spurs, and the result is likely a future knee replacement.
I actually didn’t realize these facts and always thought my bad knees were due to jumping courses and dismounting from a 17’2 hand horse for years.  Now that I know better and do not intend to get another knee replacement, I’ll follow the recommendations Dr. Warson makes below:
  1. Control inflammation. In addition to providing some pain relief, over-the-counter nonsteroidal anti-inflammatory drugs(NSAIDs) can help reduce inflammation in the knee and slow the progress of any arthritic changes. Consult your doctor before starting anti-inflammatory medication.
  2. Support joint health. Supplements that contain glucosamine, chondroitin and /or MSM are worth trying, although results are variable. (I take these supplements and they seem to help me).
  3. Watch your weight.  Carrying extra pounds adds to the pressure placed on your knees when you stand and walk. (My doctor actually told me that you relieve 3 pounds of pressure on your knees when you lose just one pound).
  4. Wear knee braces. These can minimize the sideways pressure on your knees as you ride and provide some relief from discomfort. Braces with solid or semisolid sides are useful when more support and stability are required. Your doctor or orthopedic specialist can help you in making the best selection for your situation. (I haven’t found a knee brace I actually like yet but I do know that the pull on elastic ones absolutely don’t work).
  5. Use wedge stirrup pads.  Because they position the foot so that the outside is slightly higher than the inside, wedge stirrup pads will tension the medial collateral ligament, which takes pressure off the medial meniscus and relieves stretching forces on the lateral collateral ligament. ( I’m going to try this and I’ll let you know how it feels. In the meantime, I still like the Herm Springer flex stirrups I am using).
I hope this post was helpful to everyone with older or arthritic knees.  Even if you’re younger it’s a good idea to take care of your knees now before it’s too late. I wish I had known about this earlier on so I could have taken better care of my knees. Do I sound like your mother, sorry about that. I actually am reminded of my grandmother, who had terrible arthritis, warning me “you’re going to get arthritis walking around barefoot in the cold weather” Ah, well the invincibility of youthful ignorance. Sorry Grandma, I should have listened!
Until next time
Quote for Today
In my opinion, a horse is the animal to have. 1100 pounds of raw muscle, power, grace, and sweat between your legs - it's something you just can't get from a pet hamster.
    - Anonymous


  1. Onebusymama3May 02, 2012

    Great article. I went horseback riding yesterday and my right knee was killing me, like it was being torqued. The lead lowered my stirrups and the pain lessened significantly. Your article is the most helpful explanation to me for what was happening. Thank you!

  2. Thanks for this. I am 7 weeks out from a total knee replacement and am finally admitting it was not a mistake. I haven't ridden yet, but am starting to think about it! I have read everything I can find and the tip you gave about stirrups and stirrup length is very apt. I have also read about some brands of stirrups which ease the torque by providing a swivel. I have not yet found them on any retail sites. I am still in PT and have talked at length about strengthening the knee and getting a little MORE FIT before riding. The exercise bike is my friend, as is icing. We have been working to modify a Pilates work out to accommodate my stiff, but recovering knee. At 55 I am finding that I can't depend on my body the way I used to. I have always been in the horse industry but found that in doing horses for everyone else, my own riding took the far back seat. This knee replacement has been a good thing by helping me focus and prioritize and by giving me time to think.

    1. Hi,
      Glad you got your replacement and that it's working out for you. It takes time to heal and get back in shape. Sounds like you're doing very well. I did another post on different stirrups that I use now if you're interested in it. These stirrups are a big help to me. Check it out:
      It's always good to have options. Good luck with your rehab!

  3. Hello I recently ran into your article on Google on a whim about rider's knees. I been having problems with my leg position on my right leg added to the fact I have to crack it a lot so I feel comfortable. I been riding for 11 years now and I wanted to research the effects riders get on there knee. Thanks to your article I am able to understand whats up. Since I am just 21 should I still consider getting a brace? Thanks

    1. Hi,

      Glad you found my research helpful. I feel it's up to you to do what you think you need to feel comfortable whie riding. I'm not a medical professional and so don't feel comfortable giving advice. You should contact your doctor for advice and answers to any medical questions you might have.

  4. Thank you so much! Walking upstairs has been hurting lately, and I havent been able to participate in class HPE. The only time it hasn't been hurting is riding, I don't even notice when we're doing x country. I'm 13 years old. This shouldn't be happening yet!! Well, now I know, and my mum is organising a physio appointment, and I'm gonna get a knee brace. Thanks again :)


It's so nice of you to take the time to visit. I appreciate your stopping by and commenting on what I've written. Even though I sometimes don't have the time to reply to each comment, I do enjoy reading them.