Knee health might be something that only crosses a person’s mind after the pain sets in, but there are a number of ways to prevent and minimize injuries to the knee for athletes and non-athletes alike.

The place to start is with prevention, according to Dr. Thomas Muzzonigro, an orthopedic surgeon specializing in knees and hips. Muzzonigro works with the Butler Health System and at Tri-Rivers Musculoskeletal Centers.

For younger people who enjoy working out, Muzzonigro suggests a combination of exercises to reduce the impact on the knee joint.

While running will not cause arthritis on its own, running too often or too heavily can worsen existing pain, he said.

“What I typically recommend is a combination of walking and jogging combined with a real or stationary bicycle and then get in the pool,” he said. “If you like to run, maybe run two or three days a week and then bicycle or swim the other days so your body can heal.”

For those who are starting a new exercise program or trying to get in shape, most orthopedic doctors believe people should start slowly: running on Monday, resting Tuesday and running again Wednesday, Muzzonigro said.

“There are some people who feel that running too much can cause damage to the joints, and I think that’s true. It’s a comment on doing everything in moderation and listening to your own body,” he said.

Stretching before and after every exercise, including running, is also important, but there’s a new focus that many people forget: strengthen the muscles.

Muzzonigro said, especially for runners, strengthening the muscles of the core, the butt, glutes and hamstrings can minimize any possible harm to the knee joints.

“Usually, you will have the best effect on your joint health and overall health (with stronger muscles),” he said. “(Those muscles) are dynamic stabilizers of the knee.

“Strengthen the core and the muscles associated with running, and you can minimize any negative impact of those activities.”

High impact activities, especially with jumping, can cause stress on the knees, Muzzonigro said. That includes skiing and sports like soccer or basketball, he said.

When a knee injury does happen, the most common problems are mild sprains, what Muzzonigro described as gentle stretching of the muscles and ligaments. For the average sprain, an individual should follow the RICE technique: rest, ice, compression and elevation, Muzzonigro said.

A common injury that can be more serious than a sprain is a medial meniscus tear, a semicircular band of cartilage that acts as the “shock absorber” for the knee, according to Muzzonigro.

“As you get older, the shock pad in your knee can wear out and it doesn’t have good arteries or veins so it can’t heal itself,” he said. While strengthening the knee can prevent it, “There’s very little you do about degenerative tear because that’s like early arthritis.”

Meniscus tears are typically treated with a shot of cortisone, a hormone that works to calm the inflammation of the knee. Physical therapy also will help strengthen the knee, according to Muzzonigro.

Another possible serious injury is much more common in athletes than the average person: an injury of the anterior cruciate ligament, or the ACL.

The ACL essentially stabilizes the knee from the front to the back, Muzzonigro said, and it can be injured when a person jumps and lands unusually on the leg, typically if there is a pivot.

For that reason, athletes who do a lot of jumping, like basketball players, are often taught by sports therapists and trainers how to land jumps properly to prevent injury, Muzzonigro said.

One of the first steps to address many injuries is physical therapy, Muzzonigro said.

“I’m a huge fan for therapy across a lot of the injuries,” he said. “What I like to do is instruct you. In the beginning, (it’s) good to teach proper technique.”

On the nonathlete side of the population, knee replacements can sometimes be an option for a person with significant knee pain, Muzzonigro said, but every patient is evaluated on a case-by-case basis.

Usually, a knee replacement can be an option for somebody with bone-on-bone arthritis, meaning the cartilage in the joint has worn out and the bones are rubbing on each other, Muzzonigro said.

The first steps to address that would also be cortisone shots and some physical therapy. If a brace or a cane does not relieve any of the pain, surgery may be an option.

But it’s the last resort, Muzzonigro said.

“If you fail all of (those treatments) and (you) come in and say I have 9 out of 10 pain ... if you did all of that and it’s no better, then you say you’re a good candidate for knee replacement surgery,” he said. “It is the last resort. I would normally do everything possible.”

How much knee pain affects any one person is also a factor in whether a knee replacement is necessary, Muzzonigro said. It all comes down to individual quality of life, he said.

However, when knee replacements happen, the surgery is “really successful in relieving pain and restoring function,” according to Muzzonigro.

The average knee replacement will last between 18 and 30 years, Muzzonigro said. The surgery requires three days in the hospital and involves a three-month healing process, Muzzonigro said.

Once a person has had a knee replacement, running and jumping is not recommended, and patients should minimize their time spent kneeling, Muzzonigro said.

But there’s no age requirements, “no too old or too young,” Muzzonigro said.

So when is a knee replacement an option? “When you feel you can’t live with (the pain),” he said.