Sponsored by our partner, Durolane

Whoever said "no pain, no gain" was full of B.S… or at least, all pain isn’t good. Yes, there is healthy, 'just-worked-my-butt-off' soreness that you get from training hard—and recovering properly—but it shouldn’t last more than a couple of days if you’re on target with your rehab regimen, nutrition plan, and realistic fitness goals. (Post-workout tenderness is natural. It’s your body’s way of saying: REST!, and comes from metabolizing lactic acid produced during tough exercise, as well as healing microtears in your muscle fibers, which ultimately build strength.) 

Chronic pain—especially knee pain—that sticks with you and gets worse over time, on the other hand, is no bueno if you want to stay active and fit. Knee injuries from previous training mishaps or races gone wrong, like damaged MCL and ACL tendons, or meniscus tears, can be deceiving. “Anytime the knee suffers from either minor or major instability, the cartilage is placed at risk,” says Karen M. Sutton, M.D., F.A.A.O.S., Associate Professor at Weill Cornell Medicine and Team Physician for the U.S. National Lacrosse and Ski & Snowboard teams. “Similar to if a train is slightly off track, it would wear on the wheels.” 

When left untreated (or if activity is resumed too quickly), a knee injury can result in irreversible cartilage loss, and ultimately, develop lifelong osteoarthritis in the joint, over time. We don’t mean to que the doomsday soundtrack here, but it is so important that you take care of your knees. They are your best (and worst) friend. Essential to all-things OCR, and life, healthy knees keep you at it. Knee OA will set you back—or even put you on the couch indefinitely. It’s as simple as that. 

Related: Why Dudes Should Care About Osteoarthritis (It's More Common in Under 45-ers!)

Of course, you should work closely with your doctor above all to figure out how best to treat and address knee injury and pain. However, here are a few general tips from pro docs to avoid knee OA and re-enter endurance sports post-injury in a smart way, with longevity in mind. (Remember, less is more. No matter how much you want to return to racing or start running again.)

1. Take it SLOW... (No, Slower than That)

“The most challenging thing is that osteoarthritis (as it develops) does not have any symptoms,” says Constance Chu, M.D., and Professor of Orthopedic Surgery at Stanford University. “So when you tear an ACL, for example, you have pain, swelling, and bleeding in the knee. You get surgery because the knee is not stable. Post-surgery, when the knee is stabilized, athletes focus on recovery, which in most people’s minds boils down to getting strength and coordination back to re-enter the sport ASAP.” 

The danger, though, is hacking it too soon, she says. Cartilage doesn’t feel pain when it’s injured, so though you may feel like you’re completely recovered, the knee may still be further damaged by resuming activity too soon. “I recommend not pushing it too hard just because your strength has come back and you feel like the pain has gone away,” says Dr. Chu. Instead, over-communicate with your doctor and make sure the imaging, physical therapy, and any new training plan line up with your medical team’s blessing. And even then, go easy for a while. 

2. Cross-train Like It’s Your Job

Walking, cycling, swimming, hiking, weightlifting, and other cross-training exercises are crucial to building strength in a smart way, post-injury. And if you want to prevent knee OA that circles back a decade later, consider non-running workouts your best friend. “Vigorous activity protects cartilage, as reported in studies, and can increase cartilage volume,” says Dr. Sutton. “Regular walking is also preventative in developing arthritis.  Regular exercise was shown to be beneficial for cartilage in women aged 40-67 years. Increased muscle strength and mass may be protective against cartilage loss.”

The trick is to dial back on impact-heavy workouts, like running, to ensure you’re protecting the joint and allowing it time to fully heal. Dr. Chu says it’s important to mix up your workouts and focus on core stability most of all, which directly impacts the kinetic chain leading to your joints. Think weak core = weak everything else. 

“Emphasize general fitness and cross-train, and make sure that you’re not just strong in the legs, or strong in the upper body,” she says. “To do OCR, you have to be total-body fit, but it’s also so important to improve posture, core strength, and form, and avoid doing the same workouts repeatedly.” If you gently jog one day, cycle the next and swim the following day, which according to Dr. Chu, will safely improve your ability to undertake an intense obstacle course. “Cross-training is so key.” 

3. Eat an Anti-Inflammatory, Heart-Healthy Diet 

If you think diet has little to do with how quickly you can recover from a knee injury, think again. How you choose to fuel your body truly matters. Junk in? You’ll get a junk result back. Dr. Chu recommends all of her patients eat a heart-healthy, anti-inflammatory diet. Inflammation is the name of the game with a knee injury, and mitigating it through nutrition, and proper rest and recovery should be your main priority. Though we don’t yet have specific nutritional studies around knee-injury rehab and OA prevention, she says eating whole grains, vegetables, fruits, omega-3s and healthy fats (as well as reducing processed foods) goes far in reducing your natural inflammatory response to injury and cartilage loss. 

“In my opinion, eating heart-healthy is a great place to start,” she says. “As we look more into the effects of nutrition on the joints, we find similarly that it’s helpful for maintaining joint health across the board.”  

Related: 4 Anti-Inflammatory Foods to Help Injury Rehab and Soothe Arthritic Pain 

BONUS TIP

If you find yourself already suffering from knee OA, it sucks. There’s just no way around the chronic, lifelong pain that comes with cartilage loss in the joint. The good news? In addition to managing knee OA pain and inflammation through proper fuel, sufficient rest, and cross-training, there are many treatment options clinically proven to help successfully manage symptoms over the long run. Hyaluronic acid injections, like Durolane injections, can also help decrease pain and support you as you continue your physical activity. Speak with your doctor about what treatment regimen is right for you. And always, always remember: less is more for the long game.