Synopsis: A sore or injured knee has kept many a carpenter off the job. Here, an orthopedic surgeon recommends ways of avoiding injury and includes a few exercises that will strengthen knees. A sidebar details various kinds of knee pads on the market.

Two years ago, Bob had a business as a siding contractor, keeping a couple of crews busy all the time. I met him after he hurt his knee. He was a little behind schedule siding a house and didn’t take the time to clean off his scaffold. That afternoon, he stepped on a small cutoff and twisted his knee, tearing three ligaments and injuring a nerve.

I fixed his ligaments, but his nerve damage is permanent. Bob has trouble climbing ladders and even walking across broken ground. He builds wooden toys and birdhouses in his basement now.

John is a roofer who has carried bundles of shingles up ladders since he was in high school. He developed a little knee pain and swelling, but just took increasing doses of ibuprofen and kept going. When John finally came to see me, he couldn’t walk down stairs without holding both rails, never mind climb a ladder.

John had so much damage to his knees that I had to operate on him. He’s back working almost a year later, but he makes only a four-hour day, and he doesn’t climb steep or high roofs anymore because he can’t trust his knees not to buckle unexpectedly. If he had followed the exercise regimen in this article, odds are he never would have needed surgery.

We all recognize that construction is a dangerous occupation, and some accidents are unavoidable. Still, I see a lot of patients whose problems could have been prevented, or at the very least minimized, without much effort. A clean job site and a little maintenance to the tradesman’s most important tool, his or her body, go a long way toward preventing injuries.

Knee pads don’t help if you leave them in the truck

Working on your knees is a setup to develop prepatellar bursitis, commonly called housemaid’s or preacher’s knee. I would call it tilesetter’s or drywaller’s knee.

Knees have a small sac, known as a bursa, in front of the patella, or kneecap. The bursa normally holds a few drops of fluid that allow the skin over the knee to move independently of the underlying bone. Without the padding provided by the bursa, kneeling would always hurt, and we would scrape our knees daily.

Habits that abuse the knee, such as kneeling all day or using a bent knee to hold up sheets of drywall up while securing them can cause excess fluid to collect in the bursa. This condition, prepatellar bursitis, makes bending the knee difficult and kneeling painful. Worse, it sets the stage for a serious infection that may require surgical cleaning to prevent damage to the knee.

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