With the new football season well underway, knee injuries are a threat to both active players and retired footballers.
Tragically, some Premier League footballers may be forced into early retirement, most notably in the case of Owen Hardgreaves. If played with caution, the majority of players will normally be able to cope with the physical demands of high-end sport, but many won't - and they often only find out once the damage has already been done.
It's key to understand that football is dangerous for the knees as it involves constant impact and twisting on a bent knee, combined with excessive forces when there's a hard tackle. On top of this, as people start to get a bit older there's often a tendency to move away from 11-a-side football on grass to 5-a-side football on Astroturf. But 5-a-side football involves even more twisting, turning, cutting and pivoting, and Astroturf tends to be more slippery and more dangerous than grass.
The most common injuries I see in consultation with footballers are tears of the anterior cruciate ligament (ACL rupture), medial collateral ligament (MCL) sprains (partial tears) and meniscal cartilage tears (tears of the cartilage shock absorbers in the knee). I also see a steady flow of retired footballers who tend to present with premature onset osteoarthritis in their knees, and they've often had multiple injuries and multiple previous operations in the past but have still continued playing and pounding their knees regardless.
The older you are, the more degenerate your joints tend to become and hence the less able they are to cope with the stresses of sport. Add all this together and you've got a recipe for a lot of knee injuries and a significant increase in knee surgeries.
I recommend seeking medical advice from a qualified physio or osteopath if you've got any concerns about your knee. Then, depending on the advice given, the next step is often to get a quality high-res 3T MRI scan of your knee and an opinion from a dedicated knee specialist (a consultant orthopaedic surgeon specialising specifically in knees).
If you've got any kind of significant structural damage in a knee joint, then ignoring it and just continuing to pound the knee risks making the damage even worse - and the worse the damage is in a knee joint, the harder it is to 'fix', and the bigger the likelihood of this eventually leading to arthritis in that knee at some stage in the future.
If you've damaged your knee, you need to consider very carefully the timing of when to return to play after injury. You should listen carefully to your knees, be gentle with your joints and avoid anything that hurts or aggravates your symptoms in any way.
Football is great for fitness, for health and socially, but it's not great for your knees. If you've got good genetics, train carefully and regularly, and manage to avoid injury, then you might remain lucky - and you might be able to continue playing football right up until a ripe old age. However, you need to take care with your knees. When you're young you tend to think that you're invincible. It's only later, when you're older, that you discover the true consequences of repetitive joint injuries from when you were younger, by which time it's too late, as the damage has already been done.