under pressure

Knee pain is on the rise among men and women— and with it, a messy, imperfectly regulated world of quick-fix injections marketed to offer relief. Ahead, what works (and doesn't!) to soothe joints.

- katherine ellison

I spent a chunk of my career as a foreign correspondent, and another telling war stories. Touring the front lines in Ethiopia's war with Eritrea. Running from tear gas during street protests in Seoul and Manila. To my chagrin, however, the story that my friends remember is how, back in 1990, while reporting on Nicaragua's presidential elections, I tumbled into a sidewalk manhole and shattered the tibial plateau below my left knee.

An instant earlier, I'd been running after the newly elected president, Violeta Barrios de Chamorro, in hopes of a quote for my story on her triumph that day. If not for that manhole, I know I would have caught up to her. Chamorro had recently had knee surgery and was walking, very slowly, on crutches.

When I returned to California, an orthopaedist put me in a cast, advised me to stop running, and predicted I'd need a new knee by 50. I'm now 66, with the same knee that landed in the manhole, still doing all I can to prove the ortho wrong.

Sure, at times my knee hurts, but for many reasons, I'm still balking at knee surgery. Instead, like millions of Americans, I've explored the world of alternative treatments for pain relief, including the range of knee injections.

Spoiler alert: They're a mixed bag, with questionable science to back them up (or not)-and experts have feelings about which treatment route bests the rest in any one person's unique circumstances.

what happened to our knees in the first place?

It's no secret that the average American is getting older-and heavier. The average life expectancy in the U.S. is now just short of 80, while in our increasingly sedentary culture, nearly 74 percent of adults are considered medically overweight, including 42 percent who fall into the obese category. None of this is good news for knees, which are the biggest joints in our bodies and bear roughly three to six times our body weight while walking.