by Courtney Llewellyn
Whether a farmer or not, aches and pains creep up on us all. Very often, those maladies manifest as knee pain – and trying to work while one (or two) of your most important joints isn’t working correctly can cause serious problems. Ned Stoller, with Michigan AgrAbility and founder of Disability Work Tools, recently presented “Working with Knee Pain in Agriculture” at the 2019 Great Lakes Fruit, Vegetable and Farm Market Expo.
Stoller, who earned a degree in agricultural engineering from Purdue University, has been helping farmers with mobility issues since 1998, learning how to help people with different tasks at different farms. “I love farming and inventing things,” he said.
He noted that climbing up and down, whether on machinery or ladders, is one of the biggest knee issues farmers tend to have to deal with. He hears from a lot of people dealing with arthritis, especially those spending long hours standing on concrete. There are lots of things farmers do that stress the knee, he said: prolonged standing, sitting or weight-bearing; heavy lifting; a lack of hip and knee strength; a lack of flexibility and range of motion; not wearing the proper footwear; and even being overweight.
Some of the most common knee injuries farmers see are patellar tendinitis (also known as “jumper’s knee,” an overuse injury of the tendon that straightens the knee; pain is usually felt at the lower part of the kneecap), ligament tears (when the tough, elastic connective tissues surrounding the knee are damaged), meniscal tears (a frequently occurring injury to the cartilage that cushions and stabilizes the joint), and knee osteoarthritis (which affects both the bones and the cartilage).
“Farmers see extremes, from being sedentary to participating in vigorous activity,” Stoller reported. Think of rainy days when work can’t be done, to days when you need to get that harvest in. “They don’t take rest days or even rest periods. They work through their pain and push their bodies too hard – and it’s difficult to change their habits. They often wait to make changes until major surgery is required.”
Knee problems don’t exist in a vacuum, however. The knee is just one joint – one employee – working as part of a team that keeps your whole body operational.
“The knee doesn’t work by itself,” said Dr. Ryan Marek, DPT, of Magnolia Physical Therapy. “It’s connected to your ankles, your hips and your back. They are four employees who are supposed to work together – but things still need to get done, even if one or two employees are out ‘sick.’”
Marek elaborated on this by noting that when the hips and core muscles (those on the trunk of the body) don’t work together, that takes two “people” out of the four-“person” team, which makes movement harder. Since your body can’t fire the employees who don’t perform their duties, you have to train them to work correctly.
Your thigh muscles (the quadriceps and the hamstrings) are your knee muscles. They are not hip muscles, Marek said. They don’t work the same way for the different joints. The knee is there to help, but the hip is what moves you around. “Research agrees that overuse of the quads – and not using hip or back muscles correctly – contributes to pain in the knee cap because it puts all the pressure there,” he explained. “It’s like using a rope without a pulley to lift something heavy. Eventually, it’s going to fray or even snap.”
What can a farmer do, when there is always work to be done? “Remember, ‘motion is lotion,’” Stoller said. “You have to keep it moving as best you can. Don’t stand in one position for too long. Resting doesn’t mean stop working.” And there are always the traditional treatments: rest, ice and heat, when possible; taking medication, from Tylenol to steroids; receiving cortisone injections from a doctor; minor (or major) surgical procedures; and physical therapy.
“There is no quick fix for knee pain,” Marek stated. “It’s about consistent care over time. Take the time to address issues appropriately and the right way.” He also recommended farmers contact their insurance companies to see what they can offer in terms of physical therapy coverage.
Stoller listed other tips to take pressure off your knees. “Use your steps – don’t jump,” he said. “Make sure you have good hand grips on tractors to help pull you up. I’ve also installed a lot of lower steps on machines for growers.”
He added that stretching is important, as are exercises that strengthen the muscles around the joints. Losing weight if you’re overweight can also make a big difference. Being a healthy weight takes a lot of stress off the knees.
For those wishing to make things even easier, there are some modifications and tools to aid in daily tasks. Stoller noted that on a tractor, the left knee works the clutch. To save that knee some work, you can install a hand lever. Instead of kneeling and crawling for long periods of time, use an all-terrain work seat – or, more simply, wear knee pads. You can use a stand-up planter to drop seeds. In the workshop, utilize adjustable height tables or stools. In greenhouses, rather than climbing up and down ladders, consider using rolling worksteps (like those used at big box stores). When loading crates, use rolling dollies instead of bending, lifting and carrying everything.
AgrAbility, the organization Stoller works with, is a nonprofit that helps farmers with serious medical conditions keep working. There are 23 states that have AgrAbility programs. To find one near you, and to learn more, visit www.agrability.org.