“I am a 50-year-old healthcare worker, and I have a long-standing condition in my right knee in terms of femoropatellar joint arthritis and grade 2 arthritis of the internal joint bodies. In a recent knee MRI, there is a finding of anterior cruciate ligament rupture which I believe is a result of an injury from 30 years ago. I have been involved in recreational sports, and for the past 8 years, I have been playing tennis. I have read your advice on strengthening the thigh muscles. I do not have the support of my doctor to continue playing tennis recreationally. My question is, can I strengthen the muscles and stabilize the knee to the extent that I can continue to play lightly, or is that impossible.”

Generally, with existing knee arthritis, sudden accelerations, decelerations, and changes in direction, especially in situations of anterior instability, pose risks for further cartilage damage and worsening of the condition. That is why in the medical profession, we do not like it when patients with arthritis play tennis. However, in my clinic, there are many patients like you. For them, a certain sport that they engage in with particular passion represents an important part of their overall quality of life, and they feel bad without it. Some of them are willing to accept the risk of faster progression of their degenerative diseases in exchange for the opportunity to continue engaging in activities that make them happy. If you are one of those, here are some tips to reduce overall stress on the knee and its cartilage:

Find an experienced sports physiotherapist in your area who will guide you, determine the level of load in training, give you an exercise program, persuade you to take occasional breaks, and assess the need for physiotherapy. Prefer doubles over singles, as the loads on the knee are lower. Regular low-intensity aerobic training (static bike, elliptical trainer), and regular stretching should become your best friends. Several days of complete rest each month must become routine.