Stiff fingers on waking, sore knees after new exercise: why?

Stiff fingers after waking are common and can relate to repetitive hand use, getting older, or the menopause years, but if your joints stay stiff for more than 30 minutes after waking, the UK's NHS advises seeing a doctor. Knee pain after you have just started exercising often has to do with overusing the knee, building up too quickly, poor technique, or shoes without enough support. At first, rest the knee and use ice, then return to exercise gradually.

Why are my finger joints stiff when I wake up?

The NHS says joint pain is common, especially as you get older, and that it has many possible causes, from injuries to longer-lasting problems. It is best not to guess the cause yourself; if you are worried, talk to a doctor. Here are the everyday factors.

Using your hands the same way, over and over

Typing all day, using vibrating tools, or playing an instrument are examples of activities the NHS suggests stopping or cutting down when a finger hurts. NIAMS, part of the US National Institutes of Health, notes that using the same part of the body repeatedly can cause injuries that build up gradually over time, and not only in athletes: gardeners and musicians get them too.

Joints that have not moved for a while

The NHS advises that once you can move a joint without the pain stopping you, you should keep moving it so the joint or muscle does not become stiff, and that you should not stop moving a painful joint completely. While you sleep, your hands barely move for hours, so stiffness may be most noticeable just after waking.

Age and the menopause years

The NHS notes that perimenopause and menopause can cause aching and painful joints because of lower levels of oestrogen. Women who start noticing achy joints at this stage of life are not unusual.

How long the stiffness lasts matters

When you see a doctor about joint pain, MedlinePlus (US National Library of Medicine) says you are likely to be asked whether your joints are stiff in the morning, how long the stiffness lasts, and what makes it better. Keeping a note of how long the stiffness lasts after waking each day will help you describe it clearly to the doctor. If it lasts more than 30 minutes after waking, see a doctor.

What can I do myself about stiff fingers in the morning?

If the stiffness eases soon after waking and there is no swelling, heat or redness, try these everyday steps.

• Move your hands and fingers gently after waking, for example by slowly making a fist and opening your hand. The NHS recommends gentle hand and finger exercises to help ease stiffness.
• MedlinePlus says that for everyday joint pain, both rest and exercise are important, and suggests warm baths, massage and stretching as often as possible.
• Take regular breaks when typing or doing repetitive work for long periods, and cut down activities that cause pain.
• Remove rings from a painful finger.
• Use gadgets that make painful tasks easier, such as a jar opener.
• Avoid lifting heavy objects or gripping anything too tightly while it hurts.
• If it hurts, ask a pharmacist or doctor which painkiller to use.

One caution: if your finger is painful or stiff after a knock or injury, the NHS advises against heat packs or hot baths for the first 2 to 3 days.

I've just started exercising and my knees hurt. What causes it?

MedlinePlus says knee pain may start suddenly, often after an injury or exercise, and that overusing your knee can cause pain. The NHS gives the example of pain after overstretching, overusing or twisting the knee, often during exercise. NIAMS lists factors that raise the risk of injury during exercise, and several of them fit people who have just started.

Building up too fast

NIAMS says increasing the intensity of physical activity too quickly, and training too often or for too long, raise the risk of injury. Some injuries come from repeated loading of the same area and develop gradually over time, for example when someone new to running adds a lot of distance in the first few weeks.

Technique and equipment

The NIAMS risk factors also include incorrect exercise technique, shoes without enough support, not using the proper equipment, and poor flexibility. The NHS adds that not warming up before exercise and tired muscles are common causes of sprains and strains.

Hard surfaces and impact

Running or jumping on hard surfaces is another factor. NIAMS notes that running creates forces of two to three times your body weight on the legs.

Body weight and load on the knee

MedlinePlus says every 0.5 kg of excess body weight puts about 2.25 kg of extra pressure on the kneecap when you go up and down stairs, and the extra pressure is even greater when you jump.

I've just started exercising and my knees hurt. How should I look after them?

When the pain has just started

NIAMS says you should not try to work through the pain; when a particular movement hurts, stop right away. Then follow the NHS advice:

• Put as little weight as possible on the knee, for example by avoiding standing for long periods.
• Use an ice pack or a bag of frozen vegetables wrapped in a towel on the knee for up to 20 minutes every 2 to 3 hours.
• Avoid heat, such as hot baths and heat packs, and massage for the first couple of days.
• Keep the knee raised on a pillow as much as possible, and wrap a bandage around it for support during the day.
• If it hurts, ask a pharmacist which painkiller to use.

The NHS says knee pain can often be looked after at home, and that most sprains and strains feel better after 2 weeks. Once you can move without the pain stopping you, keep moving so the joint does not become stiff.

Getting back to exercise

Once the pain has settled, NIAMS advises keeping up regular exercise by choosing an activity that suits your fitness level, increasing the intensity gradually, and using the right equipment and technique. MedlinePlus gives these general tips for knees:

• Always warm up before exercising and cool down afterwards.
• Stretch the muscles at the front and back of your thighs.
• Reduce or change the exercise you do, for example by cycling or swimming instead of running.
• Walk down hills instead of running down them.
• Run on a smooth, soft surface such as a track rather than on concrete or pavement.
• Wear running shoes that are well made, fit well and have good cushioning. If you have flat feet, shoe inserts with arch support may help.

How should I build up the muscles around my knees?

The NHS advises adults aged 19 to 64 to do strengthening activities that work all the major muscle groups (legs, hips, back, abdomen, chest, shoulders and arms) on at least 2 days a week, alongside at least 150 minutes of moderate activity a week, spread evenly over 4 to 5 days or every day rather than all at once.

Examples of strengthening activities

The NHS examples include yoga, pilates, tai chi, lifting weights, working with resistance bands, and exercises that use your own body weight. Moderate activities include brisk walking, water aerobics and cycling, and for people with knee pain MedlinePlus suggests cycling or swimming instead of running.

Before you start

The NHS advises speaking to a doctor first if you have not exercised for some time or have an ongoing health condition that needs regular care, or other concerns, and making sure the intensity suits your fitness. If your knee pain came from an injury, NIAMS notes that a physical therapist can help plan exercises that strengthen the muscles and joints before you return to the same activity.

When should I see a doctor about stiff fingers or a sore knee?

Book an appointment

The NHS advises seeing a doctor if:

• your joints are stiff for more than 30 minutes after waking up
• joint pain is stopping you doing normal activities or affecting your sleep
• the pain or swelling is getting worse or keeps coming back
• the pain has not improved after treating it at home for 2 weeks, or knee pain does not improve within a few weeks
• you notice tingling in your hand or your hand starts to feel numb

Get help soon

• you have joint pain and the skin around it is swollen and feels hot
• you have joint pain and feel generally unwell, have a high temperature, or feel hot, cold or shivery
• your knee is very painful, or you cannot move it or put any weight on it
• your knee is badly swollen or has changed shape
• your knee locks, gives way or painfully clicks (painless clicking is normal)
• you have a very high temperature and redness or heat around your knee

Go to the emergency department straight away

• you have very bad joint pain after a fall or injury
• you are unable to walk or put weight on a joint
• your joint has moved out of place
• you have tingling or no feeling around the joint after an injury