How many times have you experienced knee pain as you squat down to pick something up or walk down steps? As we get older, knee pain is more common and it can range from annoying to debilitating. What may be causing this pain?
Osteoarthritis (OA) is a common knee disorder affecting over 32 million adults in the United States. It occurs when the protective cartilage that cushions the end of your bones wears down over time. You will frequently hear people call it the wear and tear disease…meaning they have worn out their joints, but this is not exactly correct. OA is a disease of the entire joint - there is breakdown of the cartilage but there are also bony changes of the joints, deterioration of tendons and ligaments, and various degrees of inflammation of the joint lining (called the synovium). All of these changes cause the affected bones to get bigger and you may start to experience joint instability, a decrease range of motion, swelling, stiffness, a cracking or grinding noise with joint movement, and pain.
How likely are you to get OA of the knee? The lifetime risk of developing OA of the knee is about 46%! You have almost a 50-50 shot of developing knee OA! What can we do to prevent OA or at least delay the onset? Some factors that contribute to the development of OA such as age (as age increases, risk increases), gender (females are more likely to develop OA) and genetics (individuals who have family members with OA are more likely to develop it themselves) are out of our control. The good news is that there are three modifiable risk factors for OA: joint injury or overuse, occupations that require repetitive knee bending, and obesity.
Preventing injury. Preventing injuries can help you to avoid OA later in life. Injuries such as falls, sport collisions, work requirements, or even a car accident all can contribute to knee OA. Individuals with a history of knee injury are 3–6 times more likely than those without knee injury to develop knee OA. We can help prevent injury by strengthening the muscles surrounding the joint and by participating in balance training to prevent falls.
Reduce repetitive stress. Some occupations require a lot of bending and lifting which can place a lot of undue stress on the joint if the activity is performed incorrectly. Learning to properly flex the knee will help to reduce stress to the joint. When performing knee flexion (bending the knee), press your knees outward, avoid letting them cave towards each other. To perfect this movement, incorporate leg abduction exercises into your exercise routine. Leg abductions can be done while seated in a chair, with a resistance band around your thighs. Hold onto the chair and press your knees outward, stretching the resistance band, and then bring your legs slowly back together.
Weight management. Maintaining a healthy weight will help to reduce the stress placed upon the knee joint. Individuals who maintain a healthy weight are less likely to develop knee OA and, therefore, less likely to need major surgery to treat OA symptoms. Physical activity and proper nutrition are critical factors in maintaining a healthy weight.
You need to move! Individuals with knee OA, may choose to become inactive due to the pain they experience when moving. However, participating in a joint-friendly exercise program can improve arthritis pain, function, mood, and quality of life. Use the acronym SMART to get started on your journey.
Start low, go slow: begin with small amounts of activity and slowly increase duration and intensity…. give your joints time to adjust.
Modify activity when arthritis symptoms increase: On days when pain, stiffness or fatigue are more pronounced, continue your program but modify the activities to a lower level. Try to stay as active as possible.
Activities should be “joint friendly”: Choose activities that are easy on the joints such as swimming, cycling, chair exercises, or walking. Avoid activities that are high impact.
Recognize safe places and ways to be active: If you are just beginning an exercise
program it is recommended to join an exercise class that is lead by a certified exercise professional. If you are exercising outside, make sure the sidewalks or pathways are level and free of obstructions, are well-lighted, and are separated from heavy traffic.
Talk to a health professional or certified exercise specialist: Health care professionals and certified exercise professionals can answer your questions about how much and what types of activity match your abilities and health goals.
Unfortunately, there is no cure for OA. Therefore, the goal of osteoarthritis treatment is to reduce pain and improve function. Physical activity is critical in your treatment plan as it strengthens and stretches the muscles around the knee joint and may help relieve stiffness and pain. So let’s get moving!
Erin Sedig, BS, is a graduate of Long Beach State University in Kinesiology – Fitness Option (2020).