How not to have knee surgery: More Basics
Last time we introduced the concept of working to avoid knee surgery altogether. The importance of maintaining a healthy weight and keeping up your strength and conditioning were discussed. Let’s continue the discussion on strength, conditioning, and activities that are good for your knees.
Knee Motion Not Impact
A knee joint is designed to move. Movement helps keep the surrounding tissue flexible, and moves nutrients in and out of the joint surface itself. Movement keeps the muscles on either side of the joint (your quadriceps, hamstrings and calf muscles) strong and responsive to the signals that tell them to move (neuromuscular control). Impact, like jumping and landing on your feet, or repetitive impact like running, subjects your knee to quick sudden high forces. Continued high impact forces can contribute to the degenerative process of a joint.
While impact forces are not good, repetitive loading of the joint can be highly beneficial. This means activities like walking actually help to nourish the cartilage in your knees and studies have shown increases in cartilage thickness for knees that have been exercised. There are plenty of studies showing that walking is good for you for so many reasons, including bone density, heart health, metabolism, and general well-being. Swimming and cycling also provide knee motion, but do not offer the same benefits of weight bearing exercise. The World Health Organization endorses some form of aerobic exercise, walking or t’ai chi to
stimulate bone formation.
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A common question is ‘what exercises should I be doing?’ This can be a slightly different answer for each person. There are hundreds of conditioning programs online, on videos, and at the gym. I almost always refer my patients with knee pain to a physical therapist that I trust. They are experts in designing a exercise or rehabilitation plan based on you. Don’t hesitate to ask about this – a month or two in a good program can teach you good habits, know what to do on your own, and get you started in the right direction. The key is to start slow, know your limits, and stick with it.
Your Parents (Genetics at work)
You can’t choose your parents ! A part of your ability to avoid injury and damage to your knee comes from a genetic component – how were your parents’ knees? As I see plenty of patients in their 80s with great looking knees, arthritis cannot just be the result of old age. I tend to think each person has a ‘milage guarantee’ for their knees based on who they are.
Stay tuned. Next time we will look at glucosamine and the latest research to help reduce knee pain.
Well done Dr Hacker – a very timely article. It was good to see you yesterday -and I thought the visit was both useful and helpful for me to understand and get a focus on my knee issues. It was good to immediately get in writing thru this article what you were telling me in clinic. So now the trick is to see if I can take these good points and apply them