A 55-year-old state senate candidate learned the difference between young knees and old knees the hard way.
In the closing seconds of a fund-raising event pitting two local youth teams, the candidate sprinted into the game for a photo opportunity. He was soon not only on the floor but in an ambulance on the way to the hospital. “When I pulled up to shoot, my feet stopped, but my knees didn’t,” he explained.
Like most Americans, the candidate is carrying a bit of excess weight, and he has been spending more time on the campaign trail than the running path. As he put it, “True of most folks my age, I should have stretched and warmed up and all of those other things before I decided to get in the game.”
Most seniors don’t have the opportunity, let along the inclination, to get involved in youth basketball. Yet 48 percent, according to a University of Michigan study, reported chronic knee pain. At least some of these injuries are exercise- or sports-related. But while your sedentary friends may warn you against putting your knees at risk by using them, studies have shown that persons who exercise generally have less knee pain and stiffness than those who don’t.
In addition to having stronger muscles surrounding the knee joint, active persons are less prone to weight gain. One extra pound of weight on your frame translates to about four pounds of force on your knees with every step.
Minor episodes of knee pain can occur as a result of walking, running or biking a bit farther or faster than you’re accustomed to. If you get pain and slight swelling around your knee after a five-mile walk, don’t ignore it, but don’t take it as an excuse to quit walking altogether.
Prompt treatment is important even for a minor injury. Stop your activity for a few days and apply ice packs several times a day to reduce the pain and swelling. As the injury starts to get better, ease back into your routine at about half the mileage and pace you were doing before and work up gradually again. If the problem persists, you should see a doctor.
Knee pain also occurs–often with no apparent cause–in seniors who don’t exercise. Muscles, tendons and ligaments weaken quickly from lack of use and eventually become too weak to support the knee joint and protect it from injury.
Most cartilage within the knee does not have a direct blood supply but rather gets its nourishment through osmosis and pressure as muscle contracts on bone. Without movement, the cartilage within the knee joint becomes essentially starved and weakened, resulting in pain.
Osteoarthritis is a degenerative condition, often known as the “wear and tear” type of arthritis. Cartilage, the protective tissue that covers the ends of bones in the joints, gradually wears away until bones begin to rub together, causing pain and disability.
Osteoarthritis often occurs in a knee that has previously been injured, but it may also develop because of lack of use, leading to deterioration of tissue. Genetics undoubtedly plays a major role in determining who gets osteoarthritis and at what age.
Doctors know that regular exercise is important not only in preventing but treating chronic knee problems. In one study, knee pain patients age 60 and over were put in three groups: one did weight-bearing exercises, the second walked regularly and the third received verbal instruction about knee health. After 18 months, both groups of subjects who exercised had less pain and increased mobility.
High-impact activities such as running are often cited as risky for the knees, but many older runners would dispute that theory. The risk increases with faulty biomechanics or running on hard or uneven surfaces. Many problems can be treated or prevented through carefully chosen shoes and use of shoe inserts. Walking is often cited as an ideal activity for the knees. There’s less impact than with running, but poor shoes, an irregular gait or a sudden increase in distance or pace can cause problems.
Even better than walking, according to most exercise specialists, is cross training, which not only reduces impact but helps avoid problems caused by strengthening some muscles at the expense of others.
Athletes say the knees are the first to go, but that doesn’t have to be the case. Keep your knees healthy, and you’re more likely to remain active and independent for many years.
REFERENCES:
Marc Darrow, M.D., J.D. “The Functioning Knee,” WebMD Medical Reference from “The Knee Sourcebook,” 2002.
M.J. Friedrich, “Steps Toward Understanding, Alleviating Osteoarthritis Will Help Aging Population,” JAMA, September 15, 1999.
Elaine Gottlieb, “Staying Fit and Healthy at Any Age,” Knee1.com, May 24, 2005.
Jennifer Jope, “No Excuses: Runner’s Knee Doesn’t Have To Stop a Good Workout,” Knee1.com, May 19, 2006.
“Knee Anatomy,” Zimmer.com, last updated 2/16/06.
Ericka Kostka, “Six Ways To Keep Your Knees Pain-Free,” Walking Magazine, June 12, 2000.
Erika Kostka, “Six Ways To Keep Your Knees Pain-Free,” Walking Magazine, June 12, 2000.
Liz Meszaros, “Rigorous Athletic Activity Isn’t That Rough on the Knees,” WebMD Feature, 2000.
Martin Pattrick, et al, “Synovial Fluid Pyrophosphate and Nucleoside Triphosphate Pyrophosphatase; Comparison between Normal and Diseased and Non-Inflamed Joints,” Annals of the Rheumatic Diseases, April, 1991.
Leena Sharma, et al, “Quadriceps Strength and Osteoarthritis Progression in Malaligned and Lax Knees,” Annals of Internal Medicine, April 15, 2003.
“Women’s Knees, How To Avoid Injury,” MedicineNet.com, July 6, 2004.
