Osteoarthritis may be an inevitable consequence of using our knees for so many years, but pain and dysfunction can often be minimized and functional life extended by making simple lifestyle adaptations. Too often, knee problems result in avoiding activities that are beneficial to our health. My chief message is that great deal can be done to ward off knee pain and disease. Taking steps to prevent knee pain or avoid making it worse is preferable to treatment and far preferable to complex treatment.

The primary reason so many knee operations are now being performed is that osteoarthritis, the most common cause of knee pain, is a wearing out of the joint commonly associated with aging. With the graying of our population, healthcare providers and the public have come to accept knee pain and dysfunction as normal part of the aging process. While it may be true that knee pain is a normal part of aging for people who have led a sedentary, unhealthy lifestyle, that has not been the case for people with active, healthy lifestyle until they reach their 60s.

In the recent past, I have met too many people who undergo knee surgery for problems that can be resolved without surgery. This trend is alarming, not only because of the sheer number of knee surgeries occurring, but also because so many can be avoided. Total knee replacements in the United States are growing exponentially; in the coming years we can expect well over 1,000,000 procedures annually. With an average cost of $15,000 per knee replacement, this represents a whopping $15 billion in healthcare expenditures, to say nothing of lost wages and reduced productivity. Too many lives are disrupted and too much money spent for a situation that is largely a result of active people living longer.

Lifestyle Changes Advised by Knee Pain Doctors

Physical activity and exercise help to maintain the health of our muscles and joints. In the specific case of the knee, there are three muscles that need to be given special attention: the quadriceps (front thigh muscle), the hamstrings (back thigh muscle), and the iliotibial (IT) band (side of thigh muscle). These muscles act as shock absorbers for the knee, and studies have shown that strengthening the quadriceps is a very effective way of reducing pain from osteoarthritis. This is because the stronger the quads are, the less the knee is required to transmit force when performing everyday activities. By reducing the load transmitted through the knee, the rate of deterioration of knee joints lessens, hence decreasing the level of pain experienced. Conversely, when a muscle is weak, the opposite occurs; so by having weak quadriceps, pain is increased and knee osteoarthritis symptoms are worsened. The most effective exercise is something simple and can be safely done every day, such as the straight leg lift. This exercise and others that effectively strengthen the quads are often taught by physiotherapists. On the other hand, it is still important to do some form of low-impact aerobic exercise (also beneficial for knee pain) such as swimming or cycling for general health and to maintain strength and function in the other muscles of the body. Lastly, it is important to frame exercise in a sensible context; although trying to maintain a good level of fitness is beneficial, overexercising to the point where the knee is swollen and painful is counterproductive and should be avoided.

Regular Exercise

Exercises such as swimming, hydrotherapy, or riding a stationary bicycle can be used as an alternative. The density of water provides resistance and creates an environment where it is possible to attain exercise with the absence of sudden impact on knee joints. The benefits of swimming will be especially rewarding for those who suffer from knee pain due to osteoarthritis, which will be mentioned in later sections in this article. Hydrotherapy or a water exercise program will allow a person to progressively increase muscle strength and overall function without the risk of any aggravation to the knees. Aerobic exercises, unless specific to those that cause further discomfort to the knees, should also be maintained. The level of intensity should be based on the person’s fitness level, and your aerobic capacity can be progressively increased with time.

The knee pain doctor Singapore advise patients who suffer from knee pain should involve exercises as a part of their daily routine. The lack of exercises, regular or work-outs to maintain a flexible and strong body can cause the pain to get worse. This is the case for people of all different age groups; hence the need to always be conscious of the importance of regular exercise to maintain knee health has been highlighted. Exercises that require swift and sudden movements or the sudden change in direction of movements should be avoided. This is due to the fact that it can cause discomfort to the knees, and in a worst-case scenario, further damage. In lieu of these exercises, patients should focus on exercises which improve muscle tone and increase overall support to the knee.

Weight Management

Weight management programs that involve a combination of exercise and diet are effective at reducing knee pain and are more effective than diet alone. One of the most important aspects of these programs seems to be the amount of physical activity that is undertaken. High duration of moderate-to-vigorous physical activity appears to protect against both incident and progressive knee pain and has a dose-response relationship with knee pain, with greater amounts of exercise offering more protection. High physical activity and diet programs are more effective at reducing knee pain than exercise or diet programs alone. Finally, dietary weight loss with or without exercise has moderately beneficial effects on knee pain.

Weight management is another critical aspect of lifestyle change for those with knee pain. Overweight people who lose as little as 10 lbs can cut their risk of osteoarthritis of the knee by 50%. Weight loss lessens the impact on the knee. Prevention of further weight gain is another benefit from the behaviors learned in weight loss programs, which can be a major factor in the management of knee pain because secondary knee pain often occurs in people who have existing knee pain in one or both knees.

Proper Nutrition

Ideal nutrition for someone with knee pain is similar to a healthy diet for anyone else. The only difference is that it is more important for those with knee pain to adhere to these dietary guidelines. For example, it is important to get enough calcium. Studies have shown that getting the proper amount of calcium may prevent one from developing osteoarthritis and will reduce the likelihood of progression for those who already have it. Calcium is best obtained through low-fat dairy products, calcium-fortified foods, and some green vegetables. If you do not eat enough of these foods, a calcium supplement may be necessary. Just be careful not to exceed the recommended dose, as this may cause other health problems.

This is due to the fact that every pound of body weight places 4-6 pounds of pressure on each knee. So if you are 10 pounds overweight, the total load on your knees will be about 40-60 pounds per step.

Eating right is very important and will help aid in your recovery from knee pain. Also, maintaining an ideal body weight puts less stress on an injured or painful knee. For some, losing as little as 10 pounds can make a huge difference. If you are overweight, losing weight is one of the most important things you can do to help alleviate knee pain. People who are overweight are 4-5 times more likely to develop osteoarthritis in their knees than people who are not.

Avoiding High-Impact Activities

Although these activities have been shown to increase the risk of osteoarthritis, there is no definitive proof that avoiding them will prevent the disease or that participation in such activities causes permanent damage to healthy knees. The possibility of continuing to enjoy these activities in the absence of knee pain may provide little comfort to individuals who have been diagnosed with osteoarthritis or those who are experiencing chronic knee pain. They will want to carefully consider the pros and cons of curtailing or modifying these activities, especially since doing so may affect their overall level of physical fitness. But for those who are willing to make the trade-off, switching to a more knee-friendly regimen may help reduce the risk of functional limitations and the need for total knee replacement (TKR) surgery later on.

Athletes, particularly those who have had a knee injury, should be especially vigilant about this and similar knee pain prevention subjects. But it’s not just athletes. Weekend warriors and others who engage in regular exercise, as well as those who are accustomed to a highly active lifestyle, need to be mindful of these effects on the knee. Data suggests that there is an association between repetitive high-impact activities and knee osteoarthritis.

High-impact activities such as running, jumping, and carrying heavy weights can accelerate cartilage loss in the hip and knee. A recent study showed that some people are at an increased risk of greater knee cartilage volume loss if they have suffered a recent knee injury.

Other Preventive Measures

High heels are frequently culprits of knee and back pain, but any shoe that does not provide proper support can cause damage. If you have knee pain, replacing your shoes with proper supportive footwear may provide your best and easiest chance for relief.

For comprehensive knee alignment, it is possible to have your feet and body analyzed while walking or running. A gait analysis can determine if your feet roll in or out excessively and if you have poor alignment in the lower limb, which results in increased stress on the knee. If alignment is an issue, it may also be necessary for those with knee pain to avoid open-heeled shoes, which cause the sides of the foot to compress more often.

If knee pain is inhibiting your life, one of the first changes you can make is an obvious but sometimes difficult one: giving up high heels. While high fashion has its price, it is usually your knees and back that pay. For every one inch of heel height, the body is tilted forward and downward. This means that if you are wearing shoes with three-inch heels, there is an increased force on your knees equivalent to three times your body weight! Over time, this can cause misalignment of the kneecap given the increased pressure from the extra force, thereby increasing knee pain. Similarly, poor shock absorption and arch support in shoes can contribute to knee pain. It is best to select a lightweight shoe with good shock absorption and a sole with cushioning and a slight heel. Newer air sole athletic shoes may be the best in providing cushioning and shock absorption. There are also various insoles and custom orthotics which are molded to your own foot and can improve cushioning, alignment, and knee function.

Using Proper Footwear

The first step in selecting proper knee injury footwear is to pinpoint exactly what type of knee injury is being dealt with. The location of knee pain can be an indicator of what exactly is happening in the knee joint. For example, pain on the inside of the knee can be indicative of a medial ligament injury. Pain underneath the kneecap can be from patellofemoral pain or patellar tendonitis. And pain on the outside of the knee can be indicative of a lateral ligament injury. With any of these pains, mild to moderate osteoarthritis can be present as a result of the damage within the joint and hence the bones of the joint rubbing together, which can lead to further degeneration or stress between joint surfaces. The nature of the injury highly influences the type of knee injury footwear that would be most beneficial.

There are many preventive measures that can help to alleviate pain or discomfort from a knee injury. Some of these are weight loss, using proper footwear to prevent knee pain, using a walking aid, doing t’ai chi, and doing yoga. However, one of the easiest and most effective of these remedies is often overlooked. An individual who has knee pain as a result of an injury can prevent further problems by wearing the right knee injury footwear. As the old adage goes, an ounce of prevention is worth a pound of cure. Considering that an investment in proper footwear can greatly decrease the likelihood of further knee injury, it is clear that taking the time to choose proper knee injury footwear is certainly worth the effort.

Maintaining Good Posture

Maintaining good posture in activities such as walking or lifting can be key in reducing neck and back pain. When walking, one should maintain a straight line with the head, shoulders, and hips, and avoid tilting the head up or down or shifting the hips too far forward or backward. These are common problems to which most people are not conscious of. Focusing on posture during lifting can be helped by tilting the pelvis forward and pushing the hips back to keep the back straight. Always lift with the legs and avoid bending at the back. Imagine a straight line extending from the top of the head down through the rest of the body.

The Ideaworks Posture Perfect Duro-Med cushion is an example of a simple aid to help maintain a good sitting posture. This cushion tilts the pelvis slightly forward, restores the spine’s natural curvature, and provides lumbar support. This cushion can be used on any seating surface and is both firm and comfortable.

Good sitting posture looks like this: the knees should be level with the hips or slightly above, and the feet should be flat on the floor. A small cushion may be needed to support the back, or the cushion in some chairs might need to be removed. Again, it is important to keep the back straight. Reclining or leaning forward can be tough habits to break, but altering this aspect of posture can greatly reduce back and neck pain. Try setting a reminder or an alarm, or leaving notes in places where they will be frequently seen, to help establish the practice of good posture.

Maintaining a good posture keeps the body “in line.” Some people can attain a good posture by simply standing against a wall; however, others need a bit more help. A physical therapist can provide exercises to help force the body to stay in good posture. It is important to remember to do these exercises regularly because it is easy to slip back into bad posture. Sometimes, something as simple as imagining a straight line extending from the top of the head down through the rest of the body can help to attain good posture. This practice needs to be consistent whether sitting or standing. An easy way to find out if posture is being maintained while sitting is to place a small, flat wood board on top of the head. The board should make contact with the wall behind it if good posture is being maintained.

Applying Heat and Cold Therapy

There are a variety of ways to apply heat and cold therapy, and any one may be better suited to you and your circumstances. However, as a general rule, the most common and effective methods are to either use a hot water bottle, wheat pack, or heat pad for around 20 minutes at a time, or to use a packet of frozen peas or ice pack, also applied for around 20 minutes. It is important not to apply extreme temperatures to the skin and also to avoid using heat after exercise, immediately after an injury, or if an area is swollen. It is also important to ensure that you do not fall asleep on a hot water bottle, as this can, in extreme cases, cause burns. Heat and cold therapy should be useful in reducing pain or spasm in an injury and can allow you to begin rehabilitative exercises or other treatment. Often, it can be a useful adjunct before exercise. Note that these treatments may only provide temporary relief and should not be heavily relied upon in the long term. If the problem persists, it is advisable to check the usage of the treatments with a medically trained professional to see if they are correct and if there is an alternative method.

It is also important to prevent the recurrence of knee injury, as people who have a previous injury are more likely to develop pain and functional impairment in the future.

Certain occupations and sports can be detrimental to the health of the knees. If possible, consider your knee health when choosing a job or type of sports activity. High-impact activities and “twisting” motions are more likely to cause damage to the knees. If you are unable or unwilling to change your occupation or give up a specific sport, be sure to maintain strong and flexible muscles to support the knees and avoid injury. This is achieved through specific training exercises for the muscles surrounding the knees.

Weight management, through a healthy diet and regular exercise, is essential in preventing and managing knee pain. For people who are overweight, losing even a small amount of extra weight can help to relieve pain and prevent the progression of knee damage. Regular exercise is also beneficial for people of a healthy weight, as this helps to keep the knees healthy and the rest of the body.

Knee complications can limit a person’s mobility and thus negatively affect their quality of life. There are many factors that can increase one’s risk of developing knee problems. These include being overweight, occupation, sport activities, muscle strength, and previous injury. The good news is, it is never too late to make positive changes that can reduce the risk of knee problems in the future.

The best way to tackle a problem is to prevent it from happening. If you already have knee pain, making these simple lifestyle changes can prevent your pain from getting worse in the future. The changes are not easy and may be inconvenient at times, but to prevent the progression of your knee pain and preserve your knee function, it is worth making some changes.