The Aging Knee – What Can You Do?

Knee pain is a common problem, faced by many. While sportspersons are more prone to knee pain, the aging knee is also a known problem. As you continue with walking, exercises, and all other activities all through your life, your knees keep getting worn out. For people in the 45 plus age group, knee pain may be a common complaint. More importantly, if you do not take the right action at the right time, your knee pain can continue to worsen and result in more problems with advancing age.

Knee pain that occurs with aging is often a result of damage to the cartilage present in the joint. The cartilage present in between the thigh bone and the shin bone acts as a cushion in the knee joint. Normally, the cartilage absorbs a huge amount of pressure as you use your knees for different movements. With regular wear and tear, the muscles and ligaments, which are the supporting structures of the joints, get weaker. Slowly, the cartilage in the knee or the shock absorbers, begin to deteriorate. Thus the cartilage that protects the end of both the leg bones gets worn out. Hence, the end of the leg bones get exposed and begin to rub against each other. This can cause pain, swelling, and stiffness in the knee. This is the aging knee.

Simply said, the aging knee is the degeneration of the knee. The changes occurring in the knee due to wear and tear of the joint and its surrounding tissues are the degenerative changes. The aging knee may end up in osteoarthritis of the knee, which is one of the major causes of disability among the aging people.

This can cause inflammation in some while it may remain non-inflammatory in most cases.

Who is more prone to the aging knee?

The aging knee is often a result of natural wear and tear of the knee joint. Aging is the more important risk factor for osteoarthritis of the knee. While the degenerative process begins when you are young, it can show up as you grow older. The phase of 45 plus is crucial because, for many, the overall health condition too may begin to decline during this period. The hormones, lifestyle, and nutrition too may be a concern. With aging, the cartilage becomes more brittle and with less physical activity, it can easily get damaged. Factors like increased stiffness of ligaments, loss of normal bone structure, and cartilage degeneration contribute to the aging knee.

The general risk of the aging knee include

• Excessive use of the knees, either for sports, occupation-related movements, or other activities that can wear out the knee easily.
• People who have been overweight are more prone to have an aging knee, as the bodyweight exerts more pressure n the joint and cause early deterioration.
• Those who have a family history of osteoarthritis of the knee may be at greater risk due to genetic factors. The lifestyle choices of a family may also contribute to it.
• Early degeneration can be due to knee injuries, particularly in sportspersons or anyone involved in high impact knee movements. Ligament tears, meniscal injuries, muscle and bone injuries around the knee can cause early damage to the knee joint.
• Infections of the joints or more particularly those affecting the knee can result in early degeneration and cause the aging knee.
• Lack of adequate exercise can cause inadequate muscle strength, poor joint fitness, and result in muscle weakness with joint deterioration.
• Other factors like lifestyle choices, faulty dietary habits, lack of vitamin C and D, smoking, poor posture, structural changes, improper bone alignment, foot deformities that cause knee problems, etc. may contribute to the occurrence of the aging knee.

How to you know you have the aging knee?

The aging knee or osteoarthritis of the knee presents with knee pain, stiffness of the joint, and sometimes swelling around the knee area. The pain may be more after physical exertion, long hours of standing, or in the evening or night after the day’s work. Gradually, it may also become stiff if the knee remains in one position for long or after being inactive for long. Some people feel a sharp pain on rising from the chair, when stepping after a long time or when climbing stairs. It may be difficult to sit on the floor, sit cross-legged, or bend the knee completely. Brisk walking, running or other activities can cause knee pain and swelling in the knee. If this continues for long without any treatment and care, it may result in chronic knee pain.

The doctors diagnose this condition based on history, clinical examination, and scans like knee X-Rays, or other scans if needed.
What can you do for the aging knee?

While it is true the knee can degenerate with aging, it does not mean that you can let it affect your life. There is a lot you can do to protect your knees. Here are some effective ways.

• Stay active
  Even before your knees begin to pain, plan ways to stay active and do regular physical exercises. If your knee pains, you can choose low impact exercises like walking, swimming, or aqua aerobics. Wear sports shoes or footwear that have a cushion as a shock absorber, to protect the knee.
• Strengthen your muscles
  Strong muscles help absorb the pressure and stabilises the knee joint. Take professional help and plan exercises to strengthen the core, hips, and leg muscles. Doing static quads, step-ups, squats, can help.
• Lose weight
  Follow a healthy diet – a low calorie – high protein diet to maintain knee health and lose weight. Shedding some kilos can decrease some pressure on the knees and relieve knee pain to a great extent.
• Increase your range of motion
  As you begin to age, pay attention to your range of motion. Being able to straighten or bend the knee, standing, or walking without pain, sitting cross-legged is healthy. If not, seek medical advice and plan exercises to improve your joint movement.
• Improve your diet and lifestyle
  Avoid smoking and colas, as they are unhealthy for your bones. Increase the intake of food rich in proteins like legumes, dals, sprouts, eggs, and calcium-rich foods like milk and milk products, ragi, green leafy vegetables, and moringa. Go for a walk in the sun for the daily dose of vitamin D. If needed consider taking nutritional supplements.

Talk to your doctor and physical therapist to plan the best treatment and exercise regime for your condition. For some, simple tips like being active, climbing stairs, playing with kids can protect you from the aging knee. In our next blog, we will discuss if injuries can cause more joint damage and ways to prevent them.

References
1. Age-proof your knees/ https://www.health.harvard.edu/pain/age-proof-your-knees / Accessed on 21/08/2020

2. Why is Osteoarthritis and Age-Related Disease? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2818253/ Accessed on 21/08/2020

3. A naturally aging knee, or development of early knee osteoarthritis?/ https://pubmed.ncbi.nlm.nih.gov/30041054/ Accessed on 21/08/2020