By Dr. Cori Grantham
As the life expectancy and retirement age continues to increase in the United States, people are now living longer and demanding to be more physically active much later in life. The key to being able to continue with an active lifestyle as you age is the preservation of your joints. Not only does joint preservation allow you to stay active longer, but it is also important in avoiding injuries and even surgery due to improper use.
Cartilage is the single most important structure in preserving joints. Cartilage, better known as your joint “cushion”, is flexible tissue that covers the ends of bones, enabling them to move against each another without causing wear or friction. As you age, cartilage begins to wear down and thin over time. This process can be accelerated by excessive wear or pressure on joints, or by trauma or injury. The problem with cartilage loss is that it cannot be replaced! There is no treatment, surgery, or magic pill to restore lost cartilage, which is why preserving it becomes so important.
There are several ways to prevent excessive wear of cartilage. The first is by avoiding activities that increase stress on joints. This is most commonly seen in knee pain. The knee joint, in particular, receives a tremendous amount of stress during activities. For example, 3-4 times your body weight stress is felt through the knee with activities, and 7 times your body weight stress can be felt at the knee cap with bending or squatting activities. To avoid premature thinning of cartilage, it is important to limit high impact, or “pounding” activities. Such activities include running and jumping. Consistent pounding places too much impact and pressure on cartilage and can cause it to thin. It is also important to avoid too much stair/squatting/lunging activities as it places too much stress on the knee cap and increases wear and friction of the cartilage behind the knee cap. Low impact activities that are good for joints that provide increased resistance with little stress include swimming and cycling. If running or any of the popular high impact trends (Crossfit, Insanity workout, P90X) are your absolute favorite workout activities, make sure to alternate these activities with other low impact activities to reduce the amount of stress on joints. It is also important to change up your exercise routine to prevent overuse of the same joints and muscles over and over again. This can be done by changing how many days a week you do certain activities, changing the surfaces on which you are training (running on the pavement versus a track), and utilizing different types of cardio workouts such as cycling instead of running.
Strengthening your muscles also decreases the amount of stress placed on joints. Without proper muscle support, your cartilage in your joints takes the full force applied to it, while a strengthened joint shares the load with the surrounding muscles. For the lower extremities in particular, core and hip strength is the key in preventing excessive wear and overuse to the hips, knees, and ankles. Your legs act as a chain, starting at the spine and progressing down to the feet. Weak hips, for example, will cause problems not only in the hip, but will also change the alignment of the leg. This, in turn, can cause increased forces and strain down the chain to the knee and ankle. Sometimes, symptoms in one joint are actually caused by problems in another joint that is create this chain reaction.
If you already have cartilage loss, it is important to care for and nourish your existing cartilage and slow the progression of loss. Certain supplements, prescription medications, braces, and injections may be options for you depending on your particular diagnosis and wear pattern. It is important to discuss these options with your doctor to tailor a treatment plan that is specific to your needs.
Cori Grantham, MD, is a Dallas native who provides comprehensive orthopedic and sports medicine services at The Texas Institute for Surgery. To learn more about Dr. Grantham, visit www.TexasInstituteForSurgery.com or email firstname.lastname@example.org.