En español | If you've walked, jogged and hiked this far without any major knee trouble, there's more you can do than thank your lucky stars. A few basic steps can help you protect your knees as you age.
Besides being the largest joint in the human body, “the knees are unique in that the motion involved is very complex,” says Sanjeev Bhatia, an orthopedic sports medicine surgeon and codirector of the Northwestern Medicine Hip and Knee Joint Preservation Center at Central DuPage Hospital in Winfield, Illinois. “The knee has three compartments, any of which can cause pain with wear and tear.”
With the passage of time, a certain amount of wear and tear on your joints is inevitable. But it doesn't have to affect the way your knees feel, function or move. If you experience a clicking or popping sensation in the joint when you walk, bend or lunge, but there's no pain or swelling, you don't need to worry about it, says Dennis Cardone, D.O., an associate professor of orthopedic surgery and sports medicine at NYU Langone Health in New York City. On the other hand, if you have pain or swelling with that clicking or popping, it's best to schedule a visit to your doctor.
Otherwise, to minimize your risk of experiencing pain, stiffness and inflammation in your knees, take these steps to protect these essential joints.
1. Maintain a healthy weight.
Toting around excess weight places tremendous pressure on your knees. “For every pound of weight you put on, the knees will have four more pounds of force on them and even more than that when you go up or down stairs,” says John-Paul Rue, an orthopedic sports medicine surgeon at Mercy Medical Center in Baltimore. The flip side is true, as well. For every pound of excess weight you lose, you'll spare your knees from having to cope with four additional pounds of extra force.
2. Keep moving.
Regular physical activity helps maintain joint function, including strength and range of motion in the knees, which “means less force gets applied to the knee,” Bhatia explains. Although it used to be believed that high-impact activities such as running are bad for the knees, the latest evidence shows that's not necessarily true. But there is a sweet spot for runners: A meta-analysis of 17 studies, published in the Journal of Orthopaedic & Sports Physical Therapy, found that recreational runners had a much lower risk of developing osteoarthritis of the knee than competitive runners and sedentary people did. “If you run, don't run on successive days; do it every other day, because we don't recover as well as we're aging,” Cardone points out. It's also wise to mix up your workout routines; so if you run three times a week, do something low-impact, like bicycling, Pilates, swimming or using the elliptical machine, on the in-between days.
3. Strengthen the muscles that support your knees.
Developing strong thigh muscles — especially the quadriceps, hamstrings and abductors — improves range of motion, protects knee cartilage and reduces the stress you place on the knee, says Richard Willy, an assistant professor of physical therapy at the University of Montana School of Physical Therapy and Rehabilitation Sciences. Get in the habit of doing squats and lunges twice a week, making sure that your knees stay above your feet and don't extend in front of your toes. After age 50, avoid squatting below a 90-degree angle (with your hips dropping below your knees), because deep squats increase pressure on the knees, Cardone warns. If you prefer to use weight machines, opt for the leg press, hamstring curl, knee extension and outer-thigh (abductor) machines, Willy advises.
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4. Perfect your posture.
“People often slouch or get more stooped over as they get older,” Cardone says. This is problematic because poor posture changes your body's center of gravity, placing added stress on your knees and hips. So make a point of standing tall, with your head in line with your shoulders, your shoulders directly over your hips, your hips aligned with your knees, and your knees aligned with your feet. Doing “Pilates, yoga, tai chi and core-strengthening exercises such as planks and back extensions can help improve your posture, prevent irritation under and around the kneecaps, and help you avoid falling,” Cardone adds.
5. Choose the right shoes.
Wearing supportive, comfortable shoes promotes proper alignment of the joints in your lower extremities as you move, explains Barton Branam, M.D., an assistant professor of orthopaedic surgery at the University of Cincinnati. For exercise, choose kicks that suit your activity — say, running shoes for running — and that are appropriate for your gait and foot (whether you pronate or supinate, for example), Branam advises. Believe it or not, research suggests that postural abnormalities of the feet can contribute to knee osteoarthritis, which is why it's important to wear shoes that help prevent inward or outward rolling of the feet during movement. If you're in the market for new exercise footwear, it's a good idea to get professionally evaluated and fitted by someone at a top-notch running or sporting goods store, Branam suggests. When you're not exercising, avoid high heels, which increase the load that's placed on your knees, Willy says.
6. Listen to your knee pain.
If you develop pain and swelling in your knee, take a break from walking, running or any other high-impact activity you're doing. Give your knee the RICE treatment — rest, ice, compression and elevation — and take an anti-inflammatory medication such as ibuprofen, Rue advises. “If it gets better on its own, you can go back to what you were doing,” he says. If it doesn't respond in a week or two, have it looked at by a doctor. In the meantime, you can continue to exercise by doing a gentle activity, including swimming, aqua aerobics or bicycling, Willy says, so that you don't lose any of the fitness you've been building.