Greg McBride, CFA
Greg McBride, CFA, chief financial analyst for Bankrate.com, a personal-finance website that conducts annual nationwide surveys of fees at banks and credit unions, Palm Beach Gardens, Florida.
If you’re no longer as young as you used to be and you don’t already have arthritis in your knees… count your lucky stars and consider making it a priority to keep it that way. Osteoarthritis of the knee is among the most common orthopedic complaints and one that, according to current estimates, will cause discomfort for about half of us by the time we reach our 80s. The “cure” is knee replacement surgery, but it’s a major procedure and a painful one, which requires numerous weeks of arduous physical therapy. Clearly a better path is to do what you must to protect your knees now to assure their long-term health.
For information on natural ways to prevent knee osteoarthritis and keep them strong, I called Thom Rogers, ND, who taught orthopedics at Bastyr University in Kenmore, Washington. He told me that unfortunately, osteoarthritis is very often a byproduct of the aging process. It’s caused by erosion of the cartilage between the ends of bones, so they no longer are cushioned from rubbing together. Not to despair however, he says — there is much you can do to slow that development and protect your knees even when some arthritis has already set in.
The biggest gift you can give your knees is to normalize your weight. “Any excess weight you carry increases pressure on the knees,” says Dr. Rogers. Normal weight is ideal, but losing even a few pounds will help. A 2005 study from Wake Forest University demonstrated that each pound lost in total body weight reduces pressure on the knee by four pounds (which means conversely that every extra pound you carry loads on four additional pounds of pressure). Meanwhile a 2008 study from the University of North Carolina at Chapel Hill revealed that 46.9% of overweight people were at risk for having knee osteoarthritis in their lifetime, and that rate soared to 60.5% among obese people, compared with 30.2% among normal-weight people.
Exercise can help protect the knees, but it can be a double-edged sword. Dr. Rogers says that for many, intense sports are a set-up for knee arthritis. Sports that twist the knee, such as skiing and tennis, put great demands on the ligaments and joint capsule. Furthermore, he said, rotating the thigh bone (femur) while keeping the shin bone (tibia) stationary or vice-versa (again, think skiing) is challenging. “It grinds away on the meniscus, the tough cartilage tissue in the middle of the joint,” he says. High-impact sports that involve running and jumping, such as basketball and jogging, put compression on the joint — it’s better to get your aerobic workout in low-impact ways such as cycling, elliptical machines and/or swimming.
In addition to avoiding exercise that pounds your knees, Dr. Rogers says it is good to strengthen the surrounding muscles — the quadriceps in the front of the thigh and the hamstring muscles in the back. Find exercises that don’t put weight on the knees — for instance, squats are out. Weight training is good: An Australian study in 2008 evaluated 18 studies that totaled 2,832 patients with knee osteoarthritis and found that regular practice of weight training (upper body exercises and lower body resistance training) decreased joint pain and improved physical function and balance. Note: Dr. Rogers suggests using equipment that keeps your feet off the floor, such as a Nautilus for hamstring curls and quadriceps extensions, since doing so removes gravitational compression to the knees.
Chinese medicine advises eating marrow soups for prevention of arthritis, says Dr. Rogers — it’s easy to make a stock with a turkey or chicken carcass, which is a good, natural way of getting glycosaminoglycans (GAGs), which are the “building blocks of cartilage.” Also crucial are fruits, vegetables and grains. These whole foods have minerals, including copper, iron, zinc and manganese, which help synthesize the cartilage material.
Glucosamine supplementation has also been shown in many clinical trials to relieve pain while having fewer side effects than non-steroidal anti-inflammatories. Although it won’t work as quickly, over the long term glucosamine has been shown to be as effective as NSAIDs (such as Aleve) in reducing arthritis pain, but without risk to the liver, kidney and gastrointestinal tract.
You may have heard that nightshade vegetables — potatoes, eggplant, tomatoes and peppers — can aggravate arthritis. According to Dr. Rogers, these contain a kind of alkaloid that can cause a problem for people having an arthritis flare-up. He says that more than half of his patients benefit by avoiding nightshade vegetables during these times, noting they find it makes a significant difference in pain intensity.
One supplement Dr. Rogers often prescribes is high-quality fish oil for the omega-3s that reduce inflammatory chemicals in our bodies. Aging dries out the body and we start to lose the “juice” (or the quality of soft elasticity of the tissues found in youth) that in Ayurvedic medicine is called “ojas.” Ojas keep the body functioning smoothly and our joints supple and strong. The best way to maintain ojas is not only with omega-3s, says Dr. Rogers, but also by eating healthy foods every day and getting proper exercise. While it is true we can’t totally avoid losing our ojas, he adds, we can certainly modify the process — and in doing so retain some of its life-giving force.