When you have knee arthritis, you have concerns that most of us take for granted: Where will I park? Will there be hills? What about stairs? What’s the weather supposed to be like this week? As an orthopedic knee specialist, nothing makes me happier than getting patients to a point where they don’t have to worry about these things any more.
However, it isn’t easy. Arthritis—an umbrella term for more than 100 conditions—for the most part cannot be cured, only managed. Additionally, many everyday activities that most people won’t think twice about doing can cause a painful flare-up in someone with knee arthritis.
Osteoarthritis (OA), one of the most common types of arthritis of the knee, has doubled in the U.S. since the mid 20th century. Age and body mass index (BMI) are predictors of knee OA, and while we’re living longer and carrying around more weight, that’s not the whole story. Researchers aren’t sure what else is giving us more knee osteoarthritis, but there are some steps you can take to either reduce your risk or mitigate your symptoms.
The most common types of arthritis of the knee are OA, as stated, and rheumatoid arthritis (RA). Though they have similar symptoms—pain, swelling of the knee joint, stiffness, instability—they work in very different ways.
OA is degenerative—it’s a wear and tear of cartilage over time and often affects people over the age of 50. The cartilage that wraps the ends of bones and let them glide smoothly together, called articular cartilage, wears away, and bone spurs often develop as a result.
RA, on the other hand, is an autoimmune disease. Your body’s immune system mistakenly recognizes the synovial membrane (a layer of connective tissue that makes lubricating fluid for the joints) as an invader and attacks it, causing inflammation and pain. RA usually affects both knees at the same time.
There is a third somewhat common type of knee arthritis called post-traumatic arthritis. This type develops after an injury to the knee. It’s caused by an injury damaging the joints’ articular cartilage and it can present months or even years after an injury.
Risk Factors for Knee Arthritis
Knee arthritis—whichever type you have—has certain risk factors, some you can control and some you can’t. Risk factors you can’t control include age and gender; older adults are more prone to arthritis and women are at greater risk than men for OA and RA.
The number one knee arthritis risk factor you can control is your weight and body mass index (BMI). A 2016 meta-analysis suggests that your risk of RA rises by 13 percent for every five-point increase in BMI (measured in kilograms/meters2 or kg/m2). That risk is even higher for knee osteoarthritis: 35 percent for every 5 kg/m2, according to a 2015 meta-analysis.
Other risk factors for developing knee arthritis include:
- A previous injury
- Certain bacteria and other infection-causing microbes
- Genetics and family history
What You Can Do
Arthritis has no cure, but many of my patients with knee arthritis live normal, active lives by making smart lifestyle choices and proactively managing their health. Here are some of the most effective arthritis management strategies and techniques:
Lose weight: Losing weight is one of the best things you can do for your arthritis and for your knee health in general. For every pound you lose, you take about four pounds of pressure off your knees. By staying at a healthy weight, you’ll reduce your risk for OA, RA and a host of other serious health problems like heart disease and type 2 diabetes.
Exercise right: If you have knee arthritis, you have to be smart about your exercise choice. Choose low-impact cardiovascular exercise like swimming, biking or the elliptical machine in favor of running. Otherwise, when you’re pounding the pavement, you’re really pounding on your knees, and you may find yourself in the midst of an arthritis flare-up during or after your jog.
When doing resistance training, be careful about loading up the weight on squats, lunges and leg presses, which puts pressure on the knees. Bodyweight squats are probably safe as long as they don’t hurt. Think about kettlebell swings and deadlifts to work your hamstrings and glutes, and the leg extension machine for quads.
In my practice, I’ve treated hundreds of people with arthritis of the knee, many of which lead lives with minimal pain when they take the right steps. If you have knee arthritis and are seeking strategies to manage symptoms, request an appointment with me or one of my colleagues.