Well, of course that's true.
There is no easy fix for knees that hurt, that maybe swollen, have weak cartilage, and belong to someone who wants to stay active.
According to the article, "Active people in their 40s and 50s are challenging doctors to provide treatments that not only keep them walking but keep them running and jumping as well."
And then later, "....scientists at Exponent Inc., a scientific consulting firm, projected that the demand for replacement knee joints would more than sextuple by 2030, with 3.48 million people in need of a new knee."
Dr. Andrew Spitzer, the director of the joint replacement program at the Cedars-Sinai Orthopaedic Center in Los Angeles, believes that one of the reasons for the rise in knee pain and demand for surgery is that people are "keeping fit" but that this activity is creating too much physical stress and leads to wear and tear of the joint.
I don't think you can call your self fit if, when you go for a run, your knee swells, you limp for three days, and then hurt for ten more days and eat Advil like sweet tarts. I think you may be fit in certain parts of your body perhaps. May have enough flexibility but your your joints aren't fit. They're giving you fits.
What you need is a strategy to help you increase your joint fitness or at least try to before going the surgical route. Joint fitness is a new concept but is based on the science of mechanobiology. Mechanobiology is the study of how mechanical forces generated within or imposed upon living tissues affect the physiology and structure of that tissue. Joint fitness depends on something called "mechanotransduction" - the process the body uses to convert force into cellular responses.
Now, come on. You have to admit that that is very cool. Just flat out superior design.
Okay. I know. All of that has a high geek factor but it's important and the reason is that it's not new.
The best known application of mechanotransduction is bone healing. When you break a bone, the bone heals from the application of force. The force alters cell response. It tells the cells what to do. Too much force, too soon, and the bone heals slowly or sometimes not at all. The same goes for too little force for too long. Incomplete bone healing.
When it comes to cartilage though, clinicians and the general public struggle with the idea that the same principle applied to bone could apply to cartilage even though there's evidence suggesting that it does.1, 2
And, by the way, the LA Times article lists options for people with knee joint pain and one of them, and I'm going to quote this because it seems so bizarre is "...Painkillers and anti-inflammatories are a good option for early arthritis, Feeley says, if they relieve your pain and allow you to stay active."
Well, sometimes, yes, that's what you must do to get through life. But, what most people do is eat a few Motrin or Advil and then go for a run or a workout to keep from hurting or swelling or having a stiff achy knee the next day. That is not a good idea. I've written about this before (here, here, and here.)
A few things the Times left out in addition the mechanobiology of exercise, include:
- Prolotherapy
- Platelet Rich Plasma
- Stem cell therapy
The options for people with joint pain are getting better and better. Unfortunately, the Times is behind the times.
If you want the whole LA Times article, click here.
PS - Some of this information and much more is covered in great detail in my book, The Runner's Knee Bible. Click here for more information.
1. Roos, E. M. and L. Dahlberg (2005). "Positive effects of moderate exercise on glycosaminoglycan content in knee cartilage: a four-month, randomized, controlled trial in patients at risk of osteoarthritis." Arthritis Rheum 52(11): 3507-14.
2. Roos, E. M. and L. Dahlberg (2004). "[Physical activity as medication against arthrosis--training has a positive effect on the cartilage]." Lakartidningen 101(25): 2178-81.
