On my knees!

April 13, 2009 4:16 PM

How do knees stay healthy?

I'm a young woman with healthy knees. At least, I think so. They never hurt. Though, lately, probably because I'm heavier presently than I like to be, they get stiff sometimes, or even go "pop" a little. This when I've been sitting Indian-style or curled up some other way for too long. Nothing that I think is too worrisome, and I've been chalking it up to reduced flexibility commensurate with reduced range of motion or "fat thighs." But it has me thinking...

My question is really pretty general: What can I do to keep my knees healthy? What are the knee-dos and knee-don'ts? I love my knees, I love to hike and bike and... WALK with them. Yeah that walking, it really rocks my world. What should I know to make sure they stay functional as can be for another 80 years?

Of course, I know one thing is: Lose weight! (So please don't everybody say that, agggghh.)

posted by Ambrosia Voyeur to health & fitness (17 comments total)

I think you're probably already doing the right things. Eat right, exercise, don't do things which hurt your knees. I put running on asphalt in that category but YMMV -- my knees are a bit sensitive so they always get sore after a long time standing on concrete or when I was trying to run out on the streets.

Your cartilage, I recently learned, is sort of sacred -- once your cartilage goes there's no going back (it cannot be repaired and cannot repair itself). However, that is usually related to trauma or arthritis. I'm guessing that a well-balanced diet with Omega-3s, lots of water, calcium and lots of green, leafy vegetables is good for your whole body.

Yoga is great for balance and flexibility -- I so wish I could work a regular routine into my life. Actually, all kinds of exercises which focus on balance are great for your body and will help you prevent a fall which could create an injury. As you get older these things become more apparent.
posted by amanda at 4:32 PM on April 13

Lose weight. Your skeleton will thank you. Whenever I lose weight I notice my bones and muscles are less achy. This is probably due to getting more exercise and carrying less weight around.

Outside of that get into yoga (mildly, carefully, don't overdo it) and also learn how to stretch properly. Avoid skiing, rollerblades, bicycles that aren't properly fitted and adjusted and other sports or activities where your knees get torn up. Eat well. Make sure you get enough protein, which is hard to do with your veggie-fish diet. (speaking as someone who has been vegetarian and borderline vegan)

Also, a workout with a high repetition and low weight count (as found in any sane weightlifting/workout routine that isn't designed for "body-building", IE, intentionally tearing and stressing muscles for bulk) will help strengthen and tone the muscles and tendons that make up the knee.

Most people seem to have problems with their knees either due to overdoing it or not doing enough.

Also, you're just getting old. I can barely sit on the floor any more and I used to prefer it to chairs. Now if I sit on my knees for 5-10 minutes they're either complaining loudly or dead asleep and as useless as dry twigs.
posted by loquacious at 4:36 PM on April 13

Lose weight. Keep the muscles around your knee strong. Avoid knee destroying sports. Stretch.

I had two knee surgeries when I was in my twenties. Now at 43 both knees just suck. Take care of them now and you'll thank yourself later in life.
posted by DieHipsterDie at 4:46 PM on April 13

There are some strengthening exercises for other muscles in your legs (notably the quadriceps) that you should do. Strengthening the rest of your legs goes a long way towards reducing stress on your knees.

I'm sorry I can't remember any of them right now. A doctor gave me some exercises after I hurt my knee in my early 20s. I sure wish to hell that I could remember them, and that I'd stuck with them, because now in my mid-30s, I creak and pop like a freaking middle-aged linebacker.

Do some investigation into strengthening your leg muscles, yo.
posted by mudpuppie at 4:47 PM on April 13

Stretch & strengthen. IIRC, my physical therapist once recommended leg lifts and wall slides or squats or something. (I don't know what they're called, but I still do them.)

Avoid injury. I know, accidents happen. But do be careful. From my own experience, and those of others, it seems that every accident after about 30 is much more serious to deal with.

Yeah, losing weight may help. I've been pleasantly surprised by that one myself.

I find that Omega-3 helps my knees and ankles a lot; fewer achy nights, in particular.

(I'm 34 with one arthritic knee. Stupid bicycle accident, grumble grumble grumble.)
posted by epersonae at 4:59 PM on April 13

Just in case, I'm going to link to some info on and Rheumatoid arthritis. R.A. can hit women quite young, and for me it started with stiffness in my knees after sitting too long. I just want you to be aware of the possibility, because it would require different treatment. The inflamation that leads to cartilage damage in R.A. is different then the wear and tear that leads to Osteoarthritis.
posted by saffry at 4:59 PM on April 13

Severed my ACL and tore my meniscus about 5 years ago and have been battling knee issues ever since. Here's my advice:

I take glucosamine, chondroitin, MSM supplements because they supposedly lubricate the joints.

I have Superfeet insoles in every pair of shoes, including dress shoes. This helps my feet, knees, and hips. http://www.superfeet.com/

try not to sit "indian-style" for too long.

I don't think your "fat thighs" have anything to do with it--I think you're just getting "old" and your knees can't handle as much anymore (this starts in the early 20s).

when you run/walk/hike, try to make sure your toes are pointed forward, and that you're not landing with your leg straight (as in, don't land on the back of your heels). Try to run on soft surfaces, like tracks, dirt trails, or, if you must, asphalt (not sidewalks). Try not to run on roads that are slanted.

Make sure to strengthen your hamstrings, as girls' usually have a strength imbalance between their quads and their hammies.

I avoid yoga, because it makes my knees too loose, but I think I have unusually loose and wobbly joints.

Cycling's great!
posted by alohaliz at 5:23 PM on April 13 [1 favorite has favorites]

Cycling is great because it is an exercise that works the knee in its plane of movement. Injury occurs, for example in sports such as basketball or skiing, when something happens to twist the knee one way or the other, and one of the various ligaments (ACL, MCL, LCL) is torn, or the meniscus is damaged.

However, you need to strengthen the quads equally, particularly the medial quad, so that the knee cap is not pulled unevenly. When stretching the muscles around the knee joint, make sure you include the ITB. One stretch is here.
posted by computech_apolloniajames at 5:59 PM on April 13

Cycle and swim.
posted by doncoyote at 7:06 PM on April 13

Also, a workout with a high repetition and low weight count (as found in any sane weightlifting/workout routine that isn't designed for "body-building", IE, intentionally tearing and stressing muscles for bulk) will help strengthen and tone the muscles and tendons that make up the knee.

Bodybuilding means exercising with aesthetics, rather than strength or endurance, as a goal. Strength training means training to get stronger, and is done with low reps (sets of 5 are usually recommended for beginners) and heavy weights. Doing lots of reps with low weight will not make you stronger, and it will not make you lose much bodyfat either, if that's what you mean by "tone."

There are some strengthening exercises for other muscles in your legs (notably the quadriceps) that you should do.

Weak quads are probably not an issue. As alohaliz says, most people are quad dominant. You want to strengthen your hamstrings to make your knees more stable. The best way to do so is to perform correct barbell squats as described in Starting Strength. The book explains the benefits of the squat to knee health in detail, but you'll only reap them if you perform the exercise properly, which means descending until your thighs are just past parallel with the floor.
posted by ludwig_van at 8:41 PM on April 13 [1 favorite has favorites]

Don't play rugby.

Or, if you do, be a back.
posted by pompomtom at 8:50 PM on April 13

Losing weight and swimming both helped me go from someone with occasional ouching knees to someone with totally decent knees. I was surprised, very surprised that both these things made such a measurable difference in my knee life so quickly.
posted by jessamyn at 8:52 PM on April 13 [2 favorites has favorites]

You mentioned bicycling. Most bicyclists ride in too high a gear. There is little damage you can do by spinning your legs "too fast", there is much damage you can do to your knees by pushing too hard. Newer road bikes have what are called "compact cranks", which are set up for a smaller set of chainrings and thus overall lower gearings. If you ride in a low enough gear and spend a good part of your ride doing high RPM "spinning", bicycling is a great low impact cardio exercise.
posted by idiopath at 11:01 PM on April 13

One "don't" - do NOT do weighted leg extensions - that machine where you tuck your ankles under a padded bar andthen straighten your legs against resistance. It's a terrible exercise and puts really unnatural stress on your knees.
posted by restless_nomad at 7:41 AM on April 14 [1 favorite has favorites]

I'm back to emphasize what someone said above about cycling. If you do take up cycling, get a proper fit on your bike. It makes a world of difference. I bought a bike over a year ago, a more upright cruiser, and the person who sold it to me didn't bother to do a rudimentary bike fit. I should have asked for it but it felt okay on the test ride so I didn't really think about it. I discovered that not only did I not like the style of the bike but that my knees were KILLING me. I took the bike back, got it fit and the person who helped me then said that the way it was set up was basically guaranteed to kill my knees. I rode it for a week after that and it felt immensely better. I ended up returning it because I still didn't like the style and got something else and got a fit on that one! So, it really does make a difference. After you ride for awhile and get good and comfortable on your bike, go back and get a more intensive fit.

Also, I went to a physical therapist some years ago for knee pain and whenever I find my knees acting up I make sure to incorporate "wall sits" into my routine. For me, that strengthens my quads and pulls my knee into alignment. After visiting the PT, I also lost about twenty pounds and that helped enormously.
posted by amanda at 9:41 AM on April 14 [2 favorites has favorites]

Keep your quads, hamstrings, calves, adductors, abductors and ankles strong. I like walking lunges, calf raises, and yoga best. I also brush my teeth and blow dry my hair while standing on one leg (balancing exercises force your muscles to constantly readjust, strengthening in ways that the repetitive, isolating exercises may not--but do those, too).
posted by Pax at 10:22 AM on April 15 [1 favorite has favorites]

Here's the first of a series of articles about preventing/fixing knee pain from someone I know and can vouch for.

The people who tell you it's a normal part of "getting old" are just wrong.
posted by tangerine at 12:59 PM on April 16 [1 favorite has favorites]