Making your knees last longer

Making Your Knees Last Longer – by Mia Bremer
One wrong step four years ago changed my life, or at least my knee! I was playing tag with my granddaughter at the neighborhood park. I was coming around behind her as she hid on the slide and I ran across a swinging bridge, I came down on the bridge with my right leg. Unfortunately, the bridge came back up to meet me and crushed my tibia. That was the end of the game! After a year of healing, my doctor and I decided a total knee replacement was the best option and, I’m happy to report, it was! I can now run (albeit a bit like Ruth Buzzy of Laugh-In fame), jump and walk for miles!

I had an accident, a moment, but knees give us problems as we age for many reason. Sometimes it’s in an instant. But more often, knee problems arise over years and decades of muscular imbalances, bad shoes lack of exercise and a myriad of reasons. There are many things we can do to avoid or manage knee problems and like most of what I talk about in this column, it comes down to targeted exercise.

First, it helps to understand that the knee is a simple hinge joint which, in other parts of the body, doesn’t create as many problems – think elbows. The elbow is also a simple hinge but overall, it gives us fewer problems. The knee, however, is in between two complex joints; the hip and the ankle which take a lot of wear and tear. Muscular imbalances, weakness or tightness in the muscles are these two joints have a direct effect on the simple knee joint. So, along with strengthening the muscles that act directly on the knee; mainly the quadriceps and hamstrings, it’s important to understand the ways the hip and ankle joints are affecting your knee.

The knee joint needs to be aligned appropriately to allow the cartilage that cushions the joint to wear evenly over time. Muscular issues in the hip and ankle, however, can put undue stress on the knee joint, causing uneven wear or causing the joint to wear out sooner. Extra weight also causes the joint to wear more quickly. A personal trainer or physical therapist is your best bet in determining where you, specifically, need to strengthen and stretch, but there are some great exercises that most of us need to focus on in our workout routine as we age. You can find examples of these exercises online by Googling the names of the exercises I’ve included.

Gluteal and Abductor Strength
The three gluteal muscles – Gluteus Minimus, Gluteus Medias and Gluteus Maximus provide protection for the hip, movement at the hip joint and hip stability, especially when the weight is on one leg as when walking. Weakness in any of the glute muscles can affect movement patterns and change your gait which not only affects the hip joint itself, but the knee joint as it compensates for deviations in your gait. Exercises to strengthen these muscles include squats, side leg lifts (best lying on your side), rear leg
lifts, hip hikes.

Hip Flexor/Quadriceps/Hamstring Flexibility

These muscles are often tight from all the sitting we do in our lives. Tight muscles at the hip mean lack of mobility, which can negatively change your gait or walking patterns. Tight muscles shorten your steps, pull your torso forward, tuck your tailbone under and cause gait changes that, again, the knee must accommodate. Exercises to stretch these muscles include Warrior pose/hip flexor stretch, quadriceps stretch – standing or side- lying – supine hamstring stretch.

Ankle Range of Motion
Tightness or weakness in the muscles surrounding the ankle joint can change the degree of flexion and extension of the foot as we walk. Our ability to lift our toes or push off through the ball of the foot when we walk changes our gait pattern which, just like the hip, forces the hinge joint of the knee (which has less motion than both hip and ankle) to adjust, causing uneven wear of the knee joint cartilage. Exercises to improve range of motion include toe raises, heel raises, ankle circles.

Proper Shoes
Many of us wear a few pairs of favorite shoes for years and years. These shoes have long lost any support they provided. And many shoes we purchase have poor support to begin with. The support and cushioning provided by proper shoes can correct gait deviations and lessen the wear and tear on all three joints: hip, knee, and ankles. Good shoes are expensive, and inserts add to the cost (and are usually needed since no shoe is right for every foot) but they are less expensive than knee replacements and worth it if the shoes can help reduce pain when you walk. Budget for good shoes and cut costs elsewhere. And replace athletic shoes a few times a year.

Knee pain can also be avoided or lessened by doing a couple of simple things. When you get out of a chair, do you rock forward onto your toes? If so, you are putting repeated strain on your knees. Instead lean your trunk forward slightly keeping a straight spine and put most of your weight into your heels of your feet using the muscles of your glutes and legs rather than momentum stand.

Do you walk or run up stairs on your toes? When you put most of your weight on your toes, your femur – the big bone of your thigh – is propelled down and forward by gravity. The only thing that stops this bone from continuing its forward projection is your kneecap which is held in place with ligaments. Instead, try to place your whole foot on the step as you walk up a flight of stairs. Again, push through your whole foot. This helps you to engage your glutes and thigh muscles.

Like many things in our lives, we can affect our health outcomes through exercise and proper diet. Thank goodness for good medical care and it’s empowering to know that our lifestyle choices make medical care even more effective!