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Is Knee Pain Ruining Your Good-Health Goals?

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Peopleimages/Getty Images,

by Sarah Mahoney

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From weekend warriors to couch potatoes, millions of Americans insist that midlife knee pain is just a fact of life. But knee surgery—or decades of popping pain pills—isn't inevitable. Gregory M. Martin, M. D., author of

Education 4Knees: Everything You Need to Know for Happy, Healthy and Pain-Free Knees fills Life Reimagined in on the biggest midlife myths, and the essential ingredients for rewriting your relationship with your knees. Read this, and never let knee pain get in the way of your health and fitness goals again. 

How long does the average knee last before it starts giving trouble?

I see people at 90 with healthy knees, and people who are 30 where the cartilage is so worn down their knees are bone-on-bone. It depends, but about 34 percent of Americans over the age of 54 say they suffer from chronic knee or leg pain. And nearly everyone’s knees will give trouble eventually. About 7 million Americans, or 1.5 percent, have had a knee replacement.

Most people know there’s a link between being overweight and knee pain, but how big is the connection?

Huge. A lot of Americans are overweight, and each extra pound puts about four pounds of pressure on knees. So someone who is 50 pounds overweight is actually putting about 200 pounds of pressure on their knees. Imagine what a relief it would feel like to set down a 200-pound weight—and often, when people lose even smaller amounts of weight, they get enough pain relief that they no longer need medication.

So fitness is key?

Yes, but not to losing weight. You don’t exercise to lose weight; you do it for good health. We all know you need to stay on a treadmill for some time to burn off 300 calories. But you can eat that many calories in cookies in less than a second. But exercise is very important for knees and keeps the cartilage alive and healthy. (Unlike other tissues, cartilage lacks blood vessels to carry nutrients.) Try and exercise 30 minutes a day, five days a week—it doesn’t have to be strenuous, and it doesn’t have to be all at once.

That’s a tall order for people who say their knees hurt, though.

Yes, but the worst thing you can do for knee pain is nothing. I think almost everybody can exercise. I don't think they should do it through severe pain, but there may be a little bit of achiness. There’s basic walking, elliptical trainers, things you can do in a pool. Every person is different. But if you do nothing, your muscles get weak and your joints get stiffer.

What about the people whose knee pain comes from too much exercise?

I hate to see people stop doing the things they love. There are almost always modifications. So maybe die-hard tennis players find relief when they start playing doubles. Or hikers get more comfort when they take on smaller mountains or wear compression sleeves. You have to learn ways to support yourself that are healthy. And exercise is so important to overall well-being, not just knee health.

People get in this terrible cycle with knee pain. It hurts, so they can’t exercise. They gain weight and get depressed. Depression worsens the pain. Exercise is the way to break that cycle.

Gregory M. Martin, M. D.

How so?

Exercise is one of the best anti-depressants, and we’re finding, more and more, that there is a tremendous link between pain and depression. So people get in this terrible cycle with knee pain. It hurts, so they can’t exercise. They gain weight and get depressed. And depression worsens the pain. Exercise is the way to break that cycle, and the pain improves.

What about knee noises?

All joints can be noisy. If the sound comes with pain or discomfort, talk to a doctor.

What about knee replacement or other surgery?

I’m a surgeon, so I’m quick to tell people that it’s a mistake not to get surgery when you need it. But it is the last resort. There’s so much we know about the role of hydration and nutrition, for example, including eating a diet that isn’t inflammatory. There are injections and topical creams.

The most important things is that people know they have some control over how knees feel, based on how well you treat your body. There’s no magic pill. But there are simple solutions to manage those aches and pains.