In the chronology of unsolicited advice, few nuggets have been distributed so widely, and there is little evidence to support them.
The latest salvo in the knee and running debate — a systematic review of 43 previous MRI studies that have not found evidence that running causes short-term or long-term damage to the cartilage of the knee — is the knee in the ass. Swear your Thanksgiving table was triggered by a wind sprint. However, given that nearly half of Americans are expected to develop painful knee osteoarthritis at some point in their lives, the findings raise a daunting question.
How to Save Your Knees Without Giving Up Your Workout
- Nourishes the cartilage.
- Do it short and often
- Be aware of the influence of weekend warriors
- Stay away from ER
- Optimize the movement pattern
- Do not seek salvation in the jar
1. Nourishes the cartilage.
Researchers have recently begun to rethink long-standing doctrines about the properties of cartilage, a smooth layer of tissue that protects the bones of the knee and other joints, which is the main cause of osteoarthritis. Michaela Khan, a Ph.D. researcher at the University of British Columbia and lead author of a new review on running, said: And cartilage was published in Journal Sports Medicine.
But that’s not the case. Periodic weight-bearing activities such as walking and running compress the cartilage of the knee joint like a sponge, expel waste products, and draw a fresh supply of nutrient- and oxygen-rich liquid at each step. Cartilage is a living tissue that adapts and thrives with regular use in place of the inert shock absorbers, which are destined to become brittle and eventually fail with age, Khan said. So, for example, a small 2010 study found that non-runners who underwent a 10-week running program had a 1.9% improvement in cartilage strength and quality markers.
It also helps explain why exchanging one form of exercise for another is counterproductive in the first signs of knee pain. Jackie Whittaker, a physiotherapist and arthritis researcher at the University of British Columbia, said, “People with early knee problems believe that they protect their joints, so they can be used for less impactful activities such as swimming and cycling. I often switch. What I’m doing is starving my cartilage. “
2. Do it short and often.
Still, there are limits to how quickly joints can adapt to unfamiliar stress. Jean-Francois Escurier, head of research at the Running Clinic and co-author of Khan, suggested that knee pain that lasts more than an hour after exercise or appears in the morning after training is a sign of joints. It was an overload. That doesn’t mean you need to stop exercising, but you should adjust what you’re doing, he said.
Consider shorter and more frequent workouts. According to Keith Barr, a physiologist at the University of California, Davis, who studies the molecular properties of cartilage and other connective tissues, cartilage cells respond positively to about 10 minutes of exercise. After that, you are only accumulating more stress and damage in your tissue, with no further adaptive effect. Therefore, if your knees hurt during a two-hour tennis marathon each week, try switching to a one-hour session twice a week.
3. Be aware of the influence of weekend warriors.
Of course, no training is done in a vacuum. The ability of your knees to handle today depends on what you have been doing with your knees over the past few weeks or months. That’s why the arrival of the ski season is a predictable source of genocide for physiotherapists, as enthusiastic weekend warriors hit the slopes after months of inactivity.
Dr. Whitaker suggested taking a quick first day on the slopes and being willing to shorten the next day if he felt he had enough leg muscles and joints. “It’s a pace,” she said. “It adapts to your ability to handle the load on your body.”
Even better, she strongly suggested doing strength training to prepare the foot before putting new stress on the foot. A simple and common program of squats and lunges can stabilize the knee and strengthen the muscles that stiffen the tendons and ligaments around the joints. As a starting point, I did 3 sets of 10 to 15 repetitions, and when I lifted my weight, my skeletal muscles became unstable, and I feel that I was able to repeat 2 to 3 more times as needed.
4. Stay away from ER
After all, the most serious long-term risk of activities such as skiing is not long crouching. Instead, it is a traumatic knee injury, such as a torn ACL, which causes osteoarthritis within 5 to 15 years in about half of the cases. This is partly due to prolonged joint damage and instability, but also because people tend to slow down and gain weight as a result, even after the knee has healed. In fact, one study found that the high risk of knee osteoarthritis seen in former elite athletes in sports such as soccer is largely explained by the history of traumatic knee injuries rather than accumulated injuries. It has been.
Fortunately, implementing a so-called “neuromuscular” training program can cut the risk of acute knee injury in half, said Ewa Roos, a researcher at the University of Southern Denmark for osteoarthritis. I am. Specific exercises tailored to each sport promote excellent exercise patterns that stabilize joints and can be performed alone for 15 minutes three times a week or as a pre-workout warm-up.
Dr. Roos recommends the website fittoplay.org hosted by the Oslo Sports Trauma Research Center in Norway. This website offers detailed neuromuscular programs for over 50 sports. For example, alpine skiing begins with exercises such as weight squats, weight shifts, boss stacks, and forward jumps, and goes on to be even more challenging.
5. Optimize the movement pattern.
For athletes, the benefits of such a preventive program are clear. It’s more controversial for the average person who has no knee pain so far. “It’s also a philosophical question,” said Dr. Ruth: there is a risk of over-medicalizing life by spending all your energy to prevent problems that haven’t happened yet.
But even if you are currently healthy, there are some relatively unobtrusive ways to tilt the odds in your favor. Dr. Roos suggested focusing on high-quality movement patterns in routine activities such as getting up from a chair. Use both feet, do not use your hands, and align your knees and hips on your feet. Focus on the same when climbing stairs or sitting on the toilet. If you can’t align your joints, it’s a sign that you need to strengthen your leg and hip muscles.
6. Do not seek salvation in the jar.
According to both Dr. Roos and Dr. Whittaker, there is no high-quality evidence that supplements such as glucosamine and chondroitin make a difference, but neither seems to be harmful.
“It doesn’t matter if you’re okay to pay for it and you want to take it because you think it’s doing something to keep your joints,” Dr. Whittaker said. rice field. “But in addition to that, could you do periodic weight-bearing activities?”
There is one exception that can be interesting. A small 2011 study by researchers at the Tufts Medical Center found that the quality of knee cartilage improved six months after ingesting 10 grams of collagen daily. Recently, Dr. Barr’s work on ligaments grown in laboratories made primarily of collagen, such as cartilage, also supports the idea that consuming collagen before exercise can trigger new collagen synthesis in the body. doing. But so far, the actual benefits of this approach have not been proven.
For Dr. Whittaker, the most important priority is to clarify the idea that you should stop working as soon as you notice knee pain.