|
This week we are talking about knees. A strange subject, you may think, but it is a part of our body that is very likely to give us a bit of jip as we grow older.
We don’t have to have been a marathon runner to suffer with our knees, as it is just one of those parts of our body that works very hard throughout our life and over time, can give us issues. Later, I explain the likely causes.
It was in my early 60s that I decided that I would no longer record commercial fitness videos/DVDs because I noticed on the recordings that my knees were beginning to bend inwards as I exercised – ‘a real sign of ageing’, I told myself, and I was correct. Our knee alignment changes in most of us as we age and this can cause real problems later.
Some years on, I went for personal training at the gym with a physio, Judith, and she noticed my inward knee inclination and showed me how to learn to counter it. She stood in front of me as I stepped up and down a fitness step and told me to focus on keeping my knees ‘out’ as I stepped. Soon I learned to walk upstairs, concentrating on keeping my knees bending over my toes, not inwards, and before long I had learned to do this naturally and that continues today. And if we don’t make the effort to maintain the correct knee alignment, there is every chance that we will suffer knee problems later.
Because I have been running my personal fitness classes for so long, many of my class members are in their 70s or 80s – one will be 90 this year - and quite a few of them have found themselves suffering with painful knees. Sometime back I suggested they do ‘leg extensions’ with their toning bands. You can do this by sitting on the front half of a sturdy dining chair with a toning band placed under one foot. By keeping the band quite short, holding it in each hand perhaps 10ins/26cms above the ankle, with the band coming out of the top of your hand, bend the knee and raise it towards your chest whilst keeping your body upright. Now, keeping elbows fixed to your waist, slowly push the foot away, which causes the band to extend with a good deal of effort, making the thigh muscles work harder. Repeat this out/in motion 12 times then change legs. Then repeat with each leg again x 12. Many of my members with sore knees have found this exercise particularly helpful in strengthening their knees..
It works by strengthening our quads, which help to support the knee by keeping it more stable. This is really important because women tend to suffer more from ligament damage than men because of our hormones affecting our ligament laxity. If we develop stronger quads, this helps our knees to be stronger and to work so much better. You can, of course, practise this exercise with both legs to keep both knees fit and strong
With one of my members suffering with two poorly knees and awaiting further investigation, I decided to make ‘knee strength and alignment’ my mission for all of my class members. For the last three weeks, I have been training everyone to do a series of exercises specifically designed to strengthen knees. I have also asked them to stand in a circle so that I can watch them as they do exercises that involve knee bending, and I check that their knees are bending over their toes. Last week I took a long mirror with me for them to watch themselves, and practise and learn what it feels like when we bend ‘straight’ rather than ‘inward’.
So, I decided to do some further research and apparently, knee issues can happen to anyone, but interestingly, men and women experience knee problems at different rates and for different reasons. Here are some key differences:
Women are more prone to knee injuries because:
- Higher Risk of ACL Tears: Women are 2 - 8 times more likely to suffer anterior cruciate ligament (ACL) injuries than men. This is due to anatomical, hormonal, and biomechanical differences.
- Wider Hips (Q-Angle Issue): Women have a wider pelvis, which affects the angle of the knee joint, putting more stress on the ACL.
- Hormonal Factors: Oestrogen can affect ligament laxity, making women’s knees more prone to injury.
Men have more degenerative knee issues:
- More osteoarthritis in older men: While young women have more ACL injuries, older men tend to develop more knee osteoarthritis due to greater lifetime exposure to high-impact activities (e.g., sports, manual labour).
- Meniscus Tears: Men tend to suffer more degenerative meniscus tears (cartilage damage) due to wear and tear over time.
However, women experience more chronic knee pain apparently. Studies suggest women report more chronic knee pain and are more likely to develop patellofemoral pain syndrome (runner’s knee) and osteoarthritis, possibly due to joint alignment and muscle imbalances! On that basis we will continue to offer special focus on our knees in our workouts going forward!
Mary gives some very interesting information in her piece and this week’s fitness challenge is all about strengthening our knees! Let’s all take notice!
|
|
BLUEBERRY BREAD PUDDING
Serves 4
Per serving 341 calories, 3.1% fat
Preparation time: 10 minutes
Cooking time: 30 minutes
200g sliced bread
200g blueberries
50g brown sugar
4 eggs, beaten
2 tbsps caster sugar
400ml semi-skimmed milk
- Preheat the oven to 200°C, 400°F, Gas Mark 6.
- Cut the bread into quarters and place in the base of an ovenproof dish. Sprinkle with the sugar and blueberries.
- Beat together the eggs with the sugar and milk and pour over. Allow to stand for 10 minutes for the liquid to be absorbed.
- Oven bake for 30 minutes and serve immediately.
Chef's Tip: Stale bread is perfect for puddings or breadcrumbs. Freeze and label as stale to use later. If using for breadcrumbs, blend to a fine crumb before freezing.
|
|
|
|
Don't forget, you can download and print a copy of all our recipes if you click on the image to go to the recipe's page on the website.
|
|
Fun, Facts & Fitness from Mary Morris MSc.
The chances are that in the last week or so you will have had a conversation with someone about joint pain and discomfort and how it is impacting on their everyday life. Knees are probably top of the talking list, particularly mentioned when we are faced with a long set of stairs going down! Old people's noises reverberate, and frustration mounts as a young person goes flying past!
Our knee joints are the largest and most complex joint in the human body and we need to look after them! They are extremely susceptible to osteoarthritis, which normally occurs from over-use through either an excessive amount of sport and physical activity, or possibly an old injury to the joint. Being 'sporty' of course keeps us fit and reduces massively the risk of lots of serious illnesses and diseases, but the price we pay, particularly as we age, is that the degeneration of certain joints can become serious and may need some kind of intervention.
As I am about to embark on my second Total Knee Replacement (TKR), I do reflect on just how excessively physical my life has been and now I am paying the price, but I must emphasise that it is one I am happy to pay. I consider myself extremely fortunate that such procedures are available to us now and judging by the remarkable success of my first TKR I am optimistic I will return to full physical activity appropriate to my age, once I get through the early discomfort. I will work hard on my physiotherapy and I am confident that I will gradually return to what I like to do best – exercise and activity.
A TKR is the last resort on a joint that would not benefit from having other treatment options that are available, but there is a whole number of them that may help some folks get relief from the debilitating pain of an arthritic joint. I have met many people who have had these alternative treatments and been delighted with the result.
Dr David Thompson, a consultant orthopaedic surgeon, says 'Managing knee arthritis involves a multi-disciplinary approach including physiotherapy, regular gentle exercise and maintaining a healthy weight to reduce joint stress'. Doing all we can to help our ageing knee joints is a must if we are going to make walking downstairs less excruciating! But what can the medical profession offer us if the discomfort is relentless and we need more than what Dr Thompson is recommending?
Injectable Treatments
- Corticosteroids: These direct injections into the knee joint reduce inflammation and pain. They are available on the NHS with a wait of around 4 months and the effect can last from weeks to a few months. Any side effects are minimal. If the joint is not too far gone, they can be very worthwhile.
- Hyaluronic Acid: This is a gel-like substance that acts as a shock absorber and lubricant to improve joint movement and reduce pain. It mimics the natural synovial fluid in the joint, however it is only available privately, costing between £250 and £500 per knee. The effect normally lasts around 3 - 6 months and even longer for some. I did ask for this treatment when I saw my consultant, but was told the effect would be zero for me, as the joint was too far gone - it is not suitable for all knee complaints!
- Arthrosamid: This state-of-the-art hydrogel therapy was officially launched as recently as 2021. Of all the injectable treatments this solution potentially provides the longest lasting pain relief for patients of up to 4 years. It works by restoring the thickness of the synovial fluid so cushioning and protecting the ends of the bones and reducing friction. This is only available privately at a cost of £2,200 to £3,200 per knee. If you can afford it this cutting-edge treatment is a good choice because of its long-lasting effects.
Surgical Treatments
- Arthroscopy: This minimally invasive keyhole surgery is performed under anaesthetic to address meniscus tears, ligament injuries and cartilage damage, flushing out loose debris. For the best result we need to take care with physio and rehabilitation. If we do, benefits can last several years. Younger patients (under 40) tend to have better long-term outcomes. I did have this procedure many years ago but felt it had little or no effect. Maybe I was already too old!
- Partial Knee Replacement (PKR): This is where just the damaged portion of the knee joint is replaced with metal or plastic. It is available on the NHS but can cost £10-15,000 privately. The recovery is quicker than for full replacement, as Rosemary has experienced in 2023 with excellent results.
- Total Knee Replacement (TKR): This procedure involves replacing the ends of the bones that form the knee joint with a fully artificial one. It may also involve replacing the surface of the kneecap. I have found having a knee replacement more challenging than when I had my hip replaced 20 years ago. But, even though it takes longer to recover, hopefully it is possible to enjoy excellent and full use of the new joint for many years to come.
Don't Stop Moving!
Arthritic joints need movement and plenty of it. Keeping the joint mobile and maintaining as much of a Range of Movement (ROM) as possible is vital if we are to lead as near a normal life as we can. And it's not just the knees that suffer. I feel my hands stiffening up so every morning when I wake up, I do a little hand dance so my hands are ready for action.
When we first get out of bed the knees may feel horrendously stiff, but walk a bit and get them moving and it soon becomes easier, demonstrating that it is movement that loosens them up. The recommendation of an early morning stretch is perfect for stiff joints as it 'wakes them up' ready for the day ahead.
Eating Well for Arthritis
A recent and very interesting podcast I listened to with Dr Tamiko Katsumoto from Stanford University, a Professor of Rheumatology, strongly promotes a largely plant-based diet for those suffering arthritis. She strongly believes that a poor diet full of sugar, saturated fats and processed foods drives inflammation and can be a cause of arthritis, but adds that the right foods can have a protective role in reducing the severity of it.
A recent study in the Netherlands took place with participants already living with some degree of arthritis. They were given a whole food plant-based diet for 16 weeks and were found to have dramatic improvements in their level of pain and mobility using the Disease Activity Score. Even one year on many had reduced their medication and were still getting the benefit from eating well.
With 70,000 people a year in England and Wales seeking medical treatment for arthritis it is up to us to do our best to reduce its impact. Clearly there are a lot of treatments available to us and it is just a case of finding what will help us the most. The bottom line is we must help ourselves as much as we can, supported by medical advances, so we can live our lives in the way we want, without too much restriction. I know that is my mantra!
|
|
|
The Hand Dance
In this mini workout, Mary shows Rosemary a sequence of effective exercises that are particularly valuable in aiding hand mobility and flexibility.
|
Preparing for Knee Surgery
Physio Judith demonstrates some simple exercises that will strengthen the muscles around the knee that will help you toward a speedier recovery.
|
|
|
Visit the Health section of our website for lots more help and advice if you are preparing for Orthopaedic Surgery You can also find lots of information about Arthritis and how to cope with it, and many other subjects.
|
|
|
This Week's Fitness Challenge
- On your daily 30+ minute walk, focus on your knees bending over your toes as you step. Include an incline where possible. Don't forget to do the Post Walk Stretches.
- Try these knee strengthening exercises on both legs at least 3 times this week:
- Leg extensions with a Toning Band (as described in Rosemary’s piece above). Do 12 extensions with each leg then repeat.
- Sit to stand from a dining chair x 10. Do two sets.
- Walk up and down stairs x 5 consecutively, knees over toes. Hold on to rail as you descend. Take it slowly.
- Draw the alphabet with one leg/foot then repeat with other leg.
- Balance on each leg for 30 seconds whilst standing near a worktop or table for support if needed. Practise this whilst waiting for the kettle to boil.
- Do the Whole Body Stretch Programme 3 times this week.
|
|
|
And finally...
As both Mary and I learn to cope with our various bodily challenges as we advance in years, we have become passionate about helping others to do everything in their power to maximise their mobility, strength, stamina and motivation so they are able to live longer, live fitter and live healthier. Surely that is a goal worth working for!
Have a great week.
With love and best wishes,
Rosemary Conley CBE DL
|
|
LIVE LONGER | LIVE HEALTHIER | LIVE HAPPIER
|
|
|
|
And if dogs didn't have knees and elbows they wouldn't be able to lie down and do exercises with their humans like this!
