Your knees may not have crossed your mind in your 20s, but as the years go by, those same joints can start making their presence known with every step, bend, or climb.
That’s likely the result of osteoarthritis, the breakdown of cartilage that cushions joints.
“Knee X-rays showing osteoarthritis are more common as people age, but that doesn’t mean that it has to hurt,” says UNC Health sports medicine physician Michael Seifert, MD. “Some people have X-rays showing a lot of arthritis and are living a high quality of life, while some have very little arthritis on their X-rays but experience pain that’s debilitating.”
Here’s the good news: You can take steps now to improve the health of your knees and reduce your risk for chronic pain.
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Maintain a healthy weight.
Thanks to gravity, your knees are affected by your weight.
“Excess weight increases the stress load on the knee,” Dr. Seifert says. “If you’re overweight, there is a higher risk of experiencing symptoms of arthritis.”
If you need help with weight loss, talk to your primary care provider. They can help you identify realistic changes you can make to your diet or refer you to resources that provide support and education. Weight loss also reduces your risk for other health concerns, including cardiovascular conditions, some cancers and kidney disease.
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Start slow but keep moving.
Exercise is an important part of maintaining a healthy weight, but some people worry about the pain they feel in their knees when they get moving.
“If you’ve been somewhat inactive, your knees might hurt if you’re too active too quickly,” Dr. Seifert says. “It doesn’t mean you have to stop activity. It means your body is not ready for that level yet, and you need to gradually build up to tolerate a higher load of physical activity.”
Dr. Seifert says it’s common for people to stop exercising when they notice stiffness or swelling out of fear of making the pain worse or causing long-term damage. Instead of quitting, shorten the length or intensity of your workout, or both. Doing a variety of workouts can help to prevent overuse injuries.
If you’re concerned about how your knees feel when you exercise—or if you suffered an injury to your knee that’s causing pain—talk to your doctor, but know that “most people can find some form of exercise,” Dr. Seifert says. “Your knees will get weaker if you’re always resting them because of pain.”
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Build strength in all parts of your body.
If you already exercise regularly or play sports and have knee pain or stiffness, strength training is your next step.
“A comprehensive lower extremity and core strength program is important, so have a leg day once or twice a week, and spend regular time on your core,” Dr. Seifert says. “You have to work the muscles that support the knee to protect it. If all you do is play soccer or basketball once a week, you’re setting yourself up to get hurt.”
Strength training can help prevent injuries such as tears and sprains, which helps to prevent future osteoarthritis, but it also helps you do the activities you like for longer. You might get away with running in your 20s with no strength training to support your knees, but that’s a recipe for injury in your 40s and beyond. While you can continue to run, it shouldn’t be all you do, or you risk overuse injuries, Dr. Seifert says.
Sometimes, you may find that when your knee hurts, everything hurts—hips, back, shoulders. That’s a sign that strength is lacking in multiple systems, so make a plan for full-body strength training.
If you’re experiencing the symptoms of knee arthritis, strength work will help with that as well; research has shown that resistance training improves pain and function caused by arthritis.
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Ask for help.
If you’ve been diagnosed with osteoarthritis or have pain in your knee, talk to your primary care provider about how to manage the pain and keep—or start—exercising. While there are a variety of over-the-counter knee supports available, Dr. Seifert says it’s common to misunderstand their purpose.
“A compression sleeve might make someone more aware of their knee, so they protect it, but it doesn’t provide any actual support,” he says. “A brace with a hole at the front of the knee can help to stabilize the kneecap a little more.”
Sleeves or braces that are infused with metals such as copper don’t provide any extra benefit, and there’s no evidence that custom braces are better than over-the-counter options, so talk to your doctor before you spend a lot of money, Dr. Seifert says.
It’s also helpful to work with a physical therapist or personal trainer on issues of form and movement.
“Trainers and physical therapists can be valuable resources in pointing out issues with how you’re moving,” Dr. Seifert says. “The ideal is when you can get an individualized approach with a focus on building strength.”
If you’re dealing with knee pain, talk to your doctor. If you need a doctor, find one near you.