The Knee: Effects of Ageing

[dropcap]I[/dropcap][dropcap][/dropcap]n this, the final part of our knee series, we look at what happens to the knee as we age and the problems we may face. Ageing is inevitable. But there are steps we can take to slow down the process and associated aches and pains.  People often accept their aching knees as part of the process of life but nobody has to live in pain. There are many ways to keep yourself fit, active and pain-free. Firstly, we will look at common problems, and then lifestyle changes that can keep you on your feet.

We are often told that our pain is due to arthritis—a word used to describe any condition that involves inflammation of the joints. There are many types of arthritis but the most common types as we age are osteoarthritis (OA) and rheumatoid arthritis (RA). Osteoarthritis is commonly known as degenerative joint disease and, although it is prevalent in people over 50, it can affect younger people too. OA of the knee affects the cartilage covering the bones of the knee joint.  Wear and tear causes cartilage to become thinner, stiff and less spongy.  Risk factors are age, obesity and knee injury. The primary goal is to relieve pain, often by taking medication, but did you know that exercise and losing weight can also help with symptoms?  Changing your lifestyle to include daily exercise, not only strengthens the muscles, it improves bone density and feelings of well-being.

Rheumatoid arthritis is an autoimmune disease where the immune system, instead of protecting the body, starts to attack the joints, although it can also affect other parts of the body. The lining of the joints becomes swollen and painful and may be warm; you may also experience joint stiffness, fever, fatigue, weight loss and joint deformity. It is not known what causes RA although genetics may play a role, making some people more susceptible to the associated risk factors, such as

• Gender: More prevalent in women

• Age: It can occur at any age but is more common between the ages of 40–60

• Family History: If somebody in your family has RA, you are at a higher risk of developing the disease

• Smoking: Increases the risk and severity

• Environmental Factors: Exposure to substances such as asbestos and other types of dust increases the risk of contracting RA

• Obesity: Being overweight

Strengthening and stretching can not only reduce the risk of arthritis but can help to control pain and increase function. Some basic strengthening exercises are:

Bridging: Lie on your back with knees bent. Squeeze your buttocks and lift your bottom off the floor. Return to starting position.

Straight Leg Raise: Lie on your back with one leg straight, the other bent. Pull your toes up, straighten the knee and lift your leg 20 cm. Hold for five seconds, then slowly relax.

Abduction: Lying on your side, roll top hip slightly forward, use top arm for support. Keeping top leg straight, lift it towards the ceiling. Make sure the leg stays in line with your body and toes point forwards.

Hip Extension: Stand straight, holding on to a chair. Bring your leg backwards, keeping your knee straight. Do not lean forwards.

Knee Raises: Standing with legs straight, keeping your knee bent, slowly lift the leg up. Hold for three seconds.

Leg Curls: Standing, hold onto a support and bring one leg slightly backwards. Bend your knee and lift your foot off the floor. Hold for three seconds.

Wall Squats: Stand with your back against a wall and your feet about 20 cm in front. Slowly slide down the wall until your hips and knees are at right angles. Return to starting position.

Squats: Sit with your hands on your shoulders. Stand up by tightening your buttock muscles and then slowly squat down, stopping within an inch of the chair. To increase intensity, remove the chair.

Heel raises: Stand with feet flat. Using support or hands on hips, transfer weight to toes and lift heels up.

If your pain is severe and you struggle with day to day activities, consult your physiotherapist or doctor for further assessment and advice. Physiotherapists can help identify weak and tight muscles and develop a programme based on your individual needs.

Kim Jackson is a UK-trained physiotherapist with over 20 years’ experience. She specializes in musculoskeletal pain and dysfunction, including back pain and sciatica, stroke and other neuro conditions plus sports physiotherapy, having worked with local, regional and international athletes and teams treating injuries and analyzing biomechanics to improve function and performance.  She is registered with the Allied Health Council and is a member of PASL.  She currently works at Bayside Therapy Services in Rodney Bay,