If you are a female with a history of knee pain, knee injury, or arthritis, you are not alone!
Knee complaints have overtaken low back pain as the #1 complaint in the average Orthopedic Clinic and most of those complaining are women!
Add to this that slightly greater than half of all joint replacements of the knee are done on women in the United States and you have plenty of reasons to learn more about your knees and how to make them last.
Here are the answers to 5 questions about the female knee that will help you to understand how to improve your chances of avoiding pain and eventual surgery.
- What factors have contributed to the current pattern of painful knees in women?
Answer: Knee problems are likely getting worse in women, as they now participate in many of the same activities, sports, and occupations as men. This is a good thing, as being fit and in shape is important. However, female anatomy is different, in that the pelvis is a little wider, and this ultimately puts more stress on the knees. There is more on this below.
- What differences between men and women may contribute to the observed greater injury occurrences in women?
Answer: Females are more often likely to have more inward rotation of the thigh bone. When this happens, the rest of the leg has to compensate for this. The knee joint and kneecap end up taking extra stress. Women’s knees accumulate loads of up to 6-8 times body weight during running and jumping activities. Another factor thought to contribute to arthritis is the lack of estrogen that occurs in women after menopause. Family predisposition (genetics) may play a role, too.
- Is it true that if I exercise improperly I can actually cause more harm than good to my knees?
Answer: Absolutely. Proper exercise and fitness requires a balance of frequency, intensity and duration. Some years ago , I conceived the “Rule of Too’s”, which says your chances of having an injury go way up if you exercise too hard, too often, too little recovery or rest, too much of the same activity, too quick or fast an exercise, etc. We talk about “using it or losing it”, but as we age, especially over the age of 50, your knees cannot recover or adapt to stress as fast.
- Are there popular fitness exercises that can be particularly tough on the knee?
Answer: Yes. We have programs that claim to train your knee in less than 10 minutes a day! Women are a consumer target for enrollment in these fast fix schemes which tend to offer cheaper cost, availability, and shorter time commitment. Beware of such programs as Curves and Crossfit if you have had prior injury, swelling, knee pain, or have been told you have kneecap problems. Women over 50 years old have reached the decade when many knee problems and arthritis start to become symptomatic. You can easily aggravate any prior or existing problem. Bent knee exercises such a step aerobics, steppers, squat lifts, and lunges are particularly likely to be bad for you, especially if your knees already make crunchy or grinding noises on stairs and with knee bending.
- If I have started an exercise program, what do I look for to know if my knees are OK?
Answer: There are several key things about your knee to keep track of to know if you are doing more harm than good. First, how does the exercise make you feel—during, the day after, and week to week? While everyone may experience some aches and small pains when starting to exercise, what counts is the intensity of the pain, how long it lasts, and whether you feel better as time goes along. Any pain that increases or comes back every day is a red flag. Additional red flags include limping, swelling (stiffness), warmth (feel your knee with the back of your hand and compare to your non-painful knee), loss of motion (can you knee fully straighten and can you do a deep knee bend), and giving way or catching. Do not train through pain. Do not do exercises that cause your knees to make grinding noises. If any of these symptoms occur, you should seek orthopedic advice.
Stay tuned for Part 2 of Knee Pain and Arthritis in Women. To be posted next week!
Information Provided by Wayne B Leadbetter,MD. Dr. Leadbetter is a Board Certified Orthopedic Surgeon recognized for his interest and publications on the female knee and women’s knee complaints especially relating to the kneecap. He may be reached at the Center for Joint Surgery and Sports Medicine, Hagerstown ,Maryland. Appointments: 301-665-4575