Mon09012014

Your Health

Treat aching knees early to ease pain and avoid future disability

A recent visit to a sports medicine clinic for a minor knee injury resulted in a surprise diagnosis. X-rays showed that I have osteoarthritis (OA). I thought I was too young, too active and too healthy for such a thing. Was I ever wrong!

Arthritis of the knees is a very common diagnosis, especially prevalent in women. According to the Centers for Disease Control and Prevention, approximately one-third of all women have some degree of OA in their knees by age 50. OA is seven times more common in women than in men.

Knee arthritis is usually a slowly progressive degenerative disease in which the joint cartilage gradually wears away. Aging, gender, heredity, obesity, past injury and repetitive stress are among its many causes. A recent Stanford University study blames inflammation along with “wear and tear.”

OA of the knees is one of the leading causes of disability for older Americans. The American Academy of Orthopedic Surgeons reports that the risk of disability from knee arthritis in people over 65 is as great as the risk of having cardiovascular disease.

Because I intend to be using these knees for at least a few more decades, I immediately hit the Stanford Health Library shelves to learn as much as I could. I found that there were a number of things I could do to slow the development, ease the pain and prevent future disability.

There are many ways to treat knee arthritis. Medication,

injections and surgery are some of the ways that medical professionals can help. But for those of us who want to know what we can do for ourselves, exercise and weight loss reign supreme.

“The Fit Arthritic: Fighting Knee and Hip Arthritis with Exercise” (Dog Ear Publishing, 2008) is an excellent resource. Author Alan Kelton is a practicing internal medicine doctor who developed early knee arthritis as a result of athletic injury. In his 40s, with significant weight gain and constant pain, he decided to change the course of his life. Along with support from the medical literature, he shares his personal experience and knowledge in this small book full of good information that stresses the importance of exercise and weight loss.

Kelton encourages readers to lose weight with the proviso “10 pounds is 10 years.” His approach is weight-loss conservative and healthy, and he reminds readers that exercise alone will not result in weight loss – it requires a change in eating habits.

According to Kelton, the first step in an exercise program is to achieve fitness. He recommends exercising nearly every day, setting fitness goals and performing a combination of cardiovascular and strength training. He provides guidelines to help arthritics adapt their exercise routines to their level of disability. Strengthening exercises for the knees are both described and demonstrated in photographs.

Two more books worth mentioning are “Ishmael’s Care of the Knee” (Lippincott Williams & Wilkins, 2005) by Brian Krabak, M.D., and Brandee Waite, M.D., and “Treat Your Own Knees” (Lotus Publishing, 2011) by Brad Walker. Both books focus on injuries more than arthritis, but the exercises and information included are useful for both conditions.

“Ishmael’s Care of the Knee” is slightly more than 30 pages but includes photographs that illustrate the recommended exercises, along with careful descriptions.

“Treat Your Own Knees” is a more extensive exploration of 25 common injuries, with color illustrations of knee anatomy, along with rehabilitation exercises. Stanford Health Library has another book of the same name, published in 2003 by physical therapist Jim Johnson, which is full of great exercises and recommendations for stretching.

I also discovered a new book with an intriguing hypothesis. In “Biomechanics for Life: Introduction to Sanomechanics” (Springer, 2011), author Mark Pitkin, Ph.D., proposes a new way to maintain health using exercise based on body mechanics. His theory, Sanomechanics, combines the Latin “sanus,” meaning “sound” or “healthy,” with “mechanicus,” the science of the body subjected to forces in English.

Pitkin describes the skeleton as “floating within a hydraulic system of synovial joints” and believes that exercising with an understanding of sanomechanics can improve and preserve health over time, preventing and reducing the development of “wear and tear” diseases like osteoarthritis.

This informative book is technical and not light reading. However, it is quite interesting and informative. It gave me a new perspective on the way to exercise.

Stanford Health Library is free and open to the public in five locations: Stanford Shopping Center, Stanford Hospital, Stanford’s Cancer Center, the Taube Koret Center for Jewish Life and the Ravenswood Family Health Center.

Nancy Dickenson is head librarian at Stanford Health Library. For more information, call 725-8400, email This email address is being protected from spambots. You need JavaScript enabled to view it. or visit healthlibrary.stanford.edu.

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