There's one part of me that's always felt older and more out of shape than the rest of my body: my knees. Maybe it's because I tore a bunch of ligaments in one knee when I was in the fourth grade. Maybe it's because up until about two years ago, I did very little running or weight-bearing exercise, and I'm sure my knees have always been weaker than they could have been. Whatever the cause, I've had a long-standing fear about landing too hard or jumping too high and twisting something or worse—plus, a constant ache in both knees whenever I sit with my legs bent for too long.

A few weeks ago I had the chance to meet Jason Theodosakis, MD, an assistant professor at the University of Arizona College of Medicine and author of The Arthritis Cure. "Dr. Theo" wanted to give me some pointers about how to prevent osteoporosis and osteoarthritis—something I'll admit I wasn't that worried about at the age of 26. But I was curious about my knee pain, so I gave him a quick description to see what he thought.

Moviegoer's knee puts me at risk
"Aah, you've got moviegoer's knee," he said, as I described the uncomfortable sensation I get when sitting at a lunch counter, on a train ride, or even at my desk while typing. Huh? He explained that my pain is most likely caused by a decrease in blood flow and hyaluronic acid, a joint lubricator, when the knee is bent at a 90-degree angle. (Another condition, patellofemoral pain syndrome, can also cause similar pain.) Leg-strengthening exercises can help improve symptoms, he said—and I agree that since I've been hitting the weight machines regularly, I definitely have noticed less pain. But he also told me that moviegoer's knee can be a sign of early osteoarthritis. At the very least, this should be a wake-up call that maybe it is early enough to start thinking about the future.

New research released this week from the Agency for Healthcare Research and Quality shows that 1 in 10 American adults was treated for arthritis in 2005. The most common form is osteoarthritis, usually attacking the fingers, knees, and hips. I always thought of arthritis as affecting primarily senior citizens, but it can actually strike much earlier. My dad, I realize now, has had arthritis in his wrists since his mid-40s. I'm also at risk simply because I'm female: Our hormones, anatomy (wider hips), and even the way we tend to run (more upright than males) increase our chances of suffering knee injuries that can lead to arthritis.




So what can I do to protect myself? Here are some of Dr. Theo's tips.

Try tai chi
A new study shows that this ancient Chinese exercise, which focuses on balance and flexibility, effectively treats pain and physical impairment of people with knee osteoarthritis. In fact, any type of low-impact movement that improves balance and helps me become more aware of how I use my joints can help, including regular stretching, yoga, Pilates, and ChiWalking.

Cross-train
I shouldn't stop running, but it might be wise for me to give my knees a rest a few days a week by switching to a low-intensity workout, such as swimming or biking. The repetitive, rotational motion of cycling has even been shown to stimulate cartilage and hyaluronic acid production, Dr. Theo said. Triathlon, here I come!

Watch my weight
A higher-than-average body mass index may increase a person's risk of developing osteoarthritis in the hips and knees, according to research presented this week at the American College of Rheumatology's annual meeting. Scientists speculate that more pressure on the joints over time leads to faster deterioration and excess damage to the cartilage.

Eat a joint-healthy diet
There are no long-term studies that show if one diet is better than the other for arthritis prevention, but researchers believe that the Mediterranean Diet—rich in whole grains, fish, fruit, and vegetables—can help reduce arthritis-causing inflammation and provide the antioxidants I need to stay healthy.

Consider a supplement
Full disclosure: Dr. Theo does sell his own brand of glucosamine and chondroitin supplements, so this one was no surprise. But his main recommendations for someone my age were actually omega-3 fish oil and vitamin D supplements, which can reduce inflammation and strengthen the body's physical support system. Oral hyaluronic acid and ASU, a supplement made from avocado and soybeans, are also sometimes recommended for those at risk of osteoarthritis.

I might talk to my doctor about glucosamine and chondroitin as well, since I've suffered a previous knee injury and have a family history of arthritis—both of which put me at risk for developing osteoarthritis now. While research has been inconclusive (a controversial study last month found no conclusive x-ray evidence that the supplements slowed cartilage damage in osteoarthritis patients, while a larger one just this week found chondroitin extremely effective), the complementary therapy is becoming more accepted and recommended by doctors.

Get an expert opinion
The bottom line is, it was impossible for Dr. Theo to really tell what was going on in my knees without a complete examination to test my alignment, coordination, and joint strength—"really pulling your leg around to see how your knee responds," he put it simply. If I keep experiencing pain or discomfort in my knees, it's important that I see a rheumatologist for a real opinion. At this point I might not be in much danger, but ignoring the problem will only make it harder to treat in the future.





Last updated: Oct 28, 2008