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June 7, 2015

By Susan Callahan, Associate Editor and Featured Columnist

Men, your knee is one of those body parts that you never
think of until it hurts. Unlike your face or your hands and
feet –which you are at least likely to touch every day –the
knees are the forgotten soldiers of your body. Yet, the
knee is perhaps the one part of your body –other than
your hips –which do the most work.

Whenever you stand, your knee performs the heroic job of
carrying your full body weight, except for the little bit of
weight below your knees.  Whenever you climb the stairs,
your knees bear 4 times your body weight with each step.
So, if you weigh 160 lbs (72.7 kilograms or 11.4 stones) ,
your knees are carrying 600 lbs of weight up each and
every step.

The human knee is not structured ideally to carry heavy
bodies upright over a lifetime. In fact, for most of our
evolutionary history, we got around in a crouched position
on an all fours, which put far less train on our knees.  

As our ancestors evolved from crouching ape-like
creatures to upright humans, the structure of our knees
had to change.  Standing upright required adjustments to
the architecture of the knee --- the addition of bands
connecting the front and back of the knees to give us more
stability in an upright position. These later add-ons, if you
will, are simply not sturdy structures and can easily be
overloaded by work or exercise or by simply being asked
to carry increasingly heavy bodies. Little wonder, then,
with the upward trend in body weights in the U.S., U.K and
around the world, that knee problems are the most
common joint complaint. The Mayo Clinic estimates that in
2010 4.7 million Americans underwent knee replacement

The Hodge-podge Structure of the Human Knee

Our knees are not elegant structures.  Basically, two bones
come together at your knee—the biggest bone in your
body, your thigh bone (femur) and your lower leg bone

These bones are wrapped at the ends in slick, rubbery
substances  called “cartilage” which enables the bones to
slide against each other.

In effect, whenever your knee moves, you literally are
“burning rubber”, like rubber tires against asphalt.  Over
time, cartilage wears out. You can help to slow down the
wear and tear if you follow certain preventive steps that
we cover below.

To hold the two bones together as they slide to enable you
to move, the body has a contraction of “attachments”.
Tendons attach your muscles to the bones and “ligaments”
attach the bones to each other.  

How do you keep your knees in good repair?  What can
you do to decrease your risk of knee pain and injury? Here
are 5 basic steps:

Maintain an Ideal Body Weight to Save Your Knees

By far, the most important factor in predicting whether
your knee will “wear out” from arthritis (osteoarthritis) or
tendon or ligament wear-and-tear is your body weight.

If you carry an extra 10 pounds, that’s an extra 40,000 to
50,000 pounds day the knee has to bear –assuming you
walk the average 4000 to 5,000 steps a day most
Americans do.

People who have more than 28.4 body mass index have
more than 10 times greater risk for developing
osteoarthritis than those who have a BMI of 22.8,
according to a 2010 study by Cyprus International
Institute for Environmental and Public Health in association
with the Harvard School of Public Health.

A 2012 study from Canada’s de Groot School of Medicine
at McMaster University backed up those results, finding
that those with a BMI over 30 have a 7 times greater risk
for knee osteoarthritis than those with a BMI under 25.

Those who have a BMI over 30 are considered obese, and
given that over a third of Americans and almost as many in
the U.K. are considered obese, we are all at great risk for
developing osteoarthritis if we don’t get cracking and lose

Lighten Those Packages

Carrying extra loads at home and, especially at work, is
associated with a much greater risk for knee arthritis.  
Spread loads over several trips to avoid traumatizing your
knees. When you travel on holidays, always use airport
luggage carts rather than carrying loads yourself, even for
small distances.  Buy a cart with wheels to carry groceries

Avoid Squatting or Kneeling

Squatting or kneeling is associated with a much higher risk
for osteoarthritis. Scientists have learned that there is a
lifetime cumulative upper range limit of 10,800 hours of
kneeling and squatting before your knees will give out.  

So, do everything you can to stay under that lifetime limit.
The study that discovered that limit came from Germany’s
Federal Institute of Occupational Safety and Health in 2008.

If you are an athlete, keep in mind that this lifetime budget
for kneeling and squatting applies to you too. Rafael Nadal,
the great tennis champion, may be 29 years old on paper,
but the aggressive return game that he's played and the
miles he has put kneeling down to retrieve those low
returns has given him the knees of a much, much older
man. Roger Federer, by contrast, plays a much more
upright game -- he rarely bends low to the ground -- so he
has many more years to play even though chronologically
he is almost 5 years younger than Nadal.

Support Your Knees

Athletes are keenly aware of the need to support their
knees. We can borrow some of their tricks. Wear athletic
shoes with extra gel supports to reduce the shock to your
knees and other joints as you walk.  

Prioritize knee health over fashion—buy shoes with shock
supports and avoid high heels. Wrap your knees before
you engage in tennis or other activities that will demand
side to side movements. This will help to stabilize your

Eat Fish and Consider Krill  

Fish contains omega-3 fatty acids which can help to ease
joint pain. Better than fish oil, perhaps is krill oil. Krill is
made from an arctic crustacean which looks like a shrimp.
Krill oil is more easily absorbed through the cell walls of
your joints than fish oil, and for that reason is actually
prescribed in certain countries for joint osteoarthritis.

Stiff knees can be caused by problems in the knee joint
itself, by injury or conditions affecting the sacs
surrounding the knee.  Let’s tackle to joint itself first.
Stiffness in your knee joint can be caused by injury,
arthritis or damaged tendons –the rubber band-like that
connect to the bones of your knees.

In all of these cases, the very best course of action is to
have your knee diagnosed by a doctor or physiotherapist.
They may take a MRI of your knee to identify exactly
which part of your knee joint has been injured.  In any
case, you will need to rest your knee --- avoid putting any
weight on it until it has healed.

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Eating  fish oil rich in omega-3 fatty acids can help
relieve joint pain.
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