The Degenerative Knee.

The Degenerative Knee.

As we get older things start to hurt. We wake up stiff, find we can't quite stretch as far and lose our ability to lift and carry. Unless you specifically train this tends to happen in your 30s. A logical but unrecognized fact is that between 16 and 21 years of age we stop growing, and in fact, from then on we start to wear out and deteriorate.

This unpleasant situation is very prevalent in the knee joint; a fairly complex hinge joint that takes a lot of abuse over a lifetime. The knee joint is between the femur and the tibia and has a set of shock absorbers (the menisci) and a bit of oil to lubricate (synovial fluid). With the passage if time, the knee joint can start to wear as the the shock absorbers thin out or become leathery and fragment. This can be in part due to previous injury (even from childhood), obesity, the alignment of the body (i.e. the angle between the thigh and lower leg {knock-kneed or bow-legged}), hyper-mobility and occupational wear (i.e. roofing, working in confined spaces, etc.).

Over time you may find your knee(s) starting to ache, particularly at night in bed. This may be accompanied by mild swelling and a feeling of warmth. They may look "puffy". A more serious symptom is a feeling, or actual occasions of, the knee giving way or becoming unstable. This may mean that the joint has some fragments floating about "catching", or that the underlying surface of the bone ends are becoming involved due to pitting or cyst formation.

It is not all doom and gloom, however, as often intervention at the early stage can relieve and indeed slow down the degenerative process. Controlling weight, moderate non impact exercise and strengthening, the use of non-steroidal anti-inflammatories, biomechanical correction (wearing orthotics in your shoes to "straighten" the legs) and the use of certain supplements such as Glucosamine Sulphate have all been shown to help.

At the onset of spontaneous knee pain, or knee pain the day after a bout of exercise, one should seek professional advice. The physiotherapists at Seva Clinic are experienced in managing this condition and will be able to offer the correct guidance to help alleviate your symptoms. In severe cases, it may be necessary to refer on to an Orthopedic consultant as the joint may need surgical attention, such as an arthroscopic wash-out. This common and often debilitating situation is frequently seen when knee problems are left untreated, so it is advisable to seek help sooner rather than later.

Please contact Peter at seva physiotherapy for more information.

Peter McClean
April 2008