Twinkle Toes, But Not the Knees

Knee osteoarthritis development can be slowed with exercise program

/ Author:  / Reviewed by: Robert Carlson, M.D

If women are lighter on their feet than men, shouldn't that mean the same thing for their knees? Women naturally land harder on their feet than men, which makes them more prone to knee damage and possibly osteoarthritis in the future.

Knees are meant to bend the one way they do, so let them bend. It's especially important for athletes that put a lot of stress and strain on those joints.

For patients around the world, the most common joint disorder is osteoarthritis (OA) and it worsens over time. Of all the body's joints, knees are hit and affected the worst.

As populations get older, the problem will become more prevalent, which researchers say will be "an important cause of disability in the future."

What It Is:

Osteoarthritis affects the cartilage that helps buffer joints. It can be caused by a number of issues:
⁃ repeat injuries and fractures
⁃ obesity
⁃ family genetics
⁃ previous fractures and injuries

In one study, researchers from Dr. Behcet Uz Children's Diseases Training and Research Hospital in Turkey found patients had the disease a little over four years on average, though some of the study's participants have had it as long as 20 years.

It Hurts!:

From the same study, seventy-three percent of the patients felt pain on both sides of the knee with arthritis.

More than half of these patients had moderate to severe wearing and tearing down of the knee cartilage. In addition, patients had small, abnormal bone spurs growing in the diminishing spaces between the joint.

No matter the severity of knee joint damage, patients reported about the same level of disability, stiffness and pain.

Pain is their chief complaint, researchers said. That pain is the biggest cause of disability among patients who have OA and vice versa: the chances of being disabled increases their pain.

And women felt pain the most. Researchers from the Methodist Center for Sports Medicine in Houston said untrained women tend to land a jump with their knees straight and their kneecaps pointing inward. They generally are six to eight times likelier than male athletes to tear one of the major tendons in the knee

As women age, this gets compounded by a mixture of hormonal changes after menopause and imbalance in how bone restructures and builds itself.

Men on the other hand have a wider stance as they land with more bend in their knees and their feet further apart.


As there is no complete cure, patients can find a bit of relief with:
⁃ exercise programs that work and maintain the joints' range of motion and keep surrounding muscles strong and supportive
⁃ heat and cold treatments to deal with inflammation after exercise
⁃ knee supports and braces to reduce the load on the joint
⁃ weight loss
⁃ muscle relaxants and non-steroid anti-inflammatory drugs like ibuprofen
⁃ viscosupplementation, in which doctors add lubrication to the knees
⁃ knee replacements in either half or whole

"It would be better to consider mainly the functional status of patients in addition to clinic and radiological findings while planning the treatment of OA," researchers said.

Experts from the Methodist Hospital say that a six-week long program on proper jumping and landing form, known as plyometrics, will help prevent injuries, especially among female athletes.

Example of a Plyometrics Program:
⁃ Weeks 1 & 2: learn proper technique, control and form
⁃ Weeks 3 & 4: jump off a single leg
⁃ Weeks 5 & 6: demonstrate quick and explosive movements during the exercises

Kelly Osburn, a Methodist Center for Sports Medicine physical therapist, said the program would help strengthen the knee by training muscles to respond and bend appropriately. Most of her patients left stronger after completing physical therapy than before they were injured.

These exercises are not for everyone, especially without getting checked out by a doctor first. 

Review Date: 
December 11, 2012