The possibility that I may need a total knee replacement within the next 15 years motivated me to investigate how to prevent or slow down the development of this crippling condition. My search led to the following six secrets to help maintain the shelf life of our shock absorbers:

1 RESPECT PREVIOUS INJURIES

Previous injury to the knee joint can increase the risk of developing osteoarthritis.

Why?
If the injury affects the knee cartilage this can limit its ability to cope with the forces that travel through the knee during physical activity. This may lead to progressive knee cartilage damage, joint space narrowing, joint deformation and finally joint destruction.

Research shows
In a study published in the Annals of Rheumatological Disease, the researchers reported that a history of previous knee injury was the only significant risk factor, significantly increasing the odds of developing knee osteoarthritis. In support of this, a recent review in the American Journal of Sports Medicine stated that 50 to 90 percent of patients who experience knee cartilage or ligament injuries present with signs of osteoarthritis five to 20 years after the injury.

How to reduce the risk
Don’t injure your knees. But if you do, it’s important that you return to your activity slowly. Excessive or uncontrolled weight and motion on the knee too early after injury or surgery may cause further joint degeneration.

2 LOVE THE COMB
A substance called hyaluronic acid (HA) is a vital component of synovial fluid of the knee and is essential for joint health. HA is also found in rooster combs and the poor blokes donate their combs to pharmaceutical companies after death. Their combs are processed and the “comb juice” is then injected into our crumbling knee joints.

Why?
Synovial fluid in the knee joint is essential for normal joint function. The fluid acts as a lubricant during slow movements and as a shock absorber during rapid movements. The normal adult knee contains approximately two millilitres of synovial fluid and its lubricant and shock absorber properties (called viscoelastic properties), are attributed to the presence of HA.

Research shows
Research published in the Sports Medicine and Arthroscopy Review reported that the amount of HA is two to three times lower in the osteoarthritic knee compared to healthy knees. This results in decreased function of synovial fluid, causing further cartilage damage. A recent review published in The Physician and Sportsmedicine concluded that HA reduces knee pain and improves activity levels and should be
included as part of a multimodal arthritis treatment regimen.

How to reduce the risk
There are numerous joint health supplements that you can choose from such as glucosamine and chondroitin sulfate, Methylsulfonylmethane (MSM), S-adenosyl- L-methionine (SAMe) and collagen hydrolysate. Unfortunately, research has demonstrated varying results around their effectiveness in improving the health of the knee joint. Although the same is true about HA supplementation, there is just something mystical about that rooster comb that gives one hope… However, if you are allergic to eggs or chickens, avoid HA like the plague.

3 DON’T DO THE TWIST
Specific activities that increase the risk of developing osteoarthritis include those that require rapid directional changes, fast acceleration and deceleration, and repetitive, highimpact training.

Why?
The continuous stresses associated with repetitive high intensity, rotational forces through the knee joint may result in microtrauma
and degeneration of the cartilage.

Research shows
A study published in the American Journal of Sports Medicine found that men who play sports that require fast acceleration, deceleration
and rotation have a 4.5 times greater risk of developing osteoarthritis compared to lower impact sports.

How to reduce the risk
High-risk activities include power and mixed sports such as track and field, racquet sports, soccer, rock climbing and throwing activities.
If you have other risk factors for developing osteoarthritis, restricting participation in these activities is key.

4 LOSE THE LOAD
It is generally accepted that osteoarthritis occurs more frequently in overweight and obese individuals.

Why?
The increased risk of joint problems is due to the added mechanical stress on the knee joint brought about by the extra weight. Research
has also shown that obesity results in metabolic disturbances, and the release of certain molecules by fat cells that have a negative effect on the health of cartilage.

Research shows
In a recent review examining nutritional considerations for joint health, published in Clinics In Sports Medicine, it was reported that there is almost no risk of knee osteoarthritis for individuals with a body mass index (BMI) of less than 20, but that the risk increases 14-fold in those with a BMI greater than or equal to 36.

How to reduce the risk
By reducing your weight so your BMI is within the recommended normal range (18.5 to 24.9), there is a 25 percent chance that you can avoid future knee surgery. Weight loss can occur with a combination of reduced kilojoule intake and exercise. Exercise should be cardio, four to five times a week, for 45 to 60 minutes per session at a target heart rate in the range of 50 to 85 percent of maximal heart rate. Aim to burn 1 250 to 1 670kJ per session.

5 STRENGTHEN THE QUADS
Weak quadriceps have been implicated in the
development of osteoarthritis of the knee.

Why?
The quadriceps are crucial to knee joint health as they act as major shock absorbers. When the body’s weight is loaded onto the lower limb at heel strike during the normal walking cycle, the quadriceps absorb the weight, minimising stress on the joint. Weak quadriceps impair this protective mechanism, exposing the knee joint to jarring stresses during physical activity.

Research shows
In a study published in Clinics In Sports Medicine, researchers reported that the quadriceps strength of patients demonstrating early
radiographic osteoarthritis is 15 percent less than healthy controls. Another study published in the Archives of Physical Medicine and Rehabilitation demonstrated that a four-month, three-times-per-week muscular strengthening programme decreased knee pain in osteoarthritic patients by 40 percent.

How to reduce the risk
Strengthen your quadriceps. The earlier the better. Closed chain kinetic exercises,such as the horizontal leg press, as well as exercises that emphasise eccentric (lengthening) contraction of the quadriceps, such as walking lunges, are recommended. Perform these two exercises two or three times a week, building up to three to four sets of 12 to 15 repetitions with light to moderate weights, working each leg separately.

6 LUBRICATE WITH NUTRIENTS

A balanced, nutritionally-adequate diet is required to maintain healthy joints.

Why?
Cartilage is one of the few tissues in the human body that does not have its own blood supply. It obtains its nutrition principally from synovial fluid in the knee joint. Specific nutrient deficiencies, which reduce the “quality” of the synovial fluid, have been shown to increase the risk of developing osteoarthritis.

Research shows
In the Framingham Osteoarthritis Cohort Study, an intake of vitamin C (120 to 200mg per day) resulted in a threefold lower risk of osteoarthritis progression. In a review of nutritional intervention for joint health, published in Clinics In Sports Medicine, it was reported that many osteoarthritis patients have dietary intakes of vitamin E well below the recommended daily allowance.

How to reduce the risk
Ensure that you are not deficient in any of the nutrients – consult your Doc.