Why are women especially prone to weak and aching knees?

With advancing years comes the problem of aching knees, especially among women. “Seven out of 10 knee replacements are done on women,” says P. Suryanarayan, consultant joint replacement surgeon, Apollo Hospitals.
These days, it's not uncommon to see women in their thirties and forties complaining of chronic knee pain. It affects their mobility and productivity when they are in the prime of their lives. Some studies have found that more than half of all middle-aged women suffer from knee pain, the predictors of persistent pain being higher body mass index (BMI), previous knee injury and osteoarthritis.

The right diagnosis
Once we hit the forties, there is a tendency to jump to the conclusion that any pain felt near the knee joint points to arthritis. But it is important to systematically identify the cause of the pain and eliminate it. “First, check for injuries in the area, or deformities such as bowing of the legs. If the deformity is arrested, painful arthritis of the knees can be averted or postponed. Knee joint cartilage can wear out because of a deformity. Also, remember, the knee joint has to bear weight evenly; if only one side of the joint gets to bear the brunt of the body weight, it can lead to pain,” says Dr. Suryanarayan.
Knee-joint degeneration can be accentuated by injury or trauma. Some activities and habits such as improper jogging and overuse of the joint over a long period of time can cause damage. “If the ligament in the knee joint is damaged, the individual will experience a sharp pain in the knee, which can be identified precisely through an X-ray,” says Meena Bhaskar, consultant orthopaedic surgeon. Sometimes, the use of high heels and footwear with poor cushioning can accentuate knee pain, she adds.

Osteoporosis, the other major cause of painful knees in women, is the fallout of menopause-related hormonal changes in the body, leading to loss of bone mass and diminished weight-bearing capacity. “The best way to identify this is through bone density studies. Sometimes, it turns out, that women have insufficient vitamin D4 levels, despite all the sunlight that our country gets. In that case, it's advisable to go in for supplements,” says Dr. Suryanarayan.

Lack of activity can lead to soft bones and loss of bone mass. “The joint should be put through a range of movements. That is why we say ‘motion is the lotion for joints', quips Dr. Suryanarayan. In fact, it has been observed that women who have had substantial nutrition and participated in sporting activities during their childhood tend not to suffer very much from bone loss or experience such problems at a later age than many others. Excess weight predisposes women to painful knees as there is greater pressure on the knee cap while walking or standing. Of course, there are also some thin women who experience knee pain.

Breaking the vicious cycle
Aching knees can trigger a vicious cycle of inactivity, loss of flexibility, weight gain, more bone loss and, in turn, more pain. Supervised therapeutic yoga can help break the cycle. “With therapeutic yoga, flexibility is introduced gradually, which sets the ball rolling for more activity, consequent weight loss and stronger knees, ushering in knee health that's lasting,” says K. Geetha, therapeutic yoga teacher who is researching the effect of individualised therapeutic yoga on knee pain in women. For instance, Gomathi (63) who was barely able to stand, leave alone use her knees to support her weight, was first taught yoga asanas to be performed in the prone position. The flexibility and strength of her knees improved in a fortnight, and now she is able to do various asanas standing.

There is no instant solution for lasting relief from knee pain. It requires a combination of medicine and exercise. The fact that we rarely squat or sit cross-legged on the floor has robbed us of the physical work-outs that were inbuilt in our traditional lifestyles. But of course, those with problematic knees shouldn't try these postures at all. Because surgical intervention to alleviate knee pain is a delicate process; once the individual feels better, he/she has to continue with the physical exercises to prevent a relapse.

* Make exercise part of daily life with proper warm-ups and cool-downs to avoid injury.
* Get adequate exposure to sunlight.
* Get proper nutrition, especially milk and calcium-rich natural foods.
* Keep a watch on body weight.
* Avoid heels; wear comfortable shoes.

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