Northside Hospital - Going Through the Motions

Going Through the Motions

Our joints endure a lifetime of bending, twisting and rotating. Here’s how to keep them in top shape.

Without your joints, you wouldn’t be able to walk, stand   or sit. And you certainly couldn’t tackle complex tasks like buttoning a shirt, texting or busting out a killer dance move at your granddaughter’s wedding. More than 200 joints connect your bones, and despite their usefulness, they’re easy to take for granted—that is, until they get stiff or achy.

As you journey through life, the pressure you put on your hardworking joints adds up. But that’s hardly an excuse to plop on the couch and throw your feet up. “Joints are happiest when they’re moved a lot,” says Karen M. Sutton, MD, a sports medicine physician and fellow of the American Academy of Orthopaedic Surgeons. So staying active—without overdoing it—is the best strategy for keeping your joints gliding smoothly.

Limber Beginnings

It’s hard to imagine not having joints, but that’s how we begin. An embryo’s legs are solid and unbending. Then, at eight to 12 weeks, those legs start to indent, gradually forming the knee and hip joints. Fetal joints go through some pretty awkward positions in the womb—and bend even more as the baby travels through the birth canal—so infants have the sort of flexibility that would put a Cirque du Soleil performer to shame. That mobility stays with them through their toddler years.

Getting in the Game

As kids leave toddlerhood behind, many graduate from playtime to organized sports, ramping up the impact on their joints. During their growth spurt, which will continue through their teens, their joints are the healthiest they’ll ever be. But that doesn’t mean the younger set is invincible, even if they are dashing around the house in a superhero cape. At both ends of their long bones, kids have growth plates—areas of growing cartilage—that are vulnerable to fractures. Pint-sized soccer, basketball and volleyball players may develop a painful bump below the knee, called Osgood-Schlatter disease. Growth-plate injuries are also common in football, gymnastics, biking and skateboarding.

What You Can Do: “We encourage children to be active, but playing the same sport year-round puts the joints at increased risk of injury,” Sutton says. “So if they play one sport for two to three seasons, they should play a different sport the other seasons.”

Teen Knees

In adolescence, the growth plates become solid bone. But now, the ligaments—bands of tissue that connect bones—become the weak link. “We each have two menisci [cushiony cartilage pads] in our knee joints, and they start to lose blood supply around age 18, increasing the risk of injury,” Sutton says. Because of girls’ wider hips, the thighbone takes a sharper angle from knee to hip, making the knees especially vulnerable. It may not be fair, but female athletes in jumping or pivoting sports like basketball are up to 10 times more likely than males to tear their anterior cruciate ligament (ACL), a major knee component.

What You Can Do: Teens who are physically active reap the rewards—a boost in the blood supply to their joints and greater joint lubrication. Teenage athletes should also condition their muscles for better joint stability. “As girls move into puberty, the muscle mass around their joints doesn’t keep up with their growth as well as it does in boys, so even if they’re playing soccer 20 hours a week, we encourage them to put in some extra time to do strength and conditioning training for injury prevention,” Sutton says.

Grown-up Joints

By our 20th birthday, our joints have seen plenty of action. We’ve taken about 35 million steps, the equivalent of crossing the United States six times. In our 20s and beyond, the blood supply to the joints drops further, and we continue to lose joint-lubricating synovial fluid. In our 30s, our shock-absorbing cartilage starts to wear down. The cartilage under the patella (kneecap), for example, pays the price of years of squatting, bending, and walking up and down stairs. “When we start out, the cartilage is like a beautiful ice rink surface before the Olympics,” Sutton says. “But as we play sports and get into our 20s to 40s, a few peewee teams have played on the rink, and then professional hockey teams like the Bruins are playing on it. So it wears out with age.”

What You Can Do: Keep moving! It might be tempting to be sedentary during the week and then transform into a weekend warrior—but that’s asking for trouble. Regular strength and conditioning training keeps the joints healthiest. In case of knee pain, a therapy called viscosupplementation—medication that’s injected into the knee—can protect cartilage and provide relief.

Staying Fluid After 40

Into our 40s and 50s, the first few steps in the morning may be a bit stiff. And while osteoarthritis often makes an appearance now, a healthy lifestyle can go a long way toward quelling it. As metabolism gets sluggish—particularly for women, who are undergoing hormonal shifts—it’s important to be vigilant about staving off excess pounds that put more pressure on the joints.

What You Can Do: “If you watch what you’re eating, are at a good weight and do lower-impact exercises to keep the joints moving without putting a lot of force on them, you can help prevent or at least delay the onset of arthritis,” Sutton says. If you do develop arthritis, take heart: Modern therapies may allow you to participate in activities that wouldn’t have been possible just 25 years ago.

Watch Your Back

The spine consists of 26 bones that reach from the base of the skull to the pelvis. As we enter our 50s, the spinal column tends to narrow and put pressure on nerves in a condition called spinal stenosis, which causes back pain or numbness in the legs or buttocks.

What You Can Do: If symptoms are mild, therapies like acupuncture, physical therapy or steroid injections can provide relief and get you back in the swing of things. For more severe cases, your doctor might recommend surgery. Many patients can benefit from minimally invasive procedures performed through tiny incisions.

Shoulder to Shoulder

Entering the senior years, tears in the rotator cuff—the group of muscles and tendons around the shoulder joint—become common. The rotator cuff gets less blood supply as you age, so when even microscopic injuries happen, the tissue can’t repair itself as it once did. About 30 percent of people in their 60s have some sort of rotator cuff tear, and that number shoots to 50 to 60 percent for people in their 80s. These injuries, which might go unnoticed in the early stages, are especially common in factory workers and anyone who regularly pulls down with their arms.

What You Can Do: Regular shoulder exercises can help prevent rotator cuff tears. If a tear happens, it may start out small and worsen over time, occasionally developing into an irreparable problem. “For somebody who has an active lifestyle, we would recommend surgery to decrease the rate of progression,” Sutton says.


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