Knee Pain In 40's
As you may be aware, fourties are trending. More and more people once they settle in their life try to find space for themselves in their middle age. Everyone wants to go back and explore what they did in their 20’s. The most often ignored fact is that the body has aged unknowingly. You have been working hard all those years with most of the people having sedentary job. Suddenly you feel like getting back your fitness levels and stamina. You start hitting the gym, go back to the field and start playing football, and the list never ends. There is no realisation that the body can no more take the brunt that it used to take as children. Suddenly there is a knee pain and the first thing that you turn back to is denial. Why would I get knee pain? Oh, it must be a small niggle, there’s nothing wrong with me; and so on. But this may not be true. As we age, there are changes that take place in all our body structures, there is grating of hair, you get reading glasses, and there is gradual reduction is muscle power. Knee and ankle joints are especially vulnerable to all these ageing and degenerative changes. Walking and running on two legs is quite a task and all those forces give micro trauma to the weight bearing structures. The knee coating (cartilage) as well as the shock absorbers (menisci) gradually lose their elasticity and become more hard. These degenerative structures are more prone to damage and tears compared to what it was may be two decades back. Hence sometimes even minor trauma can give rise to injuries in these ageing structures. Sports like football and high contact activities also lead to excessive pivoting forces inside the joints. These forces can very easily cause damage to the knee.
Structural damages often lead to condition known as Osteoarthritis. You may be wondering that Osteoarthritis is a disease of elderly.
What’s that to do in middle age? But as Dr. Abhishek Nerurkar, Consultant Knee Surgeon, Hinduja Healthcare Surgical and SL Raheja Fortis mentions, now a days there are increased incidence of early onset knee Osteoarthritis patients presenting with chronic knee pain in active middle age. These patients do provide a management dilemma as they are often a conglomeration of more than one pathology leading to this problem. Also because of the demand in activities, the management protocols have to be individualised as per the patient demographics and their individual lifestyle.
One of the reasons to get early arthritis has been neglected knee injuries. Many people including trained sportsmen and also recreational sportsmen do suffer with knee injuries in their early age. Most of them used to carry on with the routine life neglecting what has happened to their joints. Somehow they don’t realise that these subtle injuries may lead to instabilities of the knee joint, which may eventually lead to excessive wear and tear of the intact knee structures. This accelerates the knee damage over years like a slow poison. It is often too late till you realise how much damage has happened, because knee pain may occur later on after the arthritis sets in.
What to do if you have knee pain? Many would talk to their peers and try to find out a solution. But its imperative to know that two individuals with knee pain may have difference reasons for their pain, and hence the treatment would also be different. So, one should never go and take self medications. You should visit your doctor to get the reasoning behind the pain. Your doctor will evaluate clinically to see what will be more likely to give you the pain. Then you may have to undergo some basic investigations like X-rays, or sometimes there may be a need to do advanced investigations like MRI scans. X-rays often give you good indication of your bony problems. They are usually done in standing position to see how the weight bearing is dynamically affecting your knee joint. X-rays are sensitive to diagnose arthritis as there is reduction of joint space on standing.
If the reason to your knee pain is due to soft tissue damage, you may have to undergo MRI scan. This imaging modality very well delineates the problems in meniscus and ligaments. Now you also get special cartilage mapping sequences to see the defects on the knee surface. Once the cause for pain is diagnosed, the treatment plan can be formulated. As this is age related problem, a broad outlook for management should be used. The plan starts with improvement in diet and focus of reduction of weight. Once you’re through, concentrate on building up muscle strength and stamina. Swimming, Cycling and Physiotherapy are very useful in knee injuries and also for prehab before surgeries. No-one likes to be operated, but few of these injuries will not heal by conservative methods and may need some surgical procedure.
One should completely understand the gravity of the problem after discussion with the doctor and make sure that you take right steps at right time to keep your steps moving.
One of the reasons to get early arthritis has been neglected knee injuries. Many people including trained sportsmen and also recreational sportsmen do suffer with knee injuries in their early age. Most of them used to carry on with the routine life neglecting what has happened to their joints. Somehow they don’t realise that these subtle injuries may lead to instabilities of the knee joint, which may eventually lead to excessive wear and tear of the intact knee structures. This accelerates the knee damage over years like a slow poison. It is often too late till you realise how much damage has happened, because knee pain may occur later on after the arthritis sets in.
What to do if you have knee pain? Many would talk to their peers and try to find out a solution. But its imperative to know that two individuals with knee pain may have difference reasons for their pain, and hence the treatment would also be different. So, one should never go and take self medications. You should visit your doctor to get the reasoning behind the pain. Your doctor will evaluate clinically to see what will be more likely to give you the pain. Then you may have to undergo some basic investigations like X-rays, or sometimes there may be a need to do advanced investigations like MRI scans. X-rays often give you good indication of your bony problems. They are usually done in standing position to see how the weight bearing is dynamically affecting your knee joint. X-rays are sensitive to diagnose arthritis as there is reduction of joint space on standing.
If the reason to your knee pain is due to soft tissue damage, you may have to undergo MRI scan. This imaging modality very well delineates the problems in meniscus and ligaments. Now you also get special cartilage mapping sequences to see the defects on the knee surface. Once the cause for pain is diagnosed, the treatment plan can be formulated. As this is age related problem, a broad outlook for management should be used. The plan starts with improvement in diet and focus of reduction of weight. Once you’re through, concentrate on building up muscle strength and stamina. Swimming, Cycling and Physiotherapy are very useful in knee injuries and also for prehab before surgeries. No-one likes to be operated, but few of these injuries will not heal by conservative methods and may need some surgical procedure.
One should completely understand the gravity of the problem after discussion with the doctor and make sure that you take right steps at right time to keep your steps moving.
