By Sue Sveum
Maintaining joint health is important for everyone, but even more so for women, for two important reasons. We have a higher rate of knee osteoarthritis and are also more prone to developing osteoporosis (low bone density) than our male counterparts. But according to SSM physicians, Dr. Katherine Fox, a sports medicine specialist, and Dr. Erik Kroger, an orthopedic surgeon, there are things you can do to preserve and improve your bone and joint health as you age.
While any joint can be affected by osteoarthritis, it is found most commonly in the knees, with hips and hands next in line. And according to the World Health Organization, as many as 60% of those affected are women. Although osteoarthritis can begin in your 40s and 50s, many people initially attribute it to overuse or a sports injury.
But if you’re feeling those aches, pains, creaks and stiffness more regularly these days, you aren’t just imagining it — our joints do change over time, according to Dr. Fox.
“Our joint surfaces are covered with hyaline cartilage, a material which allows for smooth movement at
the joints as well as providing cushion and shock absorption. As we age, cartilage decreases in volume and elasticity, making it less effective for joint protection,” says Dr. Fox.
“While genetics do play a role in how quickly our cartilage degrades, maintaining a healthy weight
as well as exercising regularly can help prevent cartilage loss,” she says. “Weight reduction can also significantly reduce the impact on our joints and as a result, further delay cartilage loss.”
Dr. Kroger agrees, explaining that regular movement, exercise and a healthy diet are three of the most important strategies to promote healthy joints.
“Osteoarthritis is the most common joint issue among women,” he says, adding that isolated patellofemoral osteoarthritis which affects the kneecap, is a more common issue for women than men. “Strengthening exercises for your quadriceps, the large muscle in the front of your thigh, as well as inline movements such as using an exercise bike, can be very helpful in managing this condition.”
Dr. Fox says the first thing she typically recommends to patients hoping to prevent joint pain is regular weight-bearing exercise. “Exercise is medicine, and can both treat and prevent joint pain,” she explains. “If you’re not sure how to get started, consider a low- intensity, low-impact activity such as walking, and build from there with the guidance of your physician.”
Other weight-bearing exercise includes:
- dancing
- elliptical training machines
- climbing stairs or stair-stepper machines
- low-impact aerobics
- jogging
- hiking
Other Considerations
If your joint pain is caused or exacerbated by osteoporosis, you’ll want to avoid sports like golf, tennis and even bowling that require bending and twisting — as well as exercises like sit-ups and crunches that put a lot of stress on your spine. If you think that pickleball is a better choice, the answer is both yes and no. It’s a great form of exercise and considered safer overall than tennis due to less frequent and intense running, but pickleball can be hard on the knees — especially if you have osteoarthritis. If you do have knee pain, discuss treatment options with your provider to get you back out on the court.
As for that healthy diet that Dr. Kroger mentions, he explains that eating a diet rich in whole foods while avoiding processed foods can significantly reduce joint pain.
“Elevated blood sugars can also cause metabolic dysfunction (such as heart disease and stroke) as well as causing arthritis to worsen more rapidly,” he says. “So avoiding that excess sugar and reducing simple carbohydrate intake can be very helpful.”
Recognizing Joint Pain
So how do you know if you have any of these joint issues? Well, it all starts with joint pain, but according to Dr. Kroger, joint pain can vary. “For some, it’s an achy pain. For others, it can be described as a sharp, stabbing pain,” he explains. “It is very rarely dangerous in and of itself, but if the joint is giving out on a regular basis, that could cause a fall — which could certainly be dangerous.”
The most severe type of joint pain is, not surprisingly, often caused by a fracture, which happens suddenly. “As pain and/or swelling increase, most women seek treatment for this quickly,” says Dr. Kroger. Care and management for a fracture may include a splint, brace, plaster cast, air-cast, or surgery depending on the location and severity of the fracture.
“Osteoarthritis, however, is still the most common issue causing joint pain,” explains Dr. Kroger. “Along with the combination of those non-impact exercises and healthy eating as an appropriate first step in
pain management, supplements such as turmeric and NSAIDS (naproxen or ibuprofen) can also be very helpful.”
Is It Time for Surgery?
If the non-invasive treatments recommended by Drs. Fox and Kroger don’t seem to help your joint pain — or they no longer help as much — what’s the next step?
Typically the best way to treat advanced osteoarthritis is through joint replacement surgery, according to Dr. Kroger. “I believe that all attempts should be made at avoiding or delaying surgery through non-invasive options first,” he says. “But when, despite these efforts, joint pain has progressed to the point where it is preventing people from participating in needed activities at home or at work, disrupting sleep on a regular basis or causing falls, it may be time to consider joint replacement.”
This procedure involves removing the worn outer surface of bone and replacing it with metal and plastic implants. Surprisingly, knee and hip replacement surgery is typically done on an outpatient basis — although for patients with certain health conditions, an overnight stay may be required.
“Recovery is a progression that typically takes 6-12 weeks,” explains Dr. Kroger, adding that patients usually require several weeks of walking with a walker and then progress to a cane.
“Here again, both physical therapy and exercise are essential to a good recovery — especially for knee replacement surgery.”
While osteoarthritis and osteoporosis may not be preventable, the joint pain that comes with it can often be managed through lifestyle changes or surgery. If joint pain is affecting your life, talk to your provider.
Plantar Fasciitis? What a Pain!
If you’ve ever experienced pain in the heel or arch of your foot, you’re probably familiar with plantar fasciitis.
“Most active — and many inactive people — will develop it at least once,” explains Dr. Sara Galli, orthopedic surgeon with SSM Health. “It’s especially common among women aged 40 to 60. There’s often no identifiable cause, but any new or increased heel activity can trigger it. Tight calves, overuse, shoes without heel support or cushioning — and even walking barefoot — are common factors.”
Dr. Galli says that as frustrating as it may be, time is the best healer for this issue, with 80 to 90% of cases resolving within a year. Other treatments include:
- Calf and plantar fascia stretching.
- Cushioning/supporting the heel.
- Avoiding or decreasing the activity that caused it.
- Steroid injections.
- Minimally invasive in-office treatments that essentially act to “injure” the fascia, triggering a healing response.
- Surgery (as a last resort).
According to Dr. Galli, steroid injections can help the symptoms, but there’s no proof they heal the condition. In fact, there’s a small risk of heel atrophy — especially with multiple injections — creating additional pain from insufficient cushioning on the heel.
“Stretching is the most important link to reducing plantar fasciitis symptoms and preventing recurrence,” she stresses. “Along with patience — and trust in both time and the process of healing.”
