Saturday, June 6, 2015

Knee Studies That Make Me Nervous

A lot of articles about knee pain studies land in my e-mail inbox. Recently I came across one with this provocative title:

Osteoarthritis Patients Will Benefit From Jumping Exercise

The English is a bit shaky in spots (perhaps it was translated?), but the findings are clear enough:
Progressive high-impact training improved the patellar cartilage quality of postmenopausal women who may be at risk of osteoporosis (bone loss).
Specifically, 80 women from 50 to 65 years old, who also had knee pain, participated in this Finnish study. They all had “mild knee OA,” it’s important to note. One set of subjects underwent a “supervised progressive high-impact exercise program” three times a week for 12 months. The quality of their patellar cartilage (which is located under the kneecap) improved with jumping and exercises that required “versatile rapid movements.”

Jump for better knee health! Uh, yeah sure ...

Jumping around with bad knees is not the first thing I would do. What we don’t know here is significant, I suspect. That “mild OA” may correlate with milder knee pain and minor damage, which makes more vigorous activities possible. I know plenty of regular readers of this blog who would shudder at the idea of “jumping” their way to knee health; their pain is brought on by much less strenuous exercises.

Also, it’s hard to tell what “supervised progressive high-impact exercises” means, but “supervised” and “progressive” suggest that subjects with bad knees weren’t cut loose to do jumping jacks during the first week.

My takeaway from this study is probably different from what the authors intended. I’m far from sold on advising knee pain patients to engage in jumping activities to improve their kneecap cartilage. I bet there are less impactful activities that would achieve the same end. However, if you’ve got good knees, exercises that stress your cartilage such as those that involve a reasonable amount of jumping are probably a good idea. They can help you develop stronger joints and ward off problems in the future.

An ounce of prevention!


  1. Last weekend I tried medical marijuana for the pain in my knees. They say it reduces pain. For me, the opposite has happened. The pain was quite stronger. It's the same as an ordinary joint marijuana only in the form of a paste, which is located in the syringe and a lot more powerful. I'm staying with beer.
    Today I go to a chiropractor, so will try one more thing. Sorry for off topic post.

    1. Hi Richard, Fantastic book! I finally had to stop counting the similarities to my own situation. I too lived in Hong Kong for many years, until 2010, biked many of the same hills that you wrote about, visited many of the same doctors and therapists I'm sure and spent many hours trudging around Central on painful knees. I also left work in part to try to address the aches. I'd love to contact you by email if possible. My email is robosalsa(at) if you have time.

    2. Hi, thanks for stopping by. Cycling up Hong Kong hills is definitely hard on the joints. I generally steer clear of e-mail correspondences for a few reasons: (1) I don't want to be perceived as giving people direct advice (as a doctor or physical therapist might) (2) If you have something you want to discuss, if you post a question here, someone else may have a better answer than me (or I may have a decent answer that can be turned into a blog post that can help scores of people -- not just you) (3) Frankly, I've run out of time anyway, with two small kids and a 10-hour-a-day job and a 75-minute commute to work five days a week.

      So I'd encourage you to post questions/thoughts/whatever here (or at the end of some other post). We've got some really smart people who have been through a lot who are now hanging out at this blog, I'm proud to say.

  2. Several years ago I had a shot in the knee for knee discomfort.
    But now, I have some knee complications in last couple months.

    Found Richard's book and completed it several days ago.

    I would have to say my root cause is a sedentary lifestyle. I'm one of those people that sit most of the day and pound the keyboard. Ive put off exorcize over past year due to a tennis/golf elbow from using a rowing machine. I'm not 100% sure the elbow is healed. I would love to start using my rowing machine, Ive got a nice concept2 rower.

    Anyway. I was looking for low impact training and something that I can carry on road trips. I found a mini-trampoline to fit this bill. Not cheap, but much less than Bellicon bungee rebounder.

    You can jog in place on these things or do the health bounce (lymphatic cleansing).
    Its very low impact and intend to use it regularly. Should get it two days from now.

    You can control the impact force easily. I bought this not only to clean my lymphatic system, but to help repair my knees in a low impact, high repetition manner.

    I agree would not recommend jumping up and down on hard surfaces even with Nike Air shoes. Too much force and jarring. Swimming pools and good mini-tramps should work ok for low impact.

    Anyone try mini trampolines yet?
    Basic types are bungee and spring. Some springs are more smartly made in that they have tiers designed into them to accommodate people with different weights.

    Richard's book convinced me more than ever that low impact is not embarrassing (whussy-ish) and can be very beneficial. Guess I had too much of Tim the PT's mindset. Thanks Richard!


  3. Knee/Joint issues due to toxin/waste build up and/or inflammation?

    BTW/ I see the study says "Finnish"

    I've also been considering sauna for mini-sweet sessions.

    Another study, also "Finnish" say that using a sauna to sweat 4 times per week can reduce heart issues by upto 63%.

    "Risk of sudden cardiac death was 22 percent lower after two to three sauna bathing sessions per week and 63 percent lower with four to seven sauna sessions per week."

    Finland is a big producer of saunas.

    I wonder how much inflammation near the joints and/or knee joint issues can be traced to toxins/waste that find their way to the joints?

    If people sit in a chair all day I suspect toxins and wastes can not only reside in muscle fibers but also at the joints?

    Maybe men need to sweet more than women? But I would believe it would be good for them too?

    If middle aged men sit at desks all day and go weeks and months without sweating, I suspect the knees could get stressed? True/false?


  4. There are many tips about overcoming knee pain that you can read on the internet. Some of them might be useful, but nothing beats asking the doctor for advice. Thinking about doing the tips you’ve read online can really make you nervous, especially if there’s no proof that they are true. It can either help you or harm you. It’s better to be on the safe side and consider discussing any kind of body pain that you would feel with a doctor. Take care!

    Madalyn Oconnell @ SHCDenver

  5. If you read Richard's book, he went through several doctors.

    Im looking at this from an auto-immune and toxins standpoint and very few doctors are worth their weight in salt wrt/ auto-immune reversal and detox.

    Maybe its because auto-immune and detox is still too new of a concept for them? Human body is complex, and we still know very little about it.

    1. Dennis,
      This blog is very widely read, so it is exposed to various forms of medical-commercial spam. Do not pay attention to posts that contain links to websites. Richard will delete these posts, as he did in the past.