Sunday, November 20, 2016

That “I’m Just Getting Old” Misconception About Knee Pain

As many of you know, I have Google scrape the web daily for news about knee pain. Recently the search turned up a column from the Flathead Beacon, a newspaper out of northern Montana. There are two huge national forests there; it looks like a beautiful place to live.

The writer is a devoted outdoorsman worried about how many more bird-hunting expeditions he has left in his failing knees. “I have become increasingly aware that there’s a hunting life expectancy in this body of mine,” he laments.

He had surgery on the right knee after a marathon quail hunt about 15 years ago. Then the second knee started going downhill, and what can you do? Here’s the money paragraph that had me ready to slap my palm against my forehead:
When knee No. 2 went south this spring, my doctor speculated that I just had joints built in a way that eventually wore out that knee cartilage. Like the right knee, the left seemed to just fail over time. It started aching last spring, after a casual jog with my daughter. It was fine the day of the run, but I couldn’t walk the following morning.
First, I’d get a new doctor. Yes, aging does have an effect on our bodies; that’s undeniable. But properly cared for knees don’t have to wear out over time. More typically, they fall apart because of benign or not-so-benign neglect.

Notice that the left “start aching last spring, after a casual jog.” I don’t know what happened, but a picture comes to mind, of someone attempting a little exercise after a relatively inactive winter and too many holiday treats consumed.

Of course the knee probably wouldn’t hurt during the run; that’s the problem with cartilage. But the next day – oh yeah – you’d feel it, full force. And if it was occasionally unhappy before, that casual trot could be the tipping event that pushes you into the land of chronic misery.

To be fair, the writer seems to understand the crux of the problem:
But the 10 to 20 pounds I’ve been trying to lose since, well, forever, that’s no longer a matter of just trying to look good.
If you’re carrying an extra 20 pounds (most men who say they want to lose 10 to 20 actually need to lose more like 20 to 30), you’re begging for knee trouble. If you do everything right, your knees may be fine. But you’re at risk if you lurch between sedentary and active states. What you need to do is obvious, though hard: Lose weight. That’s one piece of advice no one would dispute.


  1. Hi, Richard.
    Just started your book--I'm 30% in. I've got knee trouble (=cartilage loss in trochlear groove; very little pain when sitting or walking but knee doesn't work normally on stairs). I'm 51 & I've been seeing a PT for a month now.
    Question: what BMI do you (or Doug Kelsey or anyone else with an opinion you trust) think is healthy for knee function? <25 or as little as possible? Can you share your BMI?
    Thanks! I know I need to lose weight, but I'm wondering where the finish line is.
    Also--any thoughts on an anti-inflammatory diet? (If this is addressed elsewhere on your blog, please point me to it. If it's in the remaining 70% of your book, I'll get to it by the end of the week.)
    Thanks again!

    1. Interesting -- I hadn't calculated my BMI for a while. It appears it's about 23.7. What's best? This is a tough question, because as you know, some people are larger boned, some smaller boned. Some are muscular-heavy, some are fat-heavy. In general though, I think being as light as possible, without being cadaverous looking of course, makes sense. Just see this picture of me during my knee pain saga that I posted on the blog:

      I ate lots of garlic on my anti-inflammatory diet. But I'm not sure that it made much of a difference. What really moved the needle for me, I'm convinced, was getting the right amount of motion.

  2. I think my comment got deleted - tom.

  3. "You are just getting old" is just a poor excuse doctors give to people when they are over 40 and they don't know what the heck is happening to them. It's really sad. And it's also something people tell to themselves because when you don't know how to fix your situation and your doctor or PT can't help you, what else are you going to think?
    Very few people will take the time to research and look for alternatives.