What’s wrong with our joints, especially our hip and knee joints—the most commonly replaced—and why do they so frequently breakdown? More than 1 million people have joint replacement surgeries every year in the United States, and that number is expected to grow substantially in the coming years. More women are living with prosthetic joints than men, and the number of adults younger than age 65 undergoing these surgeries is growing significantly.
While there are times when joint replacements are necessary, they reflect a common problem that deserves an alternative solution.This is not only because avoiding major surgery and its complications is something to be strongly desired, but also because studies have demonstrated that the outcomes of such joint replacement surgeries are not always rosy, with significant numbers of people reporting unfavorable long-term pain outcomes afterward.
While a history of trauma can certainly play a role, the most common reason that joints become problematic is the slow change in the body’s posture over time. Our bodies get gripped and molded by our modern work and play habits, creating predictable patterns that include lower limb misalignment. Think of alignment as it relates to a car. If the front end is misaligned, the tires will wear out unevenly, and more quickly than they would if the alignment was true. Similarly, even the slightest change in the alignment of the lower limbs puts stress on places within the joints that weren’t designed to receive it. Considering that these limbs have the dual responsibility of bearing the weight of the body and moving it along in a repetitive fashion—walking—this is no less than a recipe for disaster.
In the hips and knees, this misalignment is frequently the end result of years spent sitting with legs crossed, turning the feet out while driving, and sleeping in certain positions, and it creates legs that turn subtly outward. This adds a damaging twisting-action to the hip and knee joints when we walk, and sets the stage for the acute problems of bursitis and tendonitis, and eventually to labral and meniscal tears, arthritis and other degenerative changes, and to a loss of joint space resulting in “bone-on-bone” dysfunction. (In the feet, the end result of years spent moving incorrectly is the formation of bunions, pain between the toes (neuromas), and pain on the bottom of the feet (plantar fasciitis), among other problems.) This is not to say that we shouldn’t move, but that we need to be aware of how we move and make every effort to do so correctly.
I believe that we are in the infancy of our understanding of how to properly care for our joints, as well as the rest of the musculoskeletal system—the muscles, bones, and other soft-tissues. It’s hard to fathom now, but not very long ago people didn’t realize the essential role of dental hygiene in keeping the teeth and gums healthy. Tooth and gum disease were common early adulthood phenomena that were accepted as absolutely normal and inevitable. Of course, we now know that a simple routine—some daily care, good habits, and occasional visits to the dentist—is essential for the care of your mouth. This seems to me to be an excellent analogy to our current understanding and treatment of the physical body. We have come to expect as normal the use of medical intervention of some sort–the use of painkillers, anti-inflammatories, injections or surgical procedures–just to keep our joints and muscles pain-free and functioning in our fifties and beyond.
Fortunately, as I’ve discovered with my own patients, the misalignment and tension that plagues the body later in life is also reversible and preventable. Not dissimilar to the care of the mouth, a simple three-step routine can also help you keep your joints pain-free and functioning well into your senior years. As detailed in my book End Everyday Pain for 50+: A 10 Minute-a-Day Program of Stretching, Strengthening, and Movement to Break the Grip of Pain, the three steps are:
1) A few minutes a day of targeted movement exercises to release the grip of the unhealthy patterns of the body.
2) A few habit changes to prevent the body from slipping back into those unhealthy patterns.
3) Occasional visits to a hands-on treatment professional—osteopath, chiropractor, physical therapist, massage therapist, or other hands-on practitioner—to help you advance your progress and maintain it.
When it comes to the care of the musculoskeletal system, moving toward a healthier state doesn’t have to be time consuming or complicated, but it does have to be done. Without preventive measures, the middle-aged and older body’s new normal becomes a succession of aches, pains, and problems. With the right strategy, however, we can avoid the premature breakdown of the joints that people take for granted as the price of growing older. We can stop associating the “golden years” with chronic pain and regular visits to the doctor’s office, and instead spend them gardening, playing golf, and dancing at our granddaughter’s wedding.