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Knee joint is the largest and one of the most important joints in our body. We all want our knees to be healthy, even at old age. We don’t want to reach the stage of Total Knee Replacement. But the fact is that knee problems are on rise in our country. Contrary to the belief that knee pain is a problem related to old age, now a days even younger people in the age bracket of 25 – 40 are experiencing knee pain.

What is the structure of my knee?

To understand this problem let us first understand the knee structure very carefully. Our knee is a “joint” formed at the junction of thigh bone (Femur) and leg bone (Tibia). Majority of people confuse a lot between a bone and a joint. Knee joint in itself is not a bone!!! In simple words it is junction where the thigh and leg bones meet and slide over each other, whenever we move our leg. It has a lubricating weight bearing content (structure) which helps in frictionless movement of this junction (Knee Joint) for walking, running and other activities like climbing up or down the stairs, squatting or sitting cross legged.

Let me further clarify, as to what is this lubricating structure. A common belief is, that the knee lubrication is basically a liquid or a gel (commonly termed as “grease” or “Charbi” or “Fatty Layer” in general language), which is not true at all!!!! The lubricating layer for walking and other activities is actually is CARTILAGE, which is not liquid. It is in the form of a layer at the lower end of femur (thigh bone) and upper end of Tibia (leg bone). It is like having a capping at the end of bones forming Knee joint (see the diagrams below).

These two bones (thigh bone and leg bone) are bound together to form knee joint by four major ligaments (Anterior Cruciate Ligament/ACL, Posterior Cruciate Ligament, Medial Collateral Ligament and Lateral Collateral Ligament). Besides lubricating layer at the lower end of thigh bone and upper end of leg bone, there are two “C” shaped cushions in the knee joint, called as meniscus (also popularly known as shock absorber, cushion, gaddi). This whole structure of knee joint is encased in a capsule and also has a lining of synovial membrane. The synovial membrane secretes a liquid called as synovial fluid.

So generally speaking, to keep our knee lubrication healthy, we need to keep our cartilage healthy. In other words, as long as our cartilage is healthy, our knees are healthy. And a healthy knee won’t require, a Knee replacement surgery.

Healthy Cartilage means Healthy Knees!!!

Some important facts & myths about Cartilage

The most important fact is that the cartilage does not have blood supply!!! For it to remain healthy, it depends a lot on the environment in the knee. When you take calcium, it supports your bone. It does not enter your cartilage!! Cartilage layer does not get nutrition by taking Calcium!!! So, it clarifies the biggest myth, which people think, that by taking lot of calcium their joints would be healthy. By taking adequate amount of Calcium and Vitamin D, you can strengthen your bones, so that you do not feel bony pains, but it does not directly strengthen your cartilage (Joint Lubrication) as such. By taking adequate amount of Calcium and vitamin D and keeping your bones healthy, indirectly you do support your cartilage to some extent, but it does not improve the health of cartilage or prolong the life of cartilage.

What keeps our cartilage healthy?

The cartilage gets its nutrition when you walk!!!

When you walk the nutrition is pumped into the cartilage from the joint. In other words, more you walk, more your cartilage becomes healthy in normal circumstances. So undoubtedly walking is healthy for your knee joints.

How much to walk?

About 30 – 40 minutes of walk every day is going to help your knee joints. But a word of caution, if for some reason your knee is unhealthy or diseased, then you need to consult a doctor to know whether you can subject your knees to regular walking or shall you initially give rest, get the disease under control, make your knees healthy with the help of medical advice, and then go for walks. But there is no doubt, if your knee is not diseased and painful, your walk will certainly help your knee joint.

Let us also see what damages our cartilage!

• Sedentary lifestyle. Be active. Go for regular walks.
• Being Overweight. Keep it under control.
• Diseases of Knee like Gout, Infection or Rheumatoid Arthritis. Visit a doctor if you have Knee pain, for early diagnosis and early treatment to minimize damage to your cartilage by disease.
• Systematic diseases like Diabetes or Uncontrolled Thyroid Disease can lead to early degeneration of Cartilage. Keep them under Control
• Lack of Exercise. Can do some office exercises even on sitting chair, like Isometric Quadriceps Strengthening exercises to strengthen your knees.
• Generally speaking, Stairs may be good for general health, but very bad for Knees.
• Trauma- Any sudden injury, such as a fall, can injure the cartilage surface and potentially cause a weak spot in the cartilage. If there are weak spots in the cartilage, it can break down faster even with normal forces. While the damage may be small, cartilage will wear faster with weak spots.
• Joint Instability- A ligament injury can cause joints to move around too much and cause joint instability. This type of extra unnatural motion can slowly continue to injure the cartilage in the joint, eventually leading to arthritis. If you feel soreness or swelling after activity it may indicate instability. In addition to that, if the instability is severe, you might experience sudden popping, cracking or shifting. Most common example is Anterior Cruciate Ligament Tear (ACL Tear).
• Diet and Supplements: Poor diet can not only affect your cartilage, but overall general health. Simple things like Turmeric, Garlic, Ginger, Avocado, Fish, Nuts and Olive Oil have been found to support joint health. Many supplements like Glucosamine, Chondroitin, Boswellia and Devil’s Claw are supposedly good for joint health.
• Biomechanics & Poor Alignment - If you have deformed legs (Bowing of Legs or Knock Knees), then asymmetrical loading of joint can lead to premature cartilage loss.
• Ageing & Genetics- Ageing is seen to be associated with cartilage loss and older patients seem to have less cartilage and some people simply have the genetic predisposition for weaker cartilage. Age related cartilage loss is one of the biggest reasons for people to go for Total knee replacement surgery.

I sincerely hope that this information will be useful you. Do send us your feedback.