Not All Knee Pain Means Arthritis
When your knee hurts, most people immediately think, "Oh no, I must have arthritis now." But this is a huge misconception. According to Dr. Kim Jun-bae from Seoul 9 Hospital in Pyeongchon, about half of the patients who visit his clinic for knee pain actually have issues unrelated to arthritis.
Patients often come in with their own self-diagnosis, saying, "My knee hurts, and I have degenerative arthritis. Please treat me." However, the reality is that there are many different causes: chondromalacia, sports injuries, rheumatoid arthritis, patellar chondromalacia, and more.
In particular, people in their 20s and 30s typically experience chondromalacia or sports-related injuries, while degenerative arthritis symptoms usually begin appearing in those in their 40s and 50s. The danger of self-diagnosis is that incorrect treatment can actually make the condition worse. Many people think, "Well, I'm going to get arthritis when I get older anyway, so what's the point of going to the doctor?" This kind of thinking and neglect can be extremely dangerous.
Misconceptions About Age and Arthritis
One of the biggest misconceptions is the belief that "joints inevitably wear out as you age." Dr. Kim Jun-bae challenges this notion with real patient examples. He's seen patients in their 80s and 90s who have maintained their health and exercised regularly, and their cartilage looks as clean as that of someone in their 20s. Conversely, he's also seen 40-year-olds with severely damaged cartilage.
In the past, we thought of cartilage like car tires – something that would inevitably wear out with use. However, we now understand that cartilage damage isn't simply physical wear and tear. It's a complex process that begins with various factors like trauma, lifestyle habits, and posture, involving not just cartilage but also surrounding bones and synovial membranes in an inflammatory process.
How Cartilage Survives and the Importance of Proper Exercise
It's well-known that cartilage has no blood vessels or nerves. So how does cartilage get its nutrition? Cartilage absorbs nutrients from the synovial fluid (joint fluid) in the knee, much like a sponge. Just as a sponge absorbs and releases water when squeezed, cartilage receives nutrients through appropriate pressure and relaxation cycles.
This is exactly why walking is such good exercise. But here's the important point: if someone who's overweight or has never exercised suddenly starts walking for an hour at a time, it can actually be harmful. The cartilage "sponge" gets constantly compressed without time to recover.
Therefore, people who are significantly overweight should start with low-impact exercises like cycling, swimming, or water aerobics. Once they've built some muscle strength and managed their weight, then they can move on to walking exercises.
Why Koreans Have High Rates of Arthritis
The high rate of arthritis among East Asians, particularly Koreans, is closely related to lifestyle habits. Squatting, sitting cross-legged, and floor-based living are major contributing factors. When you squat, the pressure on your knees increases 7-10 times compared to standing.
Many people think standing puts more strain on the knees, but squatting actually creates much more stress. It's like using pliers to squeeze the knee joint. Sitting cross-legged or kneeling also puts excessive stress on the knees.
Therefore, it's important to use chairs whenever possible and reduce habits that involve kneeling on the floor.
Proper Knee Health Management
Managing knee health is similar to skincare – it's easier to understand when you think of it this way. Consider how pressure sores develop: when you lie in one position for too long, pressure concentrates in one area, the skin begins to break down, and if left untreated, the damage goes deeper. Cartilage works the same way.
Three Core Principles for Knee Health:
1.Weight Management: Excess weight puts constant pressure on the knees
2.Strength Training: Muscles around the knee, especially thigh muscles, help distribute weight and reduce knee stress
3.Avoiding Bad Postures: Avoid positions that concentrate pressure on the knees, like squatting or sitting cross-legged
The Right Approach to Exercise
Many people say "I exercise," but when you ask for details, they often consider walking to work or walking during work as exercise. But this isn't really exercise.
Exercise can be divided into two categories:
-Exercise you want to do: Fun activities like soccer, basketball, golf, badminton
-Exercise you need to do: Strength training, cardio, weight management exercises
The problem is that most people only do the exercise they want to do. But if you don't do the exercise you need to do now, you won't be able to do the exercise you want to do later.
Koreans tend to overemphasize walking as exercise. While walking is great, suddenly walking for long periods without proper muscle strength can actually injure your knees. The ideal approach is to combine strength training and walking in a 50:50 ratio.
Symptoms for Early Detection of Arthritis
Knowing the main symptoms of arthritis can help with early detection:
1.Pain: Initially, it might feel like a dull ache or soreness
2.Swelling: The knee swells and you can feel the swelling when you touch it
3.Sounds: The sounds your knee makes when moving are important clues
- Simple "clicking" sounds are normal
- Sounds like "crunching" or "grinding" – like stepping on snow or crumpling plastic – signal cartilage damage
4.Heat: A warm, hot feeling in the knee
What to Do When Fluid Accumulates in the Knee
Many people wonder whether they should have fluid drained from their knee or not. Dr. Kim Jun-bae explains this using the analogy of a building with a leak that causes water to accumulate. When water accumulates, you obviously need to remove it, but you also need to find out why the leak is happening in the first place.
Knee fluid works the same way. When a lot of fluid accumulates and the knee swells like a balloon, it hurts, so it should definitely be drained. But more importantly, you need to find out why the fluid is accumulating. There can be various causes – arthritis, ligament inflammation, trauma – and if you don't treat the underlying cause, the fluid will accumulate again.
Knee Strengthening Exercises You Can Do at Home
The most effective and safe knee strengthening exercise is the seated leg extension:
1. Sit properly in a chair with your back against the backrest
2. Extend one leg straight out and flex your foot upward
3. Feel the tension in your thigh muscle and hold for 5 seconds
4. Rest for 1 second and repeat
5. Do 100 repetitions per leg
The key to this exercise is not speed but proper form. If you try to do it quickly, it won't be effective. You need to do it slowly while feeling the tension in your thigh muscles. One hundred repetitions per leg takes about 10 minutes, so doing both legs takes about 20 minutes.
If you have back pain, keep your back against the backrest with your pelvis fixed and move only your legs. This exercise is so safe that patients can start doing it the day after knee surgery.
Conclusion: The Key to Knee Health is Prevention and Early Management
The most important point about knee health is not to self-diagnose. When your knee hurts, don't just dismiss it as "probably because of my age" – get an accurate diagnosis. Most conditions are manageable when caught early.
It's been medically proven that you can maintain healthy knees even into your 80s and 90s. We need to abandon the stereotype that joints inevitably deteriorate with age. Through proper exercise and management, you can maintain healthy knees for life.
The key is moderation. You shouldn't use your knees too much or too little. You can protect your knee health through appropriate exercise, weight management, and maintaining proper posture. Strengthening your thigh muscles is particularly crucial for knee health, so I encourage you to consistently practice the chair exercise I described.
Once knees are damaged, they're difficult to recover. Therefore, prevention is the best treatment, and when you notice any unusual symptoms, don't suffer alone – getting an accurate diagnosis from a specialist is the wisest choice.
Remember, healthy knees aren't just about avoiding pain – they're about maintaining your mobility and independence throughout your life. Start taking care of your knees today, and they'll take care of you for decades to come.
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