02/01/2016 05:02 EST | Updated 03/27/2017 05:26 EDT

8 Ways To Keep Your Knees Strong And Healthy

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Woman reclining with knees up, close-up of bare legs

We are suffering from an epidemic of pain in Canada -- 18.9 per cent of Canadians over age of 18 said they experience some form of chronic pain, and that includes knee pain. In many cases, knee pain results in surgery: Canada is the ninth most common country for knee replacement surgery in the world -- 143 out of every 100,000 people have the procedure, and knee surgery rates are climbing. That's a lot of pain, and a lot of surgery.

The truth is, nearly everyone's knees will give them trouble eventually. Depending on how old you are, at some point, the knee just degenerates. I call this kind of degenerative joint disease the Final Common Pathway. As a knee surgeon who has helped thousands of patients with knee pain, I know there are treatments and options that can not only reduce the pain, but also postpone knee surgery -- or avoid it entirely.

Here are my 8 keys to knee health:

Educate yourself.

The more you know about your knee in terms of specific conditions, pain control, lifestyle changes and what you can expect from a treatment, the better you can manage the outcome. Being educated helps you have reasonable expectations for how your knees work and feel, and helps you maximize how they perform. The more you know, the better you can communicate with your physician, and understand the benefits and risks of medical and surgical options.

Pay attention to the what, not the why.

Simple as it appears on the outside, the knee is one of the largest, most complex joints in the human body, and many common causes of knee pain: arthritis, ligament tears, cysts in the back of the knee, pain behind the kneecap, or trauma to knee bones, ligaments and tendons. But for most adults, what you do to treat the knee is more important than why it went "bad." Many of the best treatments are the same regardless of the cause, and can help postpone or even eliminate the need for surgery.

Commit to a knee-centric lifestyle.

The decision to change your lifestyle is a big step toward improving the health and strength of your knees. Among knee pain's causes, most are not serious or rare, and some are not even located in the knees, such as back pain. Moreover, studies have linked depression and knee pain. So taking better care of your physical and mental health will further benefit your knees. These don't have to be radical changes: the simplest changes can help stave off the prospect of knee surgery.

Lighten up: cut your portions in half.

For each pound your body carries, your knees endure four pounds of pressure. If you weigh 200 pounds, 800 pounds are exerted on your knees as you walk -- and it's more so during strenuous activities such as climbing stairs or jogging. Even losing ten pounds relieves 40 pounds of pressure on your knees. Though patients often counter they're in too much pain to exercise, exercise is actually a minor component of the weight loss puzzle. What you eat is more important, and one incredibly effective way to lose weight is to cut your portions in half.

Drink more water.

Water is vital to knee maintenance. All knees contain cartilage: soft spongy tissue that lines the ends of our joints and enables pain-free motion. Cartilage is comprised mostly of water -- up to 80 per cent when we're properly hydrated. But the older we get, the lower the water content gets (to as low as 70 per cent), which can result in unhealthy cartilage, hastening the onset of degenerative joint disease. And, drinking a glass of water before and after each meal helps control your appetite.

Take glucosamine and turmeric.

It's true that the powers that be frown upon doctors recommending supplements. But many doctors, including myself, believe that supplements -- generally safer than many other treatments -- are worth the try. I recommend glucosamine sulfate and turmeric. Both have anti-inflammatory properties. The National Institutes of Health state that glucosamine sulfate is "likely effective" for treating osteoarthritis. Turmeric is a well-studied and historic natural remedy, and recent research found it eases pain as effectively as ibuprofren.

Keep moving.

Movement is vital to knee maintenance -- again, related to cartilage. Unlike most other tissues in the body, cartilage lacks blood vessels to carry nutrients into it. So knee cartilage depends on movement to stay alive, healthy, and heal. Choose your favourite activity (even walking), and build up to 30 minutes a day, five days a week. It doesn't have to be done all at once. Include warming up and stretching. Play music (it's a motivator), and find an exercise buddy to stay on track.

Start a knee exercise routine.

A short routine of standing and seated exercises can do wonders to improve knee strength, flexibility and mobility. I recommend a 10-minute series for my knee patients that includes hip abductions and extensions, marching, sit to stand/stand to sit, heel raises, hamstring curls, mini-lunges, and squats. Even if you're already heading for surgery, remember: the kind of shape you're in before surgery has a huge impact on how you are when you come out of it.


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