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Dealing with Pain Part 2: Protecting the Knees

"The knee is one of the most stressed joints in the entire body... it’s no surprise that the knees start to wear out."

Today’s episode is part 2 of Dr. Nancy Lin’s pain series, this time focusing on knees and what we can do to help keep them as healthy as possible and reduce the aches and pains that often come with aging. Learn what we need to know about nurturing the knee joint and its important surrounding components to keep them working effectively, as well as other great tips to help prevent knees issues as we age.

Video Highlights

  • 01:12: Understanding the Knees
  • 06:52: Causes of Knee Pain
  • 14:27: Postponing and Preventing Knee Pain
  • 14:51: Build Muscle Strength
  • 20:22: Increase Mobility, Flexibility, Balance, And Stability
  • 21:59: Maintain a Healthy Weight
  • 25:38: Dr. Nancy’s Top 5 Foods for Joint Health
  • 30:02: Wrap-Up

InPart 1 of this series, we talked about preventing and relieving hand, wrist, and finger pain. Today, we’re going to focus solely on the knee joints. We’ll give you some general information about the knee joint and its surrounding components that go into making it work effectively, as well as provide some tips to prevent issues in the knees as you age. You’ll also learn Dr. Nancy’stop 5 favorite foods that can optimize joint health overall. 

Understanding the Knees

Did you know that your knees absorb about one and a half times your body weight each time you take a step? That’s an incredible amount of pressure. In fact, the knee is one of the most stressed joints in the entire body, and after years and years of walking, running, jumping, dancing, and otherwise putting them to good use, it’s no surprise that the knees start to wear out.

The knee is a basic hinge joint that is surrounded by a complex network of muscles, tendons, ligaments, and meniscus. It connects the femur, or thigh bone, to the shin bones, the tibia, and the fibula. The knee serves a number of functions, in addition to acting as a shock absorber, including: 

  • Keeps the body upright (that’s pretty important, right?)
  • Helps maintain balance and stability
  • Allows the leg to twist
  • Helps you raise and lower your body
  • Propels the body forward

There are two types of cartilage in the knee that it’s important to know about. One is themeniscus, which is essentially a cushion that acts as a shock absorber. The meniscus allows the knee to move while preventing the two heads of the joint from rubbing against each other. Since there are two bones entering the knee from the shin, the nerves surrounding the meniscus help with balance, stability, and the even distribution of weight between the tibia and fibula. 

The second type of cartilage in the knee is calledarticular cartilage. This a thin layer of cartilage that also helps absorb shock and prevents the bones from rubbing directly up against each other. 

The knee is what is called a synovial joint — a joint that contains synovial fluid encased in a membrane. That membrane releases synovial fluid to hydrate the cartilage of the knee and make sure it stays slippery so the joint stays healthy and protected. 

Causes of Knee Pain

The synovial fluid can fall prey to theinflammatory response if you have a disease likerheumatoid arthritis. Rheumatoid arthritis is an autoimmune disease that triggers the inflammatory response and causes the body to attack itself. When it occurs in the knee joint, the synovial fluid becomes even thicker than normal and causes the joint to swell. Other symptoms include:

  • Redness
  • Pain in and around the knee joint
  • A warm or hot feeling surrounding the affected area

As the arthritis progresses, the synovial fluid begins to eat away at the cartilage and the bone of the knee joint. This then causes the knee joint and its many components to wear out. 

Osteoporosis is another form of arthritis that can wreak havoc on the knee joint. In this case, the cartilage breaks down so much that it eventually disappears, leaving the bones of the joint to rub directly against one another. The result here is:

  • Limited range of motion
  • Swelling
  • Pain in and around the joint

Eventually, bone spurs can develop, and the knee can even start to lose its normal shape. Plus, all that bone-on-bone friction can cause pieces of bone to break off and float freely around the joint, which can be extremely painful and cause even more damage to the joint. 

The knee also has four ligaments that attach the bones entering into the knee to other bones entering the knee. One of these is called theanterior cruciate ligament, most commonly referred to as the ACL, which attaches the femur to the tibia and prevents the femur from sliding backward on the tibia and the tibia from sliding forward on the femur. In a nutshell: it stabilizes the leg and prevent unnecessary motion. 

Atorn ACL is another byproduct of too much wear and tear on the knee. A torn ACL is most prevalent in those who play a lot of sports. As a matter of fact, knee injuries account for 2.5 million sports-related injuries in adolescents every year. That’s not to say adults aren’t prone to a torn ACL too – they are. There are up to 200,000 torn ACLs reported annually. 

A torn ACL happens as a result of constantly making sudden stops and then changing directions, pivoting off the foot, being tackled directly at the knee, or from excessive jumping up and down. Again, think sports like basketball, football, or soccer. A torn ACL is pretty self-explanatory — the ligament either tears partially, or it tears completely, or it can become stretched too far so that it doesn’t bounce back to its normal length. 

Did you know if you experienced a torn ACL earlier in life you’re more prone toosteoporosis in the knee? 

All these things we just mentioned — rheumatoid arthritis, osteoporosis, torn ACL — can either be postponed or prevented altogether. 

Postponing and Preventing Knee Pain

Build muscle strength

We talk about this all the time — integratingstrength training into your weekly exercise routine is a vital component in strengthening both the muscles and joints, which increases bone density. In addition to getting 150 minutes of moderateexercise or 75 minutes of high-intensity exercise each week, you should be doing 30 minutes of strength training each week, as well. This can include lifting weights or participating inbodyweight training where you use your own bodyweight as resistance. By doing strength training, you place stress on your bones, and that then increases bone density, which can in turn prevent arthritis. 


One great exercise you can do to specifically target and strengthen the knee is squats. Squats strengthen the quadriceps and hamstrings, which then has a ripple effect and strengthens the knee.

To perform a squat:

  • Stand with your feet hip-width apart. You want to make sure your feet are flat on the ground, toes pointed straight ahead in front of you. Try to keep your weight distributed evenly between both legs. 
  • Bend the knees and lower down as if you’re sitting in an imaginary chair. 
  • Make sure your knees don’t go behind your toes or fall in toward one another, or wing out. 
  • Be careful that you don’t lower down so deep into your squat that your seat is touching your heels. Squatting too low and putting too severe a bend in the legs can put too much pressure on the knee joints, which is the opposite of what we’re trying to accomplish.

Side Step-ups

Did you know that, in addition to strengthening the quads and hamstrings, you have to strengthen thehips andcore to keep the knee joint strong and healthy?

A great exercise to accomplish this is the Side Step-up, which requires a stool or the bottom step of your staircase. Here’s how you do these:

  • Face the stairs or your stool and then turn 90 degrees to the right so you’re facing the bannister and the step or stool is at your right side. 
  • Step up with your right leg and straighten the leg so the left leg is hovering off the ground. 
  • Repeat 10 or 12 times before switching sides and stepping up with the left leg. 

Increase Mobility, Flexibility, Balance, And Stability

Has a nice ring to it, doesn’t it? Building strength and increasing bone density serves another purpose, too: it increasesflexibility. Increased flexibility helps keep you stable and preserves the ligaments, which are not supposed to stretch. Increasing your range of motion is also important because your joints tend to get stiffer the older you get and if you can maintain a good range of motion, you can prevent that stiffness from setting in. 

Ideal activities for increasing flexibility and mobility, which, in turn will help you stay balanced and stable, include:

  • Yoga
  • Tai chi
  • Using the elliptical
  • Cycling – especially on flat terrain
  • Swimming

Maintain a Healthy Weight

One way to maintain ahealthy weight is, again,exercise regularly and participate instrength training twice a week. Strength training just keeps coming up! It is so, so important to preserving the health of your joints — we cannot stress that enough. In terms of helping you maintain a healthy weight, strength training will increase muscle mass and increased muscle mass is what helps keep your weight at a healthy level. This is because when you burn muscle, you decrease fat and increase calorie burn. The more muscle strength you have, the more calories you will burn throughout the day. 

Maintaining a healthy weight is especially important when it comes to preserving the integrity of your knees because, for every pound you’re overweight, that’s an additional 4 pounds of pressure on the knee joints. So, if you’re 10 pounds overweight, that’s 40 extra pounds of pressure on the knees! 

Something else you can do to help maintain a healthy weight is toeat a diet that’s full of:

  • Vegetables like spinach and other leafy greens
  • Fruits, especially berries
  • Leanproteins like eggs, chicken, turkey, andfish
  • Nuts like almonds, cashews, Brazil nuts, and pistachios

It’s also wise to eliminaterefined sugars, processed and packaged foods, and foods that are high in sodium, saturated fat and trans fats. These can trigger the inflammatory response in the body, which, as we’ve learned here today, can cause arthritis and undue pain in the knee joint. 

Dr. Nancy’s Top 5 Foods for Joint Health

  • Ginger adds lots of flavor to lots of dishes, but did you know that it also contains compounds that block inflammatory triggers in the body? You can add grated ginger to almost anything from soups to stews and stir fries. Or, grate a tablespoon or so and steep it in warm water for a deliciously healing tea. 
  • The compound sulforaphane inbroccoli has been proven to block the formation of cells that cause rheumatoid arthritis to occur. 
  • Walnuts are one of the most excellent nuts you can eat to help promote good joint health. They’re high in omega-3 fatty acids, which are also found in fish like salmon and mackerel, (something else you can eat to maintain healthy joints).
  • This one might surprise you, butgrapes are also good for your joints. They’re high inantioxidants, and like ginger and walnuts, they also have anti-inflammatory properties. Keep the skin on these babies, because it contains an antioxidant that prevents the joints from thickening as can happen with various forms of arthritis. 
  • Drinking 16-ounces oftart cherry juice can also help keep inflammation at bay. Be sure to drink a variety that is 100% made from tart cherries and make sure there are no added sugars, which will cause inflammation. 

In addition to eating foods that prevent inflammation and help ward off diseases and conditions that target the joints, it’s an excellent idea to take a supplement likeSmarter Nutrition’sSmarter Joint Food. The joints are like any other part of your body — they need nutrition, too, in order to function efficiently, especially as we age. Smarter Joint Food contains seven proven ingredients that have been clinically proven to nourish and lubricate the knee joints to keep them mobile, flexible, and functional.  Supplementing with it helps nourish your joint cartilage by supporting healthycollagen production and the synovial fluid that lubricates your joints. 


Today, as part of her ongoing Joint Pain Series, Dr. Nancy talked all about the knee joint. 

The knee joint is made up of: muscles, bone, tendons, ligaments, and meniscus.

The knee is also where the thigh bone and the bones of the shin enter, and it is responsible for: 

  • Absorbing shock 
  • Keeping us standing upright 
  • Propelling us forward when we walk or run
  • Keeping us balanced
  • Allowing us to move up and down as when we squat down or sit

Wear and tear on the joints is a natural sign of aging, but there are things you can do to either slow down the progression of things like arthritis, or prevent them altogether. That includes strengthening the muscles of the thighs, hips, and core, and increasing mobility and flexibility. This can be done by participating in strength training for 30 minutes a session, two times a week, as well as taking up an activity like yoga, using a recumbent bike, or swimming. 

Maintaining a healthy weight is also key to keeping your knee joints healthy. Again, strength training can help with this, but so can eating healthy foods that reduce inflammation. Some of the best foods you can eat to increase the longevity of your joints include:

  • Ginger
  • Walnuts
  • Broccoli
  • Spinach
  • Tart cherry juice
  • Grapes
  • Salmon

In addition to eating these types of foods, it’s important to take a supplement like Smarter Nutrition’s Smarter Joint Food, which is tailored specifically for feeding and nourishing your joints. 

Stay tuned for the next part in our series on joint pain, where we’ll be discussing shoulder pain!

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