Why Women ae more prone to knee arthritis

The knee joint is an extremely important hinge joint which helps perform varied movements like bending,twisting,climbing and kneeling. Therefore, it is more vulnerable to injuries due to direct blow while hitting corners of the bed/table/door, twisting during walking on an uneven surface, etc.

Load on the knees increases two times of the body weight while climbing up the stairs and threefold while climbing down.

Females are more prone to suffering from knee osteoarthritis after the age of 50 years due to the following reasons :

• Genetics does not play a key role in knee arthritis. Women whose mother suffer from knee arthritis are more likely to develop it around the same age.

• Women in country like India have a tendency of gaining weight post-child birth (due to combination of eating foods with a high fat content and lack of physical activity). An increase of one kilogramme of weight increases six kilogrammes load on the knees.

• Obesity - Men become apple shaped as the fat gets deposited around abdomen and women become pear shaped as the fat gets deposited around the buttocks. Wider hips with angling thigh bone put excessive pressure on the knees causing the knee cap shift sideways and rub the cartilage. This also over-stretches thigh muscle quadriceps leading to pain in the upper part of the knee joint.

• Females have less muscle mass as compare to men and hence less muscle support to the knee joint.

• Women have more lax/flexible knees,making them more vulnerable to injuries.

• Women have smaller ligaments which support the knee joint than men and hence knees are unstable.

• Women wear high-heel shoes which pushes the body weight forward, placing more stress on the knees.

• Cushioning of feet also changes with age, especially in females after menopause. An average foot has sufficient fat that acts as a shock absorber. With age the fat content decreases, thereby reducing the shock absorbing capacity and placing more load on the knees.

• Female hormone estrogen protects the knee cartilage which allows the smooth movement of the joint by reducing inflammation. Post-menopause estrogen levels decreases considerably, increasing the risk of developing knee arthritis.

• Osteoporosis of the bones is more common in ladies after menopause due to reduced estrogen hormone.

• Arthritis patients generally complain of knee pain while sitting or getting up which is alleviated while walking. As the disease progresses, pain is felt all the time.

  Precautions that reduces load on the knee joint

• Avoid wearing high heels. If one has to wear heels due to short height or for looking nice, adequate physical activity with strengthening of muscles is mandatory. Strong muscles absorb the load of the body, thereby putting less pressure on the knees.
• During pregnancy diet may be increased for the child but it should be balanced and nutritive. Fats should be restricted. Physical activity along with appropriate exercises should be undertaken according to the trimester of pregnancy.

• If sitting cross-legged leads to pain/discomfort, it is best avoided. Women sitting cross-legged especially at a place of worship are unable to get up. Pain/stiffness after a prolonged sitting is due to tightening of the thigh muscle quadriceps which control the knee joint. Secondly, knee cap patella, which generally floats when the knee is straightened, sits in a groove with bending and locks. After getting up and stretching, pressure decreases on patella and one feels better. Therefore avoid prolonged sitting/kneeling/deep squat,etc.

• Avoid walking on uneven and hard surface which increases load on the knees.

   Treatment

• Women suffering from knee arthritis should maintain weight, wear sports shoes and knee brace, take Glucosamine/Diacerin for cartilage repair and undertake appropriate exercises.

• Hyaluronic acid injections dramatically alleviate the symptoms of pain,stiffness,etc. 
  
  

  Exercises

  • Aerobic activity - Low impact and non weight bearing aerobic exercises like cycling and swimming are ideal for the knees. Initiate with cycling/walking in pool. When there is no pain on weight bearing, start walking for a short period of time. Increase the distance gradually every week till 20 minutes.
  • It is extremely important for females to protect their knees during younger age so as to prevent knee arthritis in older age. Total knee replacement is becoming popular as most women neglect the early signs of arthritis and try to treat it with medication only.