As Korea entered the centenarian era, knee osteoarthritis is becoming an inevitable part of life for older adults.

In recent years, the number of young people with arthritis has increased due to the increase in the number of sports and overweight people, so there is a lot of interest in how to prevent knee arthritis. However, is there a way to prevent and manage osteoarthritis so that you can live a healthy life without knee pain?

The answer is “yes.”

Professor Beom Jae-won of the Department of Rehabilitation Medicine at Seoul National University Bundang Hospital suggests eating enough protein, strengthening quadriceps, and lifestyle management as effective ways to prevent and manage knee osteoarthritis in the YouTube channel with the same names as the hospital.

Glucosamine, chondroitin, and dietary sulfur have been popularized as nutritional supplements to help prevent and manage knee osteoarthritis.

However, Professor Beom emphasized that consuming enough protein is more important for older adults.

“Glucosamine, chondroitin, and dietary sulfur often do not have enough evidence to say that they are helpful. If they seem to work, keep taking them, but don't buy new ones. If they don't work, don't take them because they are costly and ineffective,” Professor Beom said. “Instead, you need to eat enough protein to keep your muscles strong in old age. Meat, fish, tofu, and eggs should be part of your daily diet.”

If you already have knee pain due to arthritis, strength training is the most evidence-based way to reduce pain and slow the progression of arthritis.

“In particular, it is recommended to exercise the quadriceps, the muscles in the front of the thigh that distribute the load on the knee and increase stability around the knee,” Beom said. “Strengthening the quadriceps is a way to reduce knee pain in the long term and prevent osteoarthritis in the first place.”

Strength-building exercises include stair climbing, squats, and bicycling, but it's important to choose the right exercise for you, as the right intensity varies from person to person.

“Stair climbing and squatting are good exercises, but if you recommend them to a patient who has difficulty walking because of knee pain, there is a risk of injury. Recommend flat walking to someone who squats heavily, no matter how safe and good it is. It won't be very effective,” Professor Beom pointed out.

There are ways to determine the right intensity of strength training for everyone.

“The right intensity is when you feel a little stiff and sore the next day or the day after,” Beom said. “However, if you feel sore during or immediately after your workout, reduce the intensity or number of reps. Also, suppose your knee joint feels sore, swollen, or unstable at any time. In that case, you should stop exercising and seek medical attention if symptoms persist.”

Strength training can be done daily at a low intensity, but if it's at a high enough intensity that you feel fatigued, you should take a day off to give your muscles time to recover.

“Muscles don't get stronger when you work out, they get stronger when they rest and recover from micro-damage caused by exercise,” Professor Beom noted. “Exercise without rest is like labor, so you shouldn't train at a high intensity every day to build muscle quickly.”

You should also set a goal for your daily strength training and take breaks in between.

“If you walk up a hill for an hour a day and take three 20-minute breaks or four 15-minute breaks, depending on your condition, the pressure on your knee joints will increase and then decrease, and the pain will go from bad to better,” he explained.

If you do it the wrong way, it can hurt the knee joint.

“One of the things people do a lot lately to work out their thighs is cycling, and while it helps strengthen the thigh muscles if you ride stiff and hard, you need to keep the pedals elevated and away from the saddle because if you bend your knees a lot, it can increase the pressure in the knee joint,” Beom advised.

There are also ways to help your knee joints, such as hiking, which has the potential to both help and aggravate them. “It's good to go uphill, but it can be hard on your knees when you come down,” Professor Beom said. “It's better to descend slowly or go to a low hill so your knees don't hurt.”

There are ways to exercise even when your condition makes it difficult, such as if you have severe arthritis and it's painful to walk on flat surfaces for long periods. “If you have pain when walking on flat surfaces for long periods, try walking in water, which reduces your weight bearing,” Beom said.

People with chronic conditions should also consult their healthcare provider before starting any exercise program to ensure it is appropriate.

“For example, very high-intensity exercise, such as spinning, should be avoided as it can damage the muscles and kidneys. People with diabetes should avoid exercising on an empty stomach, as it can cause low blood sugar,” Professor Beom said. “Strength training can increase blood pressure, so if you have uncontrolled hypertension, you should check your blood pressure and find the right intensity for you.”

There are also ways to prevent knee osteoarthritis through lifestyle management.

“The first thing is to avoid a sedentary lifestyle,” Dr. Beom said. “If you sit on the floor, you will inevitably adopt a double-legged or kneeling position, which puts a lot of pressure on the knee joint. This is bad for your knees and spine, so it is recommended that you use chairs and dining tables instead of cushions.”

Losing weight can also help prevent and manage knee osteoarthritis if you're overweight. “Maintaining a healthy weight can reduce the load on the knees,” Beom said. “Being overweight causes knee osteoarthritis, even at a young age. Maintain a healthy weight through diet and exercise.”

Other ways to prevent knee osteoarthritis include avoiding stairs, descending hills, and jumping as much as possible.

“These movements put a lot of pressure on the knee and can cause damage,” Professor Beom said. “Basketball, running, hiking, and other sports that involve many of these movements should be enjoyed only if you don't have knee pain.”