Prevent arthritis in knees

Reducing Your Risk of Osteoarthritis

Millions of Americans have osteoarthritis, and its prevalence continues to increase as the population ages. The good news is that there are steps you can take to reduce your risk of developing osteoarthritis. While it’s true that you can’t change your genes or your age, you can achieve and maintain a healthy weight, build muscle strength, and increase your flexibility…all of which are great ways to help prevent arthritis.

Step 1: What Are You Eating?

Obesity is the leading cause of osteoarthritis. Being overweight puts extraordinary stress on weight-bearing joints, such as the knees and hips. Did you know that for every pound of weight you lose, you can achieve a four-pound reduction in the load you exert on each knee every time you take a step during your daily activities? So if you lose 10 pounds, you reduce the stress on each of your knees by 40 pounds! If you are overweight, losing 5 to 10 percent of your body weight may reduce your risk of developing arthritis.

The best ways to achieve and maintain a healthy weight are to adopt healthy eating habits and to incorporate physical activity into your routine. Aim for a diet high in fruits and vegetables (five to nine servings a day, of which five or more are from veggies), high in fiber and whole grains, and low in fat.

It’s best to be patient. Weight loss is best sustained when the weight is lost gradually. Aim to lose one to two pounds per week. It may have taken you years to accumulate those pounds, so don’t be surprised if it take several months to lose them.

Likewise, don’t expect your diet to change overnight. Start by looking at what you are eating now (keeping a food diary is a great way to do this) and identifying areas where you can improve. Little steps along the way will add up to big results over time.

Studies have shown that in populations where the diet contains lots of foods with antioxidants and omega-3 fatty acids, the prevalence of obesity and osteoarthritis are low. Foods that are high in these nutrients include: berries, fatty fish (including salmon), citrus fruits (such as oranges or grapefruit), and orange and yellow vegetables (for example, peppers).

The key to success is to make changes slowly, finding a diet that you can live with and won’t abandon. If you are finding it difficult to get started, a registered dietitian can work with you to show you how.

Step 2: Start Moving!

“Moving is the best medicine.” That’s the theme of a national osteoarthritis awareness campaign launched by the Arthritis Foundation and the Ad Council, and supported by Hospital for Special Surgery. It’s aptly named – regular physical activity is essential to both prevent and manage osteoarthritis, and for good reason:

  • Regular exercise helps facilitate weight loss, especially if you’re following a healthy diet.
  • Exercises to strengthen muscles generate more support for your joints.
  • Gentle stretching exercises keep joints flexible and increase range of motion, reducing the risk of injury. Aim for 30 to 45 minutes of exercise at least three times a week — ideally a combination of cardiovascular, strengthening, and stretching exercises. Before embarking on any new exercise program, be sure to check with your doctor to determine what types of exercise are best for you, and any special precautions you may need to take.

Here are some ideas to get you started:

  • Walking: This is the easiest exercise and can be done just about anywhere. Be sure to wear comfortable, supportive shoes. If you live in a city, you can leisurely walk its parks. For those who live near malls, many malls open their doors early so people can come in and walk in a comfortable environment. Mallwalking groups also provide a social element for people who don’t have family close by or others with whom to exercise.
  • Aquatics: Look for a water aerobics class. Exercising in water reduces stress on the joints and is not associated with a risk of falling.
  • Get on a recumbent bike: These bicycles enable you to cycle in a comfortable position and help increase your endurance, flexibility and leg strength— all in one exercise.
  • Take a class in gentle yoga, dance, or t’ai chi: These exercises have toning, flexibility and relaxation benefits. Plus there’s the added advantage of the “shared energy” in these classes as you bend and move with your classmates.
  • Take the stairs: Not all exercise requires a formal workout. Take the stairs instead of the elevator; get off the subway or bus one stop earlier and walk the rest of the way; or park a little farther out at the mall to burn a few extra calories and get your heart pumping.

Step 3: Be Careful!

Joints that have been injured have a greater risk of developing osteoarthritis over time. So as you move to a more active lifestyle, take these precautions to reduce your risk of injury:

  • Warm up and cool down. Be sure to stretch gently both before and after any exercise program.
  • Lift weights. Incorporate resistance exercises, such as gentle weight training, into your exercise routine to strengthen the muscles around your joints. The extra support will reduce your risk of injury.
  • Watch your step. Take simple precautions to prevent falls, like watching your step if you’re walking when it’s rainy or icy outside. Above all, find an exercise program that works for you. The more you like it, the easier it will be to stick with it!

For information on nutritional guidance provided by Hospital for Special Surgery, contact the Department of Food and Nutrition Services at 212.606.1293.

Posted: 7/12/2011


Sotiria Everett, MS, RD, CDN, CSSD
Clinical Nutritionist, Department of Food and Nutrition Services

Michael Silverman, PT, MSPT
Physical Therapist, Rehabilitation Department


Recipes to Reduce Arthritis Symptoms

Arthritis pain is never pleasant. While the kitchen may not be the first place you think of to fight arthritis symptoms, an anti-inflammatory diet may help keep pain and swelling under control. Studies have found that certain foods and seasonings can lower the number of inflammatory compounds in the body, so why not considering adding them to your diet!

From breakfast to dinner, we offer these recipes to help ease arthritis pain. And they can boost energy and help you maintain a healthy weight, as well. The best part? They are delicious, too!


Cherry mango smoothie

Just in time for the hot summer months, this anti-inflammatory smoothie uses fresh cherries. Cherries contain high levels of polyphenols and vitamin C, which both have anti-inflammatory and antioxidant properties. These properties can help fight arthritis pain as well as post-exercise soreness. Cherries also contain melatonin to promote a restful night’s sleep.

Try this smoothie for a fresh and anti-inflammatory start to your day.

Find the recipe here


Mediterranean Tuna Salad

Most people know that eating fish containing omega-3s is good for your heart. Did you know it’s also useful in reducing inflammation? The best sources of omega-3s are fatty fish, such as tuna, salmon, mackerel and sardines.

Omega-3s fight inflammation by interfering with enzymes called cytokines and immune cells called leukocytes, two critical components of the body’s inflammatory response. These omega-3s shut down inflammation on a cellular level even before it begins. This helps reduce your risk for developing arthritis and help combat joint pain and swelling for those who have the condition.

We love this Mediterranean tuna salad that’s packed with omega-3s to keep you feeling your best.

Find the recipe here


Turmeric Chicken & Quinoa

The deep marigold root known as turmeric is one of the best spices to use when battling arthritis, as it is known for its anti-inflammatory properties. Studies show that consuming 500 mg of turmeric every day is effective against osteoarthritis, especially in the knee.

The active ingredient in turmeric, curcumin, has also been shown to help treat symptoms of irritable bowel syndrome, Crohn’s disease and stomach ulcers.

This dish uses turmeric and quinoa, another superfood, to deliver a tasty, healthy and anti-inflammatory meal.

Find the recipe here


Chocolate-Dipped Frozen Bananas

Yes! You can have dessert! As long as you don’t overindulge, many sweet treats help fight inflammation when consumed in moderation. Dark chocolate and cocoa powder contain antioxidants and flavanols that can help reduce inflammation.

You can also treat yourself to a little red wine with dessert, as red wine contains resveratrol, a compound that is proven to reduce inflammation. Just remember to never drink too much, as excessive alcohol can also cause inflammation.

Satisfy your sweet tooth while keeping inflammation in check with these chocolate-dipped frozen bananas.

Find the recipe here

Making small yet meaningful changes to your diet can help reduce pain and inflammation caused by arthritis. We hope you enjoy these recipes that are favorites among our team. If you found these ideas helpful, then check out our favorite beverages to relieve arthritis pain!

Tips for Preventing Arthritis in the Hands

Treating arthritis

According to the Arthritis Foundation, many doctors feel that aggressive treatment is needed early on, or within the “window of opportunity.” This window of opportunity is two years after the initial onset of the disease, and many doctors aim for six months.

Arthritis is a debilitating disease, and early detection is key. Treatment varies with the type of arthritis. Certain medications help ease pain and inflammation. These include nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen (Advil) or indomethacin (Tivorbex). If you have RA, your doctor may prescribe medications that decrease inflammation by suppressing your immune response.

In extreme cases, surgery may be necessary to correct or alleviate certain problems, especially if arthritis is causing major limitations in your life.

Staying active, eating a healthy and balanced diet, and getting plenty of sleep are simple ways to manage your arthritis. Make sure to take breaks when doing strenuous or repetitive activities. Figure out the activities that cause your arthritis to flare up, and learn the best way to manage your pain.

If you do have pain in your hands, you might try using assistive devices, which are designed to take pressure off your joints. Examples include special jar openers and gripping devices.

The takeaway

When arthritis strikes, it doesn’t discriminate. The Arthritis Foundation estimates that by the year 2040, 78 million people will have arthritis. With such staggering figures, it’s important that you’re aware of the dangers of arthritis and, more importantly, the causes and symptoms. If you begin to experience any symptoms, see a doctor. When it comes to getting ahead of arthritis, early detection is the best detection.

7 Ways to Help Prevent Arthritis in Women

Arthritis pain and stiffness set in when the cartilage — the rubbery cushion in the joints that absorbs shock for the bones and allows them to glide smoothly when we move — wears away. When there isn’t enough cartilage left in the joint to protect the bones from damaging each other, we feel it. And while over 46 million Americans are living with arthritis, about 61 percent of them, or 28 million, are women.

Why are women more commonly affected by arthritis? One reason may be the physical differences between the sexes — for example, women have less knee cartilage than men. It’s no wonder that according to a recent report, knee replacement surgeries more than tripled in women between ages 45 and 64 over the past decade. Women are also at greater risk for the autoimmune condition rheumatoid arthritis than men, which experts think may be due to hormonal differences, among other factors. Finally, women may also experience a greater emotional burden from arthritis than men. A 2011 survey conducted by the supplement manufacturer Flexicin International found that 78 percent of women with arthritis feel that they receive very little support from family and friends, compared with 66 percent of men.

Fight Back Against Arthritis

So what can you do? The good news is that there are risk factors for osteoarthritis that women can target for arthritis prevention. Start with these important steps.

  1. Maintain a good body weight. Excess body weight is one of the best-known and most important risk factors for arthritis. The more pressure you put on your joints, the faster they wear out. “Every extra pound of weight you have on is 4 pounds of pressure on the weight-bearing joints, like your knees and hips,” explains Scott Zashin, MD, a board-certified rheumatologist and clinical professor of medicine at the University of Texas Southwestern Medical School. “Losing weight is one thing patients can do that really makes a difference .” As the pounds drop, you reduce stress on your joints by lowering their workload. Change up your diet by adding in fiber each day and eating more whole grains, fruits, and vegetables while limiting refined carbohydrates and fat. Remember, small changes are always easier to maintain than big ones. So focus on baby steps at first for lasting prevention of arthritis pain.
  2. Trade in your high heels. The human foot was not designed to be on its toes all day long, a fact that escapes fashion designers and shoe shoppers. And for some people, high heels will cause trouble. “It’s OK to wear them occasionally, but if used all the time, they can cause a lot of problems,” Zashin says. If you can switch to a more joint-friendly style most of the time, your body will thank you.
  3. Do non-impact exercises. According to Dr. Zashin, some activities may predispose you to osteoarthritis and arthritis pain. High-impact exercise like long-distance running and soccer put a lot of stress on the joints and can wear down the cartilage faster than normal — in essence, worsening your arthritis, he says. You may want to turn in your running sneakers for a swimsuit or biking shorts: Zashin recommends biking or water exercises for those looking to stay active and practice arthritis prevention.
  4. Use better body mechanics. When performing physical tasks, like lifting objects, how you hold your body (and any weight you’re carrying) matters. “People with bad body mechanics may be predisposed to develop arthritis,” says Zashin. Good body mechanics, like lifting with your legs instead of your back, take much of the stress off the joints, he explains. This helps with arthritis prevention by preserving cartilage. Another of Zashin’s recommendations is to carry your purse or other bags on your forearm rather than gripping the straps with your hands. Another way to approach this, he says, is to get help. Have someone carry the bags for you and give your joints a rest to avoid arthritis pain.
  5. Avoid injuries. While no one wants to be sidelined by an injury, taking preventive steps helps safeguard your health today and may serve as arthritis prevention in the future. “Avoiding injury will decrease the risk of developing arthritis later in life,” says Zashin, who points out the connection between injuries and osteoarthritis in football players who develop arthritis pain years after retiring. Though most women aren’t playing football, other injury types can cause problems. In general, Zashin says, “if you’re doing exercise that’s increasing your pain the next day, that’s probably not the right exercise for you.” Focus on sports and exercises that will be challenging but safe, and know your body’s limits. Be sure to start any new exercise program gradually — overdoing it early on is a surefire way to get hurt. Last, check in with your health care provider to get cleared before beginning any new workout regimen, and ask about any special precautions you should be taking.
  6. Check your vitamin D. According to the National Institutes of Health, about 60 percent of Americans are deficient in vitamin D, and women, especially African-American women and those of menopausal age, are especially likely to be lacking adequate levels. Asking your doctor to check your vitamin D levels is a smart move for arthritis prevention. “Patients who have adequate levels of vitamin D have less progression of osteoarthritis,” Zashlin says. The exact mechanism is not known because of limited research. About taking vitamin D supplements, he says that “the benefits probably outweigh the risks, as long as you don’t take too much.” But if you’re taking vitamin D, Zashin recommends having your blood levels monitored by your doctor because too much can be dangerous.
  7. Stay hydrated. Another reason to drink more water: arthritis prevention. The cartilage in our joints is made up mostly of water, which is what makes it such a great cushion for the joints. When we’re dehydrated, water gets sucked out of the cartilage and it’s more easily damaged by wear and tear. This can be seen in people with osteoarthritis of the spine or degenerative disk disease, says Zashin. “When the cartilage discs in the spine lose moisture or water and get dried out, that increases pain,” he says. Keep your cartilage healthy by drinking water throughout the day. A daily 6 to 8 cups now may pay off in the years to come.

Arthritis is all too common in women, but you can take some steps now to prevent arthritis later or slow its progression.

Preventing Arthritis

If you don’t suffer from osteoarthritis, take a moment to consider your good fortune. An estimated 54 million Americans suffer from arthritis or chronic joint symptoms — and the Centers for Disease Control and Prevention predicts that number will balloon to 78 million by 2040. You should also think about your future. Are you doing everything you can to protect your joints?

Osteoarthritis is the kind of arthritis you get from wear and tear on the joints — and in many cases, it is preventable. Here’s a look at the steps you can take to keep the disease out of your life.

Steps to prevention

  • Watch your weight. Extra weight can strain the joints, especially the knees and hips. Over time, this strain can lead to arthritis. The good news is that even a small reduction in your waistline can lead to a big reduction in your risk. A study published in the Annals of Internal Medicine found that women who lost an average of 11 pounds over 10 years cut their risk of osteoarthritis in the knee by half.
  • Avoid injuries. Don’t wait until your golden years to start protecting your joints. No matter what your age, serious injuries to joints — torn ligaments, torn cartilage, or broken bones — can lead to arthritis somewhere down the road. A study published in the Annals of Internal Medicine found that people who injured their knees as teenagers and young adults were nearly three times more likely than those without injuries to have osteoarthritis by the time they reached 65.
  • People who participate in intense sports like football, basketball, soccer, and gymnastics are especially vulnerable to joint injuries. But just about any type of exercise can be dangerous if you push yourself too hard. The American Orthopaedic Society for Sports Medicine urges people to follow the 10 percent rule: If you want to boost your activity level (a noble goal), do it just 10 percent at a time. For example, if you normally jog one mile a day, try jogging 1.1 miles the next day, not four.
  • Get the right gear. Whatever activity you choose to do, protect yourself from injuries by wearing the right equipment (including good shoes) and using proper form.
  • Warm up before every workout. And remember, variety is a virtue. A fitness routine that combines several different kinds of exercises — including aerobic activity and strength training — will help keep your joints strong and flexible while reducing the risk of injury, especially from overuse.

Because knee injuries are often the source of arthritis, it’s important to take care of your knees before and after exercise. The National Institute of Arthritis and Musculoskeletal and Skin Diseases advises that you always warm up before you exercise, and stretch the muscles in front of and behind your thighs (quadriceps and hamstrings) to reduce pressure on your knees. You can strengthen the muscles around your knees by walking up stairs or hills or riding a stationary bicycle.

Pay attention to your footwear as well. To help maintain your balance and leg alignment while exercising, it’s best to buy shoes that fit. Knee problems can be aggravated by feet that overpronate (roll inward), but this common problem can be corrected with shoe inserts from a podiatrist. These inserts are called orthotics, and are custom-molded to your foot.

Finally, if you do sustain a knee injury that refuses to heal, see a doctor. Left untreated, a knee that’s unstable from injury can lead to arthritis later in life.

Stay safe on the job

Jobs that require repetitive motions such as squatting, kneeling, or heavy lifting can greatly increase your risk of arthritis. According to a report in the Annals of Internal Medicine, joint strain on the job accounts for 30 percent of knee osteoarthritis in men. If possible, avoid work that over-taxes your joints. If you’re in a job such as carpet-installing, which requires a lot of kneeling, use a knee pad. At the very least, try to find a way to vary your movements throughout the day.

Get proper treatment

If you do injure a joint, don’t ignore the pain. Minor sprains and strains can usually be treated with a little RICE — rest, ice, compression, and elevation. If a joint doesn’t heal on its own, though, it’s a good idea to consult a physician. A knee that remains weak and unstable can lead to arthritis years down the road. If you have suffered a torn ligament or another serious injury, you may require a temporary knee brace, treatment, or even surgery.

Surgery isn’t the final answer, however. In fact, the hard work is still to come. Slowly but surely, you’ll need to keep moving the joint until it’s strong and stable enough to withstand your favorite activities. If you rest the joint too much, the cartilage will scar too quickly, you could easily re-injure the joint. Your doctor or physical therapist can recommend specific exercises to help speed your recovery. He or she may also suggest wearing a brace or other protective equipment to reduce your risk of further injury.

Pay attention to diet

Eat a balanced diet. Like any other part of your body, joint tissue needs proper nutrition. As reported in the Annals of Internal Medicine, two nutrients stand out for their possible ability to protect the joints: vitamin C and vitamin D. Vitamin C helps prevent cartilage damage and vitamin D protects bones. Studies suggest that a healthy supply of vitamin C may reduce the risk of osteoarthritis by three-fold. Vitamin D may have the ability slow the progression of the disease or help keep it from starting in the first place. If your daily diet is lacking in these nutrients, ask your doctor if supplements are right for you.

Arthritis. U.S. Centers for Disease Control and Prevention.

Gelber AC et al. Joint injury in young adults and risk for subsequent knee and hip osteoarthritis. Annals of Internal Medicine 133(5): 321-328.

Felson DT et al. Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham Study. Annals of Internal Medicine 116: 535-539.

American Orthopaedic Society for Sports Medicine. Baby boomer sports injury prevention tips.

Centers for Disease Control. Targeting Arthritis: Improving Quality of Life for More Than 450 Million Americans.

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