I have needanewoneitis in my lower back. It's been an issue for about ten years, now. It can be a low grade annoyance, or it can go full blown and have me down and out for days. It can give me a sciatic pinch down my leg, and that really gets on my nerves.
But today I want to talk about knees.
Almost all of us over 40 have some arthritis in our knees. We all probably have some shredded meniscus cartilage by now, too. We've put these knees through the ringer.
Here's what I know about knees and fitness over 40.
Shoes are THE most important thing for your feet, ankles, knees, hips and back. The reason? They help align those joints. As I age, my right knee bends inward more and more with each step. The cause of this, however, is not my knee. The cause is pronation of my foot. The result is foot pain, ankle pain, knee pain, hip pain, back pain...what a pain! The wonderful thing is the right combination of cushion, stability and arch support in my shoes can correct this completely. Instead of driving a Porsche, I buy expensive fitness shoes, because they prevent pain and allow me to keep doing the active things I love to do.
Ask any fitness walker or runner you know. The moment there is a twinge in the knee, we are headed to the shoe store because we know if the knee is getting cranky, it's probably worn out shoes. Many people track the mileage of their shoes. I have about ten pairs of worn out shoes sitting by my front door at home. They look fine, but their stability is gone. I wore them out on the inside. Just because they are cute, or still look new, does not mean they are correcting pronation, supporting your arches, etc.
Here's my motto at age/level 53. Function Over Fashion!
I can no longer buy shoes off the rack, or because of how they look. It's not worth the consequences. We are lucky, we have several great athletic shoe stores in the area, where not only will someone help you get fitted for shoes and inserts, they will give you up to 90 days to try them out. Here are a few general rules for trying new shoes, inserts, etc.
1. Getting the right shoes is a giant trial-and-error experiment, and it can be a pain in the arse. Hang in there until you find what works for you. Then, a few years will pass by, and you will change or the shoe company will change your model, and you will have to go through it again. It is one of the prices of being active. But it's always been worth it for me. Always.
2. Don't change more than one thing at once. For example, new shoes and new inserts at the exact same time will leave you scratching your head if something doesn't feel right. One variable at a time.
3. With anything new, don't go out for a 4 miler right off the bat, especially if you are prone to knee issues. Try half a mile. See how it feels the next day. If that went OK, try a mile. Also, new walking/running shoes do not ever need to be broken in. They should feel fabulous from day one. If they don't, they have to go back. Don't let your people-pleasing or busyness get in the way of getting the right shoe for you. Go back ten times if you have to, but get that foot/ankle/knee/hip/back aligned so that you can continue doing the things you love to do.
4. If you hurt yourself with your old shoes, you might have to wait until that issue gets resolved before you try the new ones. While you are waiting for the knee to feel better, it is so important to continue to exercise! We have helped several women prepare for and then heal from knee replacement surgery, and the longest any of them were off was four weeks. Once they could drive, they were right back in the studio, focusing on upper body and core. We can design an entirely seated workout for you, if needed. But those strong arms and core will get you through anything. I went with 83-year-old Eva to the chiropractor last week and I love what he said to her. "Thank goodness you have such strong arms to help you get up and down." Love that! One of the most important things to be able to do as we age is maintain our ability to get up and down, out of a chair AND off the floor. That becomes impossible if we don't maintain our workouts even with a cranky knee. If you can drive, you need to be here lifting.
5. I have a client who switched from walking outside to walking in the pool, and it has done wonders for her knees. I have another client who is buying time until she gets her knees replaced, and in the meantime is trying lots of pool classes at McConnell. Don't give up, keep finding what works for you.
6. Knee pain is not something to tough out when we're talking about highly repetitive exercises like walking, biking, and other forms of cardio. We each have to find our own pace, level and program that helps us stay in the best shape that we can. For some women, that means using the elliptical instead of a treadmill. For some, that means taking several shorter walks each day, instead of one long walk. For some, that means biking instead. Whatever works! In cardio, the most important thing is getting into your zones 1 and 2, and you can do that in lots of different ways. Lots. Don't give up, get bound and determined to find what works for you. I've had to let go of doing things the way I used to do them, and embrace the way I do them now. To be honest, I don't want to look back. Been there, done that, got the t-shirts. I ran my marathons. I want to look forward and see what the future holds.
7. Just because your knee hurts, doesn't mean you shouldn't work out. It could actually help, if you do the correct things. Physical therapy is simply a special set of exercises that are prescribed to help heal a diagnosis. Pilates was actually designed to help rehabilitate injured dancers in the ballet, as well as soldiers returning from war. The ability of these exercises to strengthen and heal is quite amazing. Lengthen, strengthen, and align. Those are the basic Pilates principles and they work.
8. Most of us aren't stretching enough, and that alone is causing all kinds of knee shenanigans. When the hips and hamstrings are tight, the knees come out of alignment. When the hips lose mobility, our normal squat takes on all kinds of compensations that can lead to knee pain. Even if you don't squat in the gym, you squat every time you use the bathroom, sit on a chair and stand back up, take the stairs, get out of bed, etc. You are squatting all day long. We have so many opportunities at the studio to get your stretching done. Private yoga with Margie, Tread+Yoga classes, Tread+ Pilates, Kim's foam rolling clinics, and my Saturday Pilates class. Make sure you stay mobile. If you are super stiff, start to work on that. Five minutes a day to start will lead to greater mobility and less pain. You can build from there.
9. Don't stop working out because you have knee pain. (Repeated for emphasis!)
10. Stay positive! This is the toughest part, I know. I've been there. I've had knee surgery, I have every kind of compression sleeve they make, gel packs in the freezer ready to go, and a hotline to the orthopedic doctor to help when things get too jacked up. Pain in my knee is one thing. The slew of anxiety-provoking beliefs about how the best is behind me and I'll never be able to do the things I want to do now is another. What's the antidote to this? Use it as an opportunity to get a fiercely strong core. Glutes. Shoulders. Triceps. Biceps. Back. ETC!! Get more focused than ever. This will keep the metabolism up, endorphins flowing and keep you feeling like this is a minor setback, not a permanent catastrophe. When I start feeling frustrated and sorry for myself about an injury instead of getting by arse to the gym, it never fails. I feel like crap, start eating like crap, and generally spiral down. It is my responsibility to spiral up, not down. And if I can't find that power within myself to do it, I need to ask for help.
I know our knees hurt. We all have ineedanewoneitis. It sucks. But the power comes from walking into the gym and saying to your trainer, "My knee hurts, time to rock these triceps, shoulders and core! Gimme some of those endorphins. Give me some of that "I Did It" medicine. Give me some of that empowerment.
My guaranteed prescription for sustainable, life long fitness: Sh** hurts. Do it anyway.
Now get moving!