Connecting knee, hip pain

Tuesday, January 13, 2009

I have noticed that whenever I gather with fellow Boomers, our discussions inevitably start focusing on our aches and pains. You would think that with all of the difficult and serious challenges facing our nation we would not be wasting our time paying attention to things that a steady dose of Advil could alleviate. But no, nothing takes precedence over the creaking and groaning of our own bodies; it is as if we can't really believe that they have let us down.

Shoulders, hips, sciatica, lower back, neck, hamstrings, tendinitis, knees — the list goes on. It isn't pretty.

My personal survey of this phenomenon concludes that of all the complaints, the knees take the prize. This is true for my overweight friends right down to my sinewy marathoning friends. According to Harvard Medical School's Healthbeat: "One in five Americans age 60 and older has experienced significant knee pain on most days over the last six weeks ... Each year, Americans make about 15 million visits to doctors for knee pain."

Not only are the knees and hips our largest joints, but they work together, connected by the thighbone. "This proximity means the angle of your hip affects the pressure on your knee," according to Healthbeat, and problems in one area can cause problems in the other.

Ann Brode, an experienced somatic therapist and author of the forthcoming book Body Wisdom, recently told me that when someone reports to her with knee pain that is not the result of a sports injury, she immediately looks at the dynamic of the hip and pelvis. "Most people have a chronic holding pattern in their hips. This pattern prevents the easy mechanical function of the joint and correspondingly affects both the knee and the low back."

Ann points out that we live in a culture that regards the free movement of the pelvis as suspect. For women, such free "swinging of the hips" can be seen as sexually suggestive, for men, effeminate. She suggests that you can check this phenomenon out for yourself by "taking your body for a walk and notice the mechanical action that is your habitual way of walking and then explore how the body would move if the natural mechanical design of the foot, leg and full hip were encouraged to flow with full, unencumbered freedom."

After so many years of limiting this free movement, the body will often adapt a structural holding pattern. Ann explains: "The hip and knee joints are fulcrums around which movement happens and needs to have balanced muscles pulling on the front side and back side and left side and right side in order to work optimally and without undue wear and stress."

In our quick-fix society, too often sufferers turn to surgery. For more serious conditions, there is the option of hip or knee replacements with mechanical joints. For pain associated with knee osteoarthritis or tears of ligaments or the meniscus, there is the option of arthroscopic surgery. More than 900,000 of these operations are performed annually in North America.

This rush to surgery may calm down some after the recent study published in the New England Journal of Medicine which found no advantage from arthroscopic surgery for the relief of osteoarthritic pain over less invasive treatments such as arthritic medications and physical therapy. (The study did find benefits for these surgeries for meniscus tears and ligament reconstruction.)

The general consensus among experts is that non-concussive aerobic exercise (such as cycling, elliptical trainers, and especially swimming), losing weight, orthotics, pain medications (under the supervision of a physician), strengthening program, good walking shoes, physical therapy and body work are all first responders in the battle against hip and knee pain.

Dr. Michael O.L. Seabaugh, a Cape Girardeau native, is a clinical psychologist who lives in Santa Barbara, Calif. Contact him at For more on the topics covered in Healthspan, visit his website,

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