If you know someone that has had a knee or hip replacement recently, you’re probably not alone.
That’s because about 790,000 total knee replacements and 544,000 hip replacements are performed every year in the U.S., according to the American College of Rheumatology. And that number is expected to rise as the baby boomer population ages.
What’s behind these numbers? Patients seeking a total joint replacement of the knee or hip often experience severe arthritis, bone fractures or injuries, inflammatory conditions such as psoriatic or rheumatoid arthritis that result in joint pain, stiffness, or swelling and can no longer be treated with medication, or wear and tear due to occupational or athletic demands. Others find their joint pain means they can no longer enjoy certain activities like hiking, skiing, swimming, or playing tennis or pickleball.
It takes about a year to fully recover from a total knee or hip replacement surgery, with many patients resuming normal activities within two to three months. Patients will be required to rest at home for several weeks, then maintain a two-to-three-times-a-week in-office physical therapy regimen before continuing the exercises they are prescribed at home.
The good news is that there are steps you can take to help prevent knee and hip problems and potentially avoid surgery.
1. Maintain a healthy weight
Dr. Alan Beyer, board-certified orthopedic surgeon, and executive medical director at Hoag Orthopedic Institute in Orange County, Calif., says concern about weight and its effects on the hip and knee joints is the most common question he gets on his weekly orthopedic-based radio show, Doctor in the Dugout.
“Weight is directly related to your hip and knee joint health,” he says. “Keeping your ideal weight as you age is one of the best things you can do for your body’s joints. For every pound you add to your body, that one pound translates into three more pounds of pressure on your knee joints, for example.”
If you have hip or knee pain that’s unrelated to an injury or disease, losing weight can help ease your current discomfort.
“Before a patient is a candidate for a hip or knee replacement, they may be advised by their orthopedic surgeon to lose some weight to help in recovery and rehabilitation,” he says. “It’s math. The more you weigh, the more strain on your joints with every step.”
2. Make strength training a habit
Want to keep your knees and hips strong and functioning well?
Befriend weight-bearing exercises that target leg muscles crucial to supporting these joints. Your hips, for example, will have to do less work to support your body weight if the muscles surrounding them—the quadriceps, gluteals, hamstrings, and abdominal muscles—are strong. Similarly, you can reduce the shock your knee absorbs by strengthening your quadriceps muscle.
“Focus on exercises that strengthen the glutes, hamstrings, and quads,” says Holly Rilinger, founder of the Lifted Method. “The best way to do this is to use machines and/or free weights. Squats, deadlifts, and lunges are dumbbell exercises that target these muscle groups. If you have access to a gym, use machines like the leg press, leg extension, and leg curl. If you don’t have access to either, then glute bridges and wall sits, bodyweight squats, and steps ups, which are stepping up onto a surface that is higher than knee level, are a great place to start.”
Complement these exercises with regular stretching and flexibility movements such as yoga or Pilates. Both can help increase the range of motion in the muscles and ligaments around the knees and hips, and protect against injuries associated with tight muscles.
3. Eat for joint health
Some studies have found that adopting a Mediterranean diet can reduce inflammation in those who suffer from osteoarthritis, as well as help control weight and bone fracture risk.
Key components of the Mediterranean diet include fresh fruits and vegetables; whole grains; and plant-based foods rich in healthy fats such as nuts, seeds, and legumes. Olive oil is used instead of vegetable oil and animal fats. Fish rich in omega-3 fatty acids including salmon, sardines, tuna, herring, and mackerel are also recommended. Inflammatory foods that contain refined sugar, high-fat dairy, and red meat should be limited to one serving a week.
“More calcium-based foods should be included in your diet to ensure strong bones,” says Beyer. These include low-fat yogurt and cottage cheese, 1% or less milk, and green, leafy vegetables such as collard greens, broccoli rabe, kale, and bok choy.
4. Maintain proper posture
When you were young you were often told to stand up straight. Turns out that advice was keeping your knees and hips healthy.
“Posture plays a role in all our body’s joints,” says Beyer. “From the spine to our hips, knees, and wrists, posture’s effects may accumulate over a long period and cause us pain. While posture’s effects may be relevant to long-term hip and knee pain, the effect is mostly exacerbation of the underlying health of a joint. Bad posture habits can make the pain worse.”
He advises many of his patients to be aware of their posture, especially when they are sitting for long periods of time; to wear proper footwear; and to use ergonomically designed workstations.
He also urges his patients to be aware of so-called “tech neck,” or neck and upper-back pain that results from too much gaming or mobile phone use.
“To correct any posture issue, listen to your own body,” says Beyer. “If you sit for long periods and you notice more hip or knee pain, make sure you get up and move around. Same as on a plane, where you might be in one position too long. You can talk to an orthopedist about your posture for tips on how to limit your pain and lessen long-term risk to those joints, and see if there is an underlying issue with those joints that may be more of a direct cause to your discomfort.”
