My friend Ashley mentioned a weird thing that happened at the gym. "This guy I've been working out with told me that my foot's turning out a little while I'm exercising and I should work on strengthening this muscle," she said, as she ran her hand from the inside of her upper thigh down to her kneecap. "He said that I'm compensating for the weakness, which I guess is bad for my knee."
A little alarm went off in my head. "That is bad!" I said. "I bet it's throwing off your alignment and eventually, if you don't do something about it, you're probably going to end up in a lot of pain."
Not that I'm an expert or anything, but I just spent seven months talking to doctors and physical therapists about why women's hips and knees hurt so much. Ashley, who's in her 20s, isn't too worried about her joints—not yet anyway. Maybe you aren't either. But that's the thing. These problems can creep up on you.
Hip and knee pain is incredibly common: More than 10 million women have to deal with it and almost everyone's at risk. Whether you're a super-fit workout fiend or totally exercise-phobic, your lifestyle could be contributing to joint problems that can lead to osteoarthritis—even surgery. In fact, hip replacements in women have increased by nearly 40 percent in the past 15 years, and knee replacements have more than doubled. While these procedures are still most common in older people, incidence among women 45 to 64 is growing.
Many women's knee problems start because of repetitive stress injuries from a high-impact activity like running. That's what happened to Barbara Goldrich, 43, of New York City, who trained regularly for marathons. She actually first noticed her knee pain while taking a Zumba class. "I pivoted and felt something go ‘zing,' " she says. Over the next few months, that little pain escalated. "I would get up from my desk at work and be hobbling," she says.
When she finally saw her doctor, he told her that her kneecaps were out of alignment; there was probably also some wear and tear from running. The cause? Despite all the miles she logged, certain muscles surrounding the joint didn't have the strength to support her knee properly. So he prescribed physical therapy to strengthen her thighs and increase her flexibility.
While overdoing certain types of exercise can lead to joint trouble, being overweight and inactive may be even more risky for your hips and knees. Excess body fat not only puts stress on joints but it also contains pro-inflammatory cytokines, protein molecules that can cause cartilage to break down, says Stephen P. Messier, Ph.D., professor and director of the J.B. Snow Biomechanics Laboratory at Wake Forest University. Sitting all day long weakens core muscles important for stability, makes you less flexible and affects how you move, causing pain in your hips and knees—and sometimes in both.
"People think, ‘I'm getting older, so of course my joints are wearing out and I have pain.' But that's a mistake," says Ann Duffy, physical therapist and an advanced hip clinician with New York City's Hospital for Special Surgery. "Pain means there's something wrong."
This plan works for everyone, whether you're hurting now or want to head off a problem before it starts. If you're in serious pain, you should be evaluated by a physical therapist or orthopedist, who can suggest modifications.
You may think rest is best for your joints, but experts say the opposite: Exercise keeps joints healthy by increasing the blood flow to them. If you're not already doing some type of aerobic activity, like brisk walking, tennis or swimming, now is the time to start. Aim for 30 minutes of moderate activity five days a week. If you're a beginner or in pain, start by walking for 10 minutes just two days a week and increase the length and frequency as it gets easier.
Strengthening the muscles in your midsection is just as important to your hips and knees as strengthening the muscles in your legs. "When the muscles in your core are weak, your pelvis tilts, which throws everything off," says John Galluci, Jr., founder of JAG Physical Therapy in New Jersey. Do these exercises, which work your legs and important core muscles, three times a week.
Improving your flexibility even a little bit can work wonders for joint pain. These three basic stretches target the muscles that help support your hips and knees and will help keep them in alignment.