Osteoarthritis Of The Knee
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Very informative thank you. And made me think. I am a 72 yr old whitewoman, have never used ( or even been offered) HRT since menopause ~15 yrs ago. Now I’m wondering if it would have delayed the onset of osteoarthritis ( knee) and give me more energy in general. And is it wise to start taking hrt after being without those hormones for so long?❞
(this was in response to our article about menopausal HRT)
Thanks for writing! To answer your first question, obviously we can never know for sure now, but it certainly is possible, per for example a large-ish (n=1003) study of women aged 45–64, in which:
- Those with HRT were significantly less likely to have knee arthritis than those without
- However, to enjoy this benefit depended on continued use (those who used it for a bit and then stopped did not enjoy the same results)
- While it made a big difference to knee arthritis, it made only a small (but still beneficial) difference to wrist/hand arthritis.
We could hypothesize that this is because the mechanism of action is more about strengthening the bones (proofing against osteoporosis is one of the main reasons many people take HRT) and cartilage than it is against inflammation directly.
Since the knee is load-bearing and the hand/wrist joints usually are not, this would mean the HRT strengthening the bones makes a big difference to the “wear and tear” aspect of potential osteoarthritis of the knee, but not the same level of benefit for the hand/wrist, which is less about wear and tear and more about inflammatory factors. But that latter, about it being load-bearing, is just this writer’s hypothesis as to why the big difference.
The researchers do mention:
❝In OA the mechanisms by which HRT might act are highly speculative, but could entail changes in cartilage repair or bone turnover, perhaps with cytokines such as interleukin 6, for example.❞
What is clear though, is that it does indeed appear to have a protective effect against osteoarthritis of the knee.
With regard to the timing, the researchers do note:
❝Why as little as three years of HRT should have a demonstrable effect is unclear. Given the difficulty in ascertaining when the disease starts, it is hard to be sure of the importance of the timing of HRT, and whether early or subclinical disease was present.
These results taken together suggest that HRT has a metabolic action that is only effective if given continuously, perhaps by preventing disease initiation; once HRT is stopped there might be a ‘rebound’ effect, explaining the rapid return to normal risk❞
~ Ibid.
You can read the study here:
On whether it is worth it now…
Again, do speak with an endocrinologist because your situation may vary, but:
- hormones are simply messengers, and your body categorically will respond to those messages regardless of age, or time elapsed without having received such a message. Whether it will repair all damage done is another matter entirely, but it would take a biological miracle for it to have no effect at all.
- anecdotally, many women do enjoy life-changing benefits upon starting HRT at your age and older!
(We don’t like to rely on “anecdotally”, but we couldn’t find studies isolating according to “length of time since menopause”—we’ll keep an eye out and if we find something in the future, we’ll mention it!)
Meanwhile, take care!
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Loving Life at 50+ – by Maria Sabando
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What a pleasant mix of a book! Sabando writes about aging with a great blend of light-heartedness and seriousness, and gives extra attention to the important balancing act of:
- Indulging sufficiently to enjoy life
- Staying well enough to enjoy life
…because one without the other will not generally result in an enjoyable life! An American proud of her Italian heritage, she blends (as many immigrant families do) cultures and perspectives, aiming where she can for “the best of both” in that regard, too.
Nor is this just a philosophical book—there’s yoga to be learned here, chapter by chapter, and recipes peppered throughout. The recipes, by the way, are simple and… Honestly, not as healthy as the recipes we share here at 10almonds, but they are good and when it comes to those indulgences we mentioned, her philosophy is that strategic mindful indulgence keeps mindless binge-eating at bay. Which is generally speaking not a bad approach, and is one we’ve written about before as well.
When it comes to health advice, the author is no doctor or scientist, but her husband (a doctor) had input throughout, keeping things on track and medically sound.
The style is very casual, like talking to a friend, which makes for a very easy and enjoyable read. Absolutely a book that one could read casually in the garden, put down when interrupted, pick up again, and continue happily where one left off.
Bottom line: whatever your age (no matter whether your 50th birthday is in your shrinkingly near future or your increasingly distant past), there’s wisdom to be gained here—it’s not a manual (unless you want to treat it as one), it’s more… Thought-provoking, from cover to cover. Highly recommendable.
Click here to check out Loving Life at 50+, and love life at 50+!
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Sugar Blues – by William Dufty
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This is a “read it cover to cover” book. It charts the rise of sugar’s place in world diets in general and the American diet in particular, and draws many conclusions about the effect this has had on us.
This book will challenge you. Sometimes, it will change your mind. Sometimes, you’ll go “no, I’m sure that’s not right”, and you’ll go Googling. Either way, you’ll learn something.
And that, for us, is the most important measure of any informational book: did we gain something from it? In Sugar Blues, perhaps the single biggest “gain” for the reader is that it’s an eye-opener and a call-to-arms—the extent to which you heed that is up to you, but it sure is good to at least be familiar with the battlefield.
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Why are my muscles sore after exercise? Hint: it’s nothing to do with lactic acid
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As many of us hit the gym or go for a run to recover from the silly season, you might notice a bit of extra muscle soreness.
This is especially true if it has been a while between workouts.
A common misunderstanding is that such soreness is due to lactic acid build-up in the muscles.
Research, however, shows lactic acid has nothing to do with it. The truth is far more interesting, but also a bit more complex.
It’s not lactic acid
We’ve known for decades that lactic acid has nothing to do with muscle soreness after exercise.
In fact, as one of us (Robert Andrew Robergs) has long argued, cells produce lactate, not lactic acid. This process actually opposes not causes the build-up of acid in the muscles and bloodstream.
Unfortunately, historical inertia means people still use the term “lactic acid” in relation to exercise.
Lactate doesn’t cause major problems for the muscles you use when you exercise. You’d probably be worse off without it due to other benefits to your working muscles.
Lactate isn’t the reason you’re sore a few days after upping your weights or exercising after a long break.
So, if it’s not lactic acid and it’s not lactate, what is causing all that muscle soreness?
Muscle pain during and after exercise
When you exercise, a lot of chemical reactions occur in your muscle cells. All these chemical reactions accumulate products and by-products which cause water to enter into the cells.
That causes the pressure inside and between muscle cells to increase.
This pressure, combined with the movement of molecules from the muscle cells can stimulate nerve endings and cause discomfort during exercise.
The pain and discomfort you sometimes feel hours to days after an unfamiliar type or amount of exercise has a different list of causes.
If you exercise beyond your usual level or routine, you can cause microscopic damage to your muscles and their connections to tendons.
Such damage causes the release of ions and other molecules from the muscles, causing localised swelling and stimulation of nerve endings.
This is sometimes known as “delayed onset muscle soreness” or DOMS.
While the damage occurs during the exercise, the resulting response to the injury builds over the next one to two days (longer if the damage is severe). This can sometimes cause pain and difficulty with normal movement.
The upshot
Research is clear; the discomfort from delayed onset muscle soreness has nothing to do with lactate or lactic acid.
The good news, though, is that your muscles adapt rapidly to the activity that would initially cause delayed onset muscle soreness.
So, assuming you don’t wait too long (more than roughly two weeks) before being active again, the next time you do the same activity there will be much less damage and discomfort.
If you have an exercise goal (such as doing a particular hike or completing a half-marathon), ensure it is realistic and that you can work up to it by training over several months.
Such training will gradually build the muscle adaptations necessary to prevent delayed onset muscle soreness. And being less wrecked by exercise makes it more enjoyable and more easy to stick to a routine or habit.
Finally, remove “lactic acid” from your exercise vocabulary. Its supposed role in muscle soreness is a myth that’s hung around far too long already.
Robert Andrew Robergs, Associate Professor – Exercise Physiology, Queensland University of Technology and Samuel L. Torrens, PhD Candidate, Queensland University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Reasons to Stay Alive – by Matt Haig
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We’ve previously reviewed Matt Haig’s (excellent) The Comfort Book, and now it’s time for his more famous book: Reasons To Stay Alive. So, what’s this one, beyond the obvious?
It narrates the experience of anxiety, depression, and suicidality, and discovering how to find beauty and joy in the world despite it all. It’s not that the author found a magical cure—he still experiences depression and anxiety (cannot speak for suicidality) but he knows now how to manage it, and live his life.
You may be wondering: is this book instructional; is it reproducible, or is it just an autobiography? It’s centered around his own experience and learnings, but it gives a huge sense of not feeling alone, of having hope, and it gives a template for making sense of one’s own experience, even if every person will of course have some points of differences, the commonalities are nonetheless of immense value.
The writing style is similar to The Comfort Book; it’s lots of small chapters, and all very easy-reading. Well, the subject matter is sometimes rather heavy, but the language is easy-reading! In other words, just the thing for when one is feeling easily overwhelmed, or not feeling up to reading a lot.
Bottom line: whether or not you suffer with anxiety and/or depression, whether or not you sometimes feel suicidal, the contents of this book are important, valuable insights for everyone.
Click here to check out Reasons To Stay Alive, and see through the highs and lows of life.
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Water: For Health, for Healing, for Life – by Dr. Fereydoon Batmanghelidj
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Notwithstanding the cover’s declaration of “you’re not sick, you’re thirsty”, in fact this book largely makes the argument that both are often the case simultaneously, and that dehydration plays a bigger role in disease pathogenesis and progression than it is credited for.
You may be wondering: is this 304 pages to say “drink some water”?
And the answer is: yes, somewhat. However, it also goes into detail of how and why it is relevant in each case, which means that there will be, once you have read this, more chance of your dehydrated and thus acutely-less-functional brain going “oh, I remember what this is” rather than just soldiering on dehydrated because you are too dehydrated to remember to hydrate.
The strength of the book really is in motivation; understanding why things happen the way they do and thus why they matter, is a huge part of then actually being motivated to do something about it. And let’s face it, a “yes, I will focus on my hydration” health kick is typically sustained for less time than many more noticeable (e.g. diet and exercise) healthy lifestyle adjustments, precisely because there’s less there to focus on so it gets forgotten.
The style is a little dated (the book is from 2003, and the style feels like it is from the 80s, which is when the author was doing most of his research, before launching his first book, which we haven’t read-and-reviewed yet, in 1992) but perfectly clear and pleasant to read.
Bottom line: this book may well get you to actually drink more water
Click here to check out Water: For Health, for Healing, for Life, and get hydrating!
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Healthy Brain, Happy Life – by Dr. Wendy Suzuki
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We talked about Dr. Wendy Suzuki’s research in the category of exercise and brain-benefits in our main feature the other day. But she has more to say than we can fit into an article!
This book chronicles her discoveries, through her work in memory and neuroplasticity, to her discoveries about exercise, and her dive into broader neurology-based mental health. So what does neurology-based mental health look like?
The answer is: mitigating brain-busters such as stress and anxiety, revitalizing a fatigued brain, boosting creativity, and other such benefits.
Does she argue that exercise is a cure-all? No, not quite. Sometimes there are other things she’s recommending (such as in her chapter on challenging the neurobiology of the stress response, or her chapter on meditation and the brain).
The writing style is mostly casual, interspersed with occasional mini-lectures (complete with diagrams and other illustrations), and is very readable and informative throughout.
Bottom line: if you’d like the more in-depth details of Dr. Suzuki’s work, this book is a very accessible way to get 320 pages of that!
Click here to check out Healthy Brain, Happy Life, and give yours the best!
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