I heard both these lines in clinic this week..
Are these throw away remarks
a little or a lot wide of the mark??
Cartilage likes to be loaded, right? My Ode to Cartilage. has the detail..
The TLDR* [*Too Long Didn’t Read]..
Our cartilage needs load to stay healthy.. but NOT too much.
- Load switches on the genes that maintain our cartilage.
Joint cartilage has no blood, nerve or lymph supply.
- Joint fluid provides the fresh components, nutrition and oxygen
Cycles of load give diffusion a push.
- On / off joint forces nourish our cartilage.
So, could it be that our knees only inflame (long term) when we stop moving? When we stop footballing ⚽️ + dancing 💃🏻..?
That’s what I’ll dig into over the next few newsletters..
Whether we’re footballers ⚽️, dancers 💃🏻, runners 🏃♀️, gardeners 🌿, golfers 🏌️♀️or walkers 👣..
Will our knees wear out?
And is osteoarthritis inevitable?
At a molecular level..
Well, we do know that some cartilage components degrade as we get older.
Massive ‘bottlebrush’ Aggrecan shows molecular changes with age.
These behemoths hold water, giving cartilage compressive strength.
Degrade that structure => cartilage can’t take as much force.
It's more prone to damage.
Moreover, cartilage, without a blood supply, is slow to turnover.
Micro-damage is slow to repair.
Time is not cartilage’s friend..
However, while cartilage doesn’t function quite as well as it once did- like a middle-aged marathon runner- it still works okay.
These molecular properties alone don’t account for the wide variation in osteoarthritis that we see. Other factors contribute. Some are more obvious than others..
