A study from the university of Washington shows that young female professional dancers are at high risk for joint damage presumably because they have to keep on exercising , even when they hurt (1). This supports many other studies that show the competitive athletes are at high risk for osteoarthritis (2,3,4,5).

The very high incidence of permanent joint damage in former athletes, and lower incidence in non-athletes (6), should serve as a warning to you when you exercise. If your muscles or joints start to hurt, stop exercising and don't try to resume exercising until you can exercise without pain. Fortunately, you are not likely to lose your job if you stop exercising.

If you try to exercise through pain, you can break cartilage that can never heal. Surgery to remove broken cartilage may increase your chances of needing a knee replacement in the future (7,8), particularly if you continue to run and jump. Repeated cortisone-type injections can weaken cartilage and cause further damage (9,10,11,12). Nonsteroidal pain medications do not prevent further damage. Weak thigh muscles increase chances for further knee damage (13). so all people with knee damage should strengthen the muscles that control their knees with special knee machines (14) and start a supervised program of cycling or swimming, provided that it does not hurt to do them.

1) CC Teit, RF Kilcoyne. Premature osteoarthritis in professional dancers. Clinical Journal of Sport Medicine, 1998, Vol 8, Iss 4, pp 255-259.

2) Lane NE.TI - Exercise: A cause of osteoarthritis. J Rheumatol 1995 FEB;22( Suppl. 43):3-6.

3) A Deacon, K Bennell, ZS Kiss, K Crossley, P Brukner. Osteoarthritis of the knee in retired, elite Australian Rules footballers. Medical Journal of Australia 166: 4 (FEB 17 1997):187-190.

4) NE Lane, JW Oehlert, DA Bloch, JF Fries. The relationship of running to osteoarthritis of the knee and hip and bone mineral density of the lumbar spine: A 9 year longitudinal study. Journal of Rheumatology 25: 2 (FEB 1998):334-341.

5) TD Spector, PA Harris, DJ Hart, FM Cicuttini, D Nandra, J Etherington, RL Wolman, DV Doyle. Risk of osteoarthritis associated with long-term weight-bearing sports. Arthritis and Rheumatism 39: 6 (JUN 1996):988-995.

6) ibid.

7) DA Raber, NF Friederich, F Hefti. Discoid lateral meniscus in children - Long-term follow up after total meniscectomy. Journal of Bone and Joint Surgery - American Volume. 80A: 11 (NOV 1998):1579-1586.

8) LS Lohmander. Knee osteoarthritis after meniscectomy: Prevalence of radiographic changes after twenty-one years, compared with matched controls. Arthritis and Rheumatism 41: 4 (APR 1998):687-693.

9) G Papacrhistou, S Anagnostou, T Katsorhis. The effect of intraarticular hydrocortisone injection on the articular cartilage of rabbits. Acta Orthopaedica Scandinavica 68: Suppl. 275:OCT 1997):132-134.

10) ME Wiggins, PD Fadale, MG Ehrlich, WR Walsh. Effects of local injection of corticosteroids on the healing of ligaments - A follow-up report. Journal of Bone and Joint Surgery - American Volume. 1995(Nov);77A(11):1682-1691.

11) SC Clark, MW Jones, RR Choudhury, E Smith. Bilateral patellar tendon rupture secondary to repeated local steroid injections. Journal of Accident & Emergency Medicine 12: 4(DEC 1995):300-301.

12) S Stahl, T Kaufman. The efficacy of an injection of steroids for medial epicondylitis - A prospective study of sixty elbows. Journal of Bone and Joint Surgery - American Volume 79A: 11 (NOV 1997):1648-1652. local injection of steroids provides only short-term benefits in the treatment of medial epicondylitis.

13) Lancet 1997(August 16);350:503-09. 14) Annals of Internal Medicine July, 1997.

Reported 4/22/99; checked 8/9/05

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