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The Female Knee

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The Female Knee

The Female Knee

December 29, 2005
By: Jean Johnson for Knee1 “The last time I saw a physician I had on black, textured stockings and I must admit when he did the reflex check, my knees looked rather lovely with the skin screened by the translucent lozenge pattern,” said Kizim Breen of Newburg, Oregon. “The truth is though my knees aren’t that good. It’s my own fault, I guess. I got into jogging in the late 70s and 80s, and used to run right on the pavement. They really took a pounding back when I thought I’d live forever.”
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Shoe Buying Tips:

  • Have your feet measured while you’re standing.

  • Always try on both shoes, and walk around the store.

  • Always buy for the larger foot; feet are seldom precisely the same size.

  • Don’t buy shoes that need a “break-in” period; shoes should be comfortable immediately.

  • Don’t rely on the size of your last pair of shoes. Your feet do get larger, and lasts (shoemakers’ sizing molds) also vary

  • Shop for shoes later in the day; feet tend to swell during the day, and it’s best to be fitted while they are in that state.

  • It sounds elementary, but be sure the widest part of your foot corresponds to the widest part of the shoe.

  • Try on shoes while you’re wearing the same type of socks or stockings you expect to wear with the shoes.


  • Breen may not have the bee’s knees any more, but at least these days she’s taking better care of them. “For my cardio I get on the elliptical bike at my club, so that’s gentle on my knees,” said Breen. “Then my trainer has me doing all sorts of strengthening exercises designed to support those joints. Quads are a big one. Yes, she’s very much into the quad thing. So I comply and we’re both happy campers.” It’s a good thing that Breen has started taking care of her knees. Along with the shoulder, the knee is the body’s most physiologically weak joint. Also since the knees carry the weight of the body, they can be especially vulnerable to injury. The female knee, particularly, is twice as prone to injury as men’s knees. So ladies – here’s the scoop. Keep the Weight Down Skip all that Barbie doll curvy image stuff and think in terms of the knees’ health and welfare. It’s just a matter of a few bones and some elegantly-designed soft tissue, so when they get loaded down with more weight than nature intended, the knees will let us know. “I’ve fought my weight for years and used to have a horrible time,” said Breen. “But since I took the focus off pleasing males – perish the Scarlet “O’Hara thought – and put it on my own health, I’ve found I do much better. I’m a couple sizes down from where I operated for a long time, so I’m pleased about that. The rhetoric’s gone from what I should and should not do, to what choices I really do want to make for my own health. These days I’m much more likely to enjoy fruit and cheese for dessert than I am to load my body up with something buttery and chocolaty.” Go for Librarian Shoes We know; all the jokes about librarians and their sensible shoes bring to mind anything but having fun. But we submit: When was the last time a conversation matched the communication you found between the covers of a good book? Librarians and books aside, if women want strong ankles and normal length tendons running up the back of their legs, they’ve got to get into some flat shoes now and again. But that’s putting it mildly. The folks at Harvard approach it straight on with strong language. “High heels are dangerous to your health.” In particular, in 1998 and 2001 research teams looked at knee osteoarthritis which is a painful degenerative joint disease. They found that high heels from the stiletto variety to the wider, more comfortable and fashionable styles are not at all friendly to female anatomy. In results published in The Lancet researchers concluded that low-heeled or no heeled shoes are the way to go for women interested in caring for their knees. According to lead researcher D. Casey Kerrigan, M.D., “It takes a long time to feel the effects of knee osteoarthritis, and once you do, it’s too late.” Kerrigan added that “Wide-heeled shoes give you the perception of more stability when you’re standing, and they feel comfortable, so women wear them all day long. They are better for your feet than stiletto heels, but just as bad for your knees.” Enzo J. Sella, M.D., attending orthopedic surgeon at Yale-New Haven Hospital and associate clinical professor at the Yale University School of Medicine who directs the Foot and Ankle Service, expands on the Harvard study. “High heels whether they’re thick or thin, can cause problems in women’s knees, their ankles, and their feet. Shoe-related problems I see very frequently include ankle sprains and breaks from rolling over on high-heeled shoes,” said Sella. “The health of the cartilage that forms the padding between the bones in the knee is dependent on the fluid in the knee,” he explained. “It absorbs nutrients it needs from this liquid to repair itself, but stress on the knee restricts the absorption of the fluid, and the cartilage begins to dry out and shred. Over time it wears out and arthritis sets in. There are also genetic components of arthritis and there may be nutritional aspects as well, but we know high heels don’t help.” Sold? Kizim Breen is – almost. “I don’t wear silly shoes – I picked that expression for high heels up from a Canadian – you know how women dress more sensibly up there. But I confess I do wear my clogs fairly often. It’s vanity. My legs are a little heavy and so the heels make me look better,” Breen said. “But now that I know about the science and how the fluid thing works, I’ll probably slip into my flats more often. After all, I spend so much on my trainer and time doing all the quad exercises and everything else, it doesn’t seem too smart of me to go and squander it, now does it?” “Yes,” said Breen after pondering for a moment. “That will be my New Year’s resolution this year. Slip into a pair of comfortable shoes. I don’t know why I didn’t think of that year ago!”

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