2016-11-30 / Health

Can too much walking wear out our knees?

DEAR DR. ROACH: I am a reasonably healthy 66-year-old male. I walk 5 miles a day. I have no knee problems. My doctor says I am walking too much and will wear out my knees. Do you agree? — M.D.

ANSWER: No, I don’t agree at all. I think I understand why your doctor said that: osteoarthritis, the most common arthritis in the knee, used to be considered a wear-and-tear injury, and if that were the case it might make sense to protect your joints by not overdoing it. However, we believe now that osteoarthritis is caused by an injury to the joint, not by regular exercise. More importantly, studies show clearly that people who are very active don’t have higher arthritis rates than sedentary people. Most important of all, people with osteoarthritis who exercise get better, not only in pain and stiffness levels, but also in ability to walk.

Exercise is so good for your body, mind and spirit that this persistent myth needs to be corrected.

The arthritis booklet discusses rheumatoid arthritis, osteoarthritis and lupus. Readers can order a copy by writing: Dr. Roach — No. 301W, 628 Virginia Drive, Orlando, FL 32803. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.

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DEAR DR. ROACH: When I was 60, my doctor told me to take a baby aspirin daily to prevent heart attack and stroke. So I did. When I was 70, a new doctor said the risk wasn’t worth the benefit, so I stopped. I heard and read a lot more about the benefits of aspirin. But a friend of mine had a horrific nosebleed that was thought to be from the aspirin.

I and a few of my senior friends are confused. Should we or shouldn’t we take aspirin? — A.H.

ANSWER: When you see multiple opinions on a topic in medicine, it usually means there is conflicting evidence, and that certainly is the case with aspirin. The difference of opinion takes place at the highest levels: the United States Food and Drug Administration recommends, in general, against using aspirin to prevent heart attack and stroke in people who have not already had a heart attack or stroke. However, the US Preventive Services Task Force recommends aspirin in general for men age 45-79 and women age 55-79. The USPSTF makes no recommendation about men or women over age 79. Both groups agree that your physician should be helping you make the decision about whether to take aspirin.

Aspirin has the risk of causing bleeding, and the bleeding can be more serious than a nosebleed. A bleed inside the stomach or intestines can be lifethreatening, and there also is a very small risk of bleeding in the brain.

As a physician, I prescribe aspirin for those at increased risk based on multiple factors, and do not prescribe aspirin to people at high risk of a gastrointestinal bleed. This is a judgment call about which physicians may differ.

Readers may emai l questions to ToYourGood- Health@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.

©2016 North America Synd.

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