Dear Dancers,

Welcome to 2025! I love the energy, promise, and the renewal that the start of the year seems to bring. The start of this year feels like the exhalation of a breath that’s been collectively held for quite a while; a bit like trying on a pair of pants that you pull out of a dusty wardrobe after a few years, only to find that they fit the contours of your trunk perfectly. It feels as though the acrid taste of “almost there” that has been lingering on my tongue for the past few years has finally been replaced by that sweet sensation of “I-am-in-the-process-of-becoming-something-and-someone.” 

It may be arbitrary to assign these revelatory sentiments to the start of a New Year– or if not arbitrary, then perhaps just naïve; a symptom of youth and irrelevant optimism. Perhaps as the years start to blend together and the number of “firsts” slowly dwindle, so too will my enthusiasm to assign value to the first day of January. The passage of time will gradually become an impartial occurrence, wholly unobtrusive like a constant, low-frequency, barely audible buzzing. At least so I gather from speaking with others who are further into this multi-act drama that we call “life.”

Now, Reader, I have to warn you that what I am about to say is– what I assume to be– an entirely scientifically unsubstantiated statement.

I firmly believe that one of the greatest contributors towards the Great New Year’s Apathy is the persistent ache of the knees that seems to only grow with each passing year.

Laugh if you want to! But my guess is that if you have stumbled upon this article during your quest to understand why your knees groan in the way that they do, chances are you are not thrilled with the idea that as the numerical value of the year progresses, so too does your body. 

I feel that in the past few years, we have seen such a wonderful resurgence of older adults following their passion for dance and continuing with a practice that they left behind in their childhood. In Indian Classical Dance, it is quite common for practitioners to continue dancing and performing well into their sixties and even seventies! Longevity is the new name of the dancer’s game, but it can be hard to feel like your dance practice is sustainable for your body if your knees are fighting every movement.

In today’s discussion, we will demystify exactly what is going on inside your knee as you age, and why you may be feeling the way that you are feeling. My hope is that by putting a scientific name and process to these experiences, you walk away feeling empowered. I want you to see this journey towards building a stronger, healthier knee joint with the same lens that you may see training any other part of the body: as just another quest to become stronger, rather than as an indicator of your age as an impediment to all that you want to become. 

What Exactly Is Wrong With My Aging Knees?

Your knee joints act as the body’s shock absorbers for activities essential to daily life. Even just by walking, the knee joint absorbs 1.5x the body’s weight. Because of the nature of the activity that the knee joint has to endure, it’s designed very smartly to accommodate such movement. The knee joint is composed of smooth cartilage that lines the femur (the bone that makes up your thigh area), the tibia (your shin), and the patella (your kneecap). Similarly, the menisci, which you may be familiar with, are also cartilaginous and act as shock absorbers. Your knee joint is also well-lubricated with synovial fluid, minimizing friction between the bones that compose the knee joint. If you’d like a more in-depth commentary on the anatomy of this joint, check out my article on the Anatomy of the Knee for Dancers. 

Because our lives are filled with activities that implicate the knee joint, it’s natural that the joint suffers some amount of wear. When the cartilage that lines the patella, femur, and tibia breaks down and begins to cause inflammation and pain, it’s diagnosed as osteoarthritis. You may be familiar with this condition, as it is very prevalent in older populations. The pain that you may experience with osteoarthritis comes from the increased friction between those bones. The cartilage that articulates with the joint is there because it cushions the joint, sort of like the soft foam in your sneakers that cushions your bony heel from the hard road. When that cartilage breaks down, it’s akin to your bare heel striking a hard, concrete ground. There’s nothing there to pad the joint, and this is what causes the pain and inflammation that accompany osteoarthritis. 

No discussion on joint health is complete without discussing weight, and in the case of the aging knee, it’s even more relevant. The unfortunate truth is that so much of the world we live in today functions against the healthy body, whether it is in the food that we eat or the sedentary lifestyles that go hand-in-hand with most corporate jobs. Similarly, there is a positive correlation between aging and gaining weight, and some weight gain can be attributed to simply growing up. 

I feel the need to include here, as I so often do in my discussions, that weight or body size does not define a dancer. As dancers, and as scientists especially, we need to be able to look at the body objectively, and this includes looking at weight objectively. Your body simply needs to be healthy. It needs to be able to walk and run and metabolize food and perform cellular respiration and laugh freely. It needs to exist pain-free so that you can live life fully. That is a healthy body. It needs to exist in a way where you can dance the way you want to dance without hindrance. You have to decide what that healthy body is for you, and you have to do it objectively. 

Let’s continue to examine the knee with this framework, and I’ll introduce today’s mini molecular biology lesson! 

In keeping that there is a healthy weight for each of our bodies, there is also an unhealthy weight for each of our bodies where our bodies do not perform their cellular processes in the most optimal way. When our weight exceeds that of the healthy weight threshold, biologically speaking, there is an excess of fatty adipose tissue present in the body. Adipose tissue is made up of adipocytes, the kind of cell associated with fatty tissue. Adipocytes secrete leptin, a hormone that gauges your hunger/satiety and communicates this to your brain. This is the first “cellular symptom” of surpassing your healthy weight threshold: hyperleptinemia. Additionally, excessive numbers of adipocytes will secrete proinflammatory markers, causing a constant activation of immune cells. These two “cellular symptoms” (among many others) contribute to constant, low-grade, chronic inflammation in individuals who have surpassed their healthy weight threshold. 

This chronic inflammation is not a desirable condition, as it is associated with a wide variety of health concerns. Returning specifically to our discussion on the aging knee, we want to ensure that we are reducing any kind of phenomenon that contributes to inflammation in the knee joint. It becomes apparent, then, that maintaining a weight that is healthy for you is absolutely necessary to the health of the knee joint. 

Most pain that is associated with the aging knee pertains either to chronic inflammation or to the breakdown of cartilage. Osteoarthritis, bursitis of the patella, rheumatoid arthritis, and tendinitis all describe inflammation of different aspects of the knee joint. Chondromalacia patella and osteoarthritis are associated with the destruction of the cartilage that pads the knee joint. 

So What Can I Do To Fix This???

Dearest reader, I wish there was a one-size-fits-all cure for your aging knees! Sadly, as is the case with most parts of the body, there is no magical cure for this ailment.

Before we discuss some tangible approaches, I want to encourage you to reframe the way you look at your knees, and your body as a whole. Your body is your home; your vehicle that has carried you through every high and every low. It has been there for you at your worst, when you may have wished to disappear, and it has been there for you when you were on top of the world, brimming with fearlessness. While there may not be a precise solution for these ailments, I can tell you with certainty that there is an enemy: your self-dislike.

I am not saying you need to love your aging knees. I am just saying that the least they deserve is neutrality, if not appreciation. I hope this, above everything else I’ve discussed– even the molecular biology!– is what you take forward.

The first thing you are going to start doing to ease this knee pain is WARMING UP. The number of Indian Classical Dancers whom I interact with who tell me that they don’t warm up before dancing is staggering!!! And even of those who do, and those who show me their warm-ups, it is entirely inadequate in warming up the joint effectively. The first thing that you are going to focus on is making sure that your knee joint is ready to perform BEFORE you start your dance practice or your class.

What does this look like? Again, it depends on what your body can do. Some examples, from easy to more advanced:

1. While sitting on a bench or chair, practice extending one leg in front of you at a time. Work on straightening the leg completely, extending through the knee joint. Repeat until you feel any stiffness start to subside.
2. Perform the same exercise, but this time using a resistance band around your ankles. This will provide some tension as you work on extending the leg, and help strengthen all the tiny Vastus muscles around the knee.
3. While standing, practice micro-lunges. Step one foot forward, and bend the knee as far as you are able to, while dropping the back knee as far as your body allows. Stay in this bent position and perform tiny pulses. Hold onto the wall or a chair for support if needed. 
4. Progress the exercise above by adding a resistance band and deepening your lunge. You can also bend far enough so that the knee surpasses the toes to seriously develop knee mobility.
5. Practice slow yogic squats (Malasana) over the course of 10 seconds. Lower your glutes towards the ground over the course of 10 seconds, and hold the posture for 10 seconds before taking another 10 seconds to push back up and return to standing.
6. If you are not able to perform the exercise above, modify by squatting down to a bench or chair over the course of 10 seconds. Continue to use lower and lower benches/chairs/pillows to assist you as you develop mobility.
7. Laying on the back with the knees bent and feet on the floor, practice sliding the feet out further and bringing them back in. You can wear socks while doing this to help your feet slide. Make this exercise more advanced by adding a resistance band around the mid-shin. 

Mobility is going to be your best friend in combating your chronic knee pain, and the great thing is that it actually isn’t that difficult to develop! You just have to be consistent.

I hope you find some value in these words, dear reader, whether it is the actual content, the mini-biology lesson, or simply that your knees deserve neutrality. And with that, our knee series is (finally) wrapped up (for now)! I will see you soon to begin a new series on the hips/pelvis, and I’m very excited to write about both the anatomy and psychology of this region. 

Happy New Year, dear readers!

Some resources:

If you found my mini molecular biology lesson interesting:

https://pmc.ncbi.nlm.nih.gov/articles/PMC8967417/

I actually wrote my undergraduate thesis on a similar topic, but I don’t think anyone is interested in reading that 🙂

https://pmc.ncbi.nlm.nih.gov/articles/PMC10231007/

https://pubmed.ncbi.nlm.nih.gov/39219017/