Cartilage is Hard To Heal: Protect Yours Now.

Cartilage healing has been the subject of quite a bit of study, for obvious reasons.  Unfortunately, the findings are not very encouraging.  At this point it seems that cartilage does not heal itself very well, except, perhaps for small defects.  Best advice: protect your joints before they are injured.  I’ll tell you the easiest way.

Strangely, among the best treatments known today is “Continuous Passive Motion,” where a limb is strapped to a machine that constantly flexes and extends a joint, without the patient using their own muscles.  Two things about this seem interesting to me:  First, Not only does the constant motion NOT contribute to “wear and tear,” it actually seems to stimulate healing.  Second, the machine-guided motion is done in the pattern the joint is supposed to use.

Joints are astonishingly well-designed.  For instance, the ball and socket of the hip joint do NOT match when there is no weight on them.  However, the stress imposed by weight-bearing changes the shape of the contact areas, so that there is a precise fit at the moment it is most necessary.  Orthopedists call this “Joint Congruity.”  It is well-known that injury to the joint will alter this precise fit, and it becomes very likely that degenerative arthritis will result in later years.

Injury is not the only way to alter joint congruity.  Joints, of course, are the places where bones meet, and the muscles moving the bones will affect the alignment of that meeting-place.  Joints and ligaments play a role, but to a large extent, bones do what the muscles tell them to do.  If you have tight muscles that rotate your hips to the outside, then your hip joints will spend most of their time rotated to the outside.  If your stomach muscles are too weak (or even excessively strong,) then your pelvis will be tipped backwards or forwards, and the alignment of your hip joints will be thrown off.  Joint congruity suffers.

When the top joint changes its alignment, the next one down also changes.  In my practice I often see people whose pelvis is tipped forward, and their femurs are rotated out (their kneecaps point to 10 and 2 o’clock.)  These same patients often tell me they have knee pain as well as hip pain.  The alignment of the spine has affected the alignment of the hips, which in turn, has affected the knees.  Even the feet are affected as the postural changes affect gait and result in plantar fasciitis and bunions.

The good news is that alignment is very easy to change.  It does take commitment, because only you can train the muscles that tell the bones what to do.  You can't just "sit up straight" like your mother told you to do, because your voluntary pose will change as soon as you stop thinking about it.  You have to figure out which muscles are too loose, which ones are too tight, which ones are doing the heavy lifting for movements they're not not supposed to control, and which ones have to be coaxed into doing their proper work.  It's a kind of detective work, and it's best done by a chiropractor or PT who knows how to analyze posture and specializes in this type of rehab.


You can't do very much about the big injuries that break joints.  But you very easily can improve joint alignment, and thereby reduce a lot of wear and tear.