Why hip and knee pain increases with age - even if you stay active

We’ve all heard it: “Use it or lose it.” Walking regularly is one of the best things you can do for your joints, especially as you age. But many people are surprised when hip or knee pain creeps in despite staying active. So what’s going on?

1. Natural Degeneration of Joint Structures

As we age, the cartilage in our joints naturally thins and wears down. This cartilage acts as a cushion between bones. Even in people who walk daily, this gradual breakdown is part of the aging process.

In the hips and knees—both weight-bearing joints—years of loading and microtrauma can lead to osteoarthritis (OA), even in the absence of injury. OA affects an estimated 1 in 5 Canadians over 45, with the knee being the most commonly affected joint. [1]

2. Age-Related Muscle Loss (Sarcopenia)

Maintaining strength around the hips and knees is crucial for joint stability. But starting around age 40, we begin to lose muscle mass—up to 8% per decade, and even more rapidly after 70. [2]

Walking alone doesn’t typically build or preserve enough muscle strength to offset this loss. Without adequate support from muscles like the glutes, quads, and hamstrings, more load is transferred to the joints, increasing pain and dysfunction.

3. Changes in Biomechanics

With age come subtle changes in posture, balance, and gait. These changes may be caused by:

  • Reduced ankle mobility

  • Core and pelvic weakness

  • Previous injuries or surgeries

Even small shifts in gait mechanics can lead to abnormal loading patterns, increasing strain on the hips and knees during walking. [3]

4. Chronic Low-Grade Inflammation

Aging is associated with a systemic increase in low-grade inflammation, sometimes called “inflammaging.” This background inflammation can sensitize joint tissues and contribute to pain, even without major structural damage. [4] Inflammation also slows healing and increases the risk of conditions like bursitis or tendinopathy around the hip and knee.

5. Joint Overuse Without Cross-Training

While walking is excellent, doing only one type of activity may not provide enough variety for full-body joint health. Repeated stress in the same planes of motion can lead to wear and tear. Without resistance training, stretching, or mobility work, joints may lose the range of motion or become imbalanced.

So What Can You Do?

Even if you already walk regularly, here are a few tips to protect your hips and knees as you age:

  • Incorporate strength training (especially for the hips and thighs)

  • Stretch daily, focusing on hip flexors, hamstrings, and calves

  • Add balance and core exercises to improve joint control

  • Consult a chiropractor or physiotherapist to correct biomechanics and gait

Hip and knee pain isn’t inevitable, but it becomes more common with age due to a combination of wear-and-tear, muscle loss, and biomechanical changes. Even if you walk regularly, your joints still need targeted support and maintenance. Staying active is vital, but how you move matters just as much as how much you move.

Learn more about the GLA:D program HERE

References

  1. Statistics Canada. (2022). Osteoarthritis in Canada

  2. Roubenoff R. (2000). Sarcopenia and its implications for the elderly. Curr Opin Clin Nutr Metab Care, 3(6), 489–493. PubMed

  3. Kerrigan, D. C., et al. (2001). Women’s shoe heel height and gait: Physiologic and pathomechanical changes. Arch Phys Med Rehabil, 82(5), 571–575.

  4. Franceschi, C., & Campisi, J. (2014). Chronic inflammation (inflammaging) and its potential contribution to age-associated diseases. J Gerontol A Biol Sci Med Sci, 69(Suppl_1), S4–S9.