TL;DR
Knee osteoarthritis (KOA) is the most common site of osteoarthritis and a leading cause of disability in older adults.
It is something we MUST consider when we are trying to balance strength and hypertrophy gains with recovery and mobility.
If your knees can predict the weather (or you want to make sure they never do)… this Mini Pause is dedicated to you.
We're talking prevention strategies that actually work, like strength and aerobic training, balance and rehab, weight management, and evidence-backed supplements. PMC
We just got through Canadian Thanksgiving (yeah, it's in October for us) and on my list of things to be thankful for… my knees.
Seems weirdly specific, maybe, but the knees are where women start to notice those whispers of midlife. It starts with stiffness when you get up… then clicking after a long day… then a dull ache that shows up on your way up the stairs.
I want you to treat those whispers like screams.
Your knees are begging for attention. Not punishment. Not restriction. Not pushing through.
And no Betty is giving up running and squatting forever. Not on my watch.
We're training smarter. Recovering better. And protecting your foundation so you can keep moving powerfully for decades to come.
WHY
Knee osteoarthritis is not just “wear and tear.”
It's a whole-joint disease that affects cartilage, bone, synovium, and the muscles that hold it all together.
I have treated countless geriatric patients, and KOA is tied only with rheumatoid arthritis for the most devastating diseases I've seen.
It's quiet at first… but over time, KOA destroys structure and function.
The data will blow your mind.
Globally, osteoarthritis affects hundreds of millions of people. The knee is the biggest culprit.
Planning to live past 70? It's one of the leading causes of disability. The Lancet
But here's the truth: You have more control than you think.
Weight Reduction & Strength Training
For every pound of body fat lost, you reduce knee joint load by FOUR POUNDS. Lose 10% of your body weight, and you're completely changing your future mobility. PMC
Muscle is medicine.
Strength training protects the knee joint by supporting the muscles that stabilize it… quads, hamstrings, calves, and glutes.
Now, I know losing fat is easier said than done. Do you feel like you've tried everything in the book with no success?
I've got 2 options locked and loaded for you:
1. YES
This is my 9-week LIVE coaching program. Every week, you, me, and a group of fellow women in midlife get together to dive into nutrition, strength training, and recovery. The program is geared specifically toward women who have tried every trick and hack and are ready to go into what the research shows.
2. LIFT
The other major lever in your control is your muscle size and strength. LIFT helps develop those quads, hamstrings, calves, and glutes… all which directly influence knee mechanics and support.
LIFT prevents sarcopenia and whole-body inflammation with it's form-focused and joint-friendly strength training. PLOS
Supplements
Supplements can help, but not everything is backed by promising evidence. Here's what I'd recommend to help with KOA specifically:
- Curcumin (500-1000 mg/day): Modest pain and function improvements. Talk to your doctor if you're on blood thinners. ScienceDirect
- Hydrolyzed collagen (5-10g/day): Small to moderate pain improvements. PMC+1
- My fave is Equip. Use code BETTER for 20% off your first purchase.
- Omega-3 (EPA/DHA): Systemic inflammation support, but truthfully, the results are mixed for KOA. PMC+1
Rehab: Vibration Plates
Y'all know I love my vibration plate (code DRSTEPHANIE, if you're interested), and it has been my bestie in rehab and prehab since my clinic days.
Adding whole body vibration (20-40 Hz for 5-10 minutes, 2-3x/week) to exercise improves pain, function, and quad strength compared to exercise alone.
The takeaway is that you have to already be exercising and strength training FIRST. WBV amplifies (not replaces) your gains in the gym. PubMed
HOW
Here's what I recommend – and what I do myself – to keep those knees healthy:
Step 1: Strength Training (2-3x/week)
Join LIFT! I am shamelessly and not shamelessly (sorry not sorry!) saying this program will change your life.
I don't care if you're a beginner or an advanced lifter. This is the full-body 4-day split program I use to this day. It will build strength EVERYWHERE, and give you what you need for your quads, glutes, hamstrings, and calves – they all influence knee load and stability.
Bonus points (which are included in LIFT): Add in hip abductor work. Aside from giving you a killer peach in jeans, strong hips protect knees. OARSI Journal
Step 2: Aerobic Training (3-5x/week, >150 minutes total)
Opt for low-impact. Think cycling, walking intervals, or aquatic exercise. It all counts. Personally, I do bike sprints 1x/week, and do a longer ride 1x/week and love this for women in midlife. PubMed
Want to mimic my home gym? Get $100 off your Carol Bike with code DRSTEPHANIE and an exclusive offer on your Walking Pad with code DRSTEPHANIE.
Step 3: Balance and Neuromuscular Work (2-3x/week, 10-15 minutes per session)
A little goes a long way to improve motor coordination, joint control, balance, and, yes… confidence (that you're not going to fall on your ass).
Try narrow-stance weight shifts, tandem stands near a counter, step-over, and mini-lateral lunges. Start with eyes open and progress to eyes closed. PMC
Step 4: Daily Mobility (10 minute doses)
Simple moves show big results. Try these:
Heel slides (flexion): 10-15 reps
Knee extension props (towel under heel): 2×60 s
Calf wall stretch, knee straight and bent: 2×30 s each
Hip flexor stretch (half-kneel): 2×30 s/side
Seated tibial rotations (gentle): 10-15 reps
Patellar self-glides (if comfortable, patella relaxed, light skin glide): 30-60 s each direction. PMCPubMed
Step 5: Vibration Plate (in addition only)
Start 20-30 Hz with soft knees.
Do semi-squat holds, calf raises, and wall-supported mini-lunges.
Stop if you feel dizzy or if pain increases. PMC
NOW
Knee osteoarthritis doesn't happen overnight, but prevention does.
Your knees carry you through every workout. Every walk. Every moment of your life.
Move… lift… nourish… do everything you can to protect your knees, and you are setting yourself up for a healthier future.
Need guidance? I got you.
I created LIFT (strength-training program) and YES (full midlife framework that includes LIFT) to help women in midlife build muscle, manage recovery, and protect joints for the decades ahead.
On behalf of your knees, thank you for getting started.
In strength and science,
Dr. Stephanie
P.S. This is general education, and not personal medical advice. If you have red-flag symptoms (locking/giving-way with falls, fever, hot/swollen joint, rapidly worsening pain), recent surgery, or significant comorbidities, seek clinician guidance before starting.
P.P.S. Know someone with Knee OA that can benefit from this? Forward this email to them!
WHAT I LOVE THIS WEEK
Apollo: The Wearable that Calms Your Nervous System
Let's get one thing straight: your nervous system runs the show.
Anxious? Wired? Can't sleep… it's not you. It's biology.
Apollo Neuro is a wearable that uses gentle vibrations to cue your parasympathetic nervous system – the calm, rest, and repair side of your stress response.
Think of it like strength training for your stress. Over time, your body learns how to come back to balance faster, with less cortisol and more calm.
Clinical studies show Apollo improves heart rate variability (HRV), lowers stress hormones, and boosts serotonin and dopamine. Translation: better sleep, steadier moods, and a more resilient YOU.
I wear mine when I'm working, before bed, or when I feel that squirrel in my brain start tap dancing.
Within minutes, I can feel my body exhale and release.
Give your nervous system a reset and try Apollo Neuro risk-free for 30 days. I know you'll feel the difference.
Use code BETTER for $90 off.¹
Equip: The Collagen Your Midlife Body Craves
Forget the hype. Collagen is a structural must-have.
By midlife, we lose about 1% of our collagen every year… which means less elasticity, weaker joints, and a gut that needs support.
I use Equip's Grass-Fed Collagen for 15,000 mg of pure bovine collagen from pasture-raised US cows. No fillers. No junk. Just results.
Clinical research shows daily collagen supports bone strength, joint comfort, gut health, and skin resilience. Most women notice real changes in 4-6 weeks.
Betty, your body is 30% collagen. Let's keep it that way. Equip helps you rebuild what time tries to take away. One scoop at a time.
Use code BETTER for 20% off your first purchase.2
Fresh Pressed Olive Oil: Are You Sabotaging Your Health with Olive Oil?
Hard truth: Most olive oil in North America is old, oxidized, or outright fake.
Six months after harvest, olive oil loses the polyphenols that make it so heart-healthy and anti-inflammatory.
Harvard researchers showed just half a tablespoon of quality EVOO can reduce heart disease by 19%, cancer by 17%, and dementia by 29%. But only if it's FRESH.
That's why I only use T.J. Robinson's Fresh-Pressed Olive Oil.
It's lab-certified, 100% pure, and harvested from small family farms at peak ripeness. (The harvest date is even on the bottle, so you know exactly what you're getting.)
The first difference you'll notice is the taste… bright, peppery, and alive. The second difference you'll feel in your body.
Try a $39 bottle for just $1 (shipping).3
🌟 Love these recommendations? Find more resources to support your health in midlife in my Health Toolkit!
1.$90 off auto-applied with the link or use code BETTER. Taking orders and shipping within the United States, Canada, Europe, and Australia. Terms and conditions may apply.
2. Equip ships everywhere! Shipping times are variable based on location. Code BETTER works for first-time orders or first subscription. Terms and conditions may apply.
3. No-commitment, 100% money-back guarantee. Terms and conditions may apply.