As a team of orthopedists and rehabilitation specialists from the University of Iowa explained, “Recent research suggests that acute joint damage that occurs at the time of an injury initiates a sequence of events that can lead to progressive articular surface damage.” That means deterioration of the surface of the bone itself and the connecting tissues that cushion and stabilize bones of a joint like the knee, which is what arthritis is all about.

Osteoarthritis afflicts some 27 million Americans, and that number will certainly grow with the increase in obesity, the current emphasis on lifelong physical activity and the aging of the population. It is a degenerative joint disease that occurs when the protective cartilage on the ends of bones and often the surface of the bones themselves wear down, causing pain, stiffness, instability and disability that can interfere with work and mobility and diminish quality of life.

The Iowa team noted that arthritis will eventually develop in more than 40 percent of people who seriously injure the ligaments (the stabilizing bands that connect bones to one another); the meniscus (the crescent-shaped cartilage that cushions the knee and certain other joints), or the articular surface of a joint. People with a history of trauma to the knee, for example, are three to six times more likely to develop arthritis in that knee. Even without an acute injury, highly repetitive impact on a joint can damage the articular cartilage.

This may help to explain why I ended up with bone-on-bone arthritis and had to replace both knees at age 63. I’d sustained three ligament injuries (while skiing) and after years of running and singles tennis, the meniscus in both knees had shredded. Although I did the recommended physical therapy after each injury, I now know that I was not sufficiently diligent about maintaining the strength and flexibility of the supporting muscles and other tissues that might have better protected my knees for years longer.

Recognizing how common a scenario this is, a prestigious group of athletic trainers has issued a call for a more aggressive approach to both preventing and managing post-traumatic arthritis among physically active people. Although athletic trainers most often treat team players and elite athletes, they also work at physical therapy and rehab clinics where they often see joint damage among recreational athletes like me.