Weeks after your big trip to the National Park or the pickleball tournament, your joints are still hurting. When you were younger, your knee would ache for a day or two, but now your body isn’t bouncing back as quickly. Is something wrong?

Probably not, according to James Johnston, MD, Chief of the Division of Orthopedics at GBMC HealthCare. While a combination of mild degenerative changes and aging can affect your ability to bounce back, these symptoms are also completely normal and don’t necessarily mean the end of an active life. It just means it’s time to move a little smarter and set realistic goals.

“The knees and hips have a thin cushion of cartilage that wears down slowly with age like the tread on tires,” Dr. Johnston said. “But your cartilage doesn’t have any sensation; there’s no nerve supply to it. Which means you don’t feel pain when the cartilage starts to wear down. Without the cartilage cushioning, the bone directly underneath gets irritated when you quickly ramp up, and that’s what causes pain. At the same time, as we age, the bone underneath the cartilage gets a bit softer. The combination of the lack of cushion and softer bone can lead to inflammation.”

Imagine driving around Baltimore with all the potholes but no shocks in your car. The same thing happens to the bone with mild arthritis. That’s why an arthritis flare-up can take six to eight weeks to calm down. Soft tissue pain, like tendonitis or a pulled muscle by comparison, usually eases within a few days of rest.

The good news is it can be managed with lifestyle modifications.

“I would say 80 to 90% of the time, with anti-inflammatories, rest, activity modification, maybe a little bit of bracing, and maybe some physical therapy, most people will get back to their normal function with no issue,” Dr. Johnston said.

Staying active is important for overall health, but activity may need to look different to prevent injuries or future flare-ups.

“If your tires have 50% of the tread, don’t go around the corners at 60 miles an hour,” Dr. Johnston said. " You still want to be active, but you need to be mindful of ramping up activity and not overdoing it."

Swapping out running for walking or high-intensity aerobics for swimming puts less force on the joints and therefore lowers risk of pain and injury. The goal is to keep the heart-healthy benefits of exercise without the wear and tear. Dr. Johnston follows his own advice by walking three miles every day on a flat treadmill.

Strength matters, too. Yoga for stretching and exercises to keep the core and supporting muscles strong and flexible, like planks, help tremendously. Losing extra weight also greatly reduces the force on your joints and can help you stay active longer.

Even with the best of intentions and commitment, injuries happen. Dr. Johnston said if you have sudden onset of severe pain, trouble putting weight on a leg, or if you feel catching or locking in the joints, it is a good idea to get it checked out.

Dr. Johnston and the other orthopedic surgeons in his practice can see patients by appointment or through GBMC’s walk-in clinics on GBMC’s main campus in the Physicians Pavilion West building, and at GBMC Health Partners Primary Care—Padonia. Visit gbmc.org/ortho to learn more.