(Dis)jointed Understandings: How Young, Active Adults Make Sense of Knee Health, Injury and Osteoarthritis

OBJECTIVE: Health beliefs predate the onset of injury or illness and predict future health behaviours. This study aimed to describe how healthy adults made sense of (their beliefs about) knee health, cartilage injury and osteoarthritis. DESIGN: Qualitative, Interpretive Description study METHODS: Participants (purposively sampled for age and gender) were adults in Australia, aged 18-40 years, who met WHO guidelines for physical activity, recruited through community groups and social media. Fifteen semi-structured interviews (n = 8 women) explored motivations for physical activity, understandings of knee health, cartilage injury and osteoarthritis. Sample size was informed by parallel processes of data collection and inductive Thematic Analysis. RESULTS: Five themes were generated. Participants valued the benefits of exercise in maintaining healthy bodies and minds (Theme 1: “Exercise makes me feel good”). However, they described a process of balancing exercise benefits with injury risk, often accompanied by fear (Theme 2: “There is that level of fear”). While injury prevention was a preoccupation, knowledge about joint health was lacking (Theme 3: “I’ve never heard of joint health before”). Similarly, knowledge gaps revealed uncertainty about body structures (Theme 4: “Is cartilage the stuff between the bones?”); while osteoarthritis was understood to be an old people’s problem (Theme 5: “I only know osteoarthritis is for old people”). CONCLUSION: Unhelpful beliefs among healthy adults could lead to adverse outcomes in the event of future knee injury. Health promotion initiatives may equip the general population with a way of making sense of knee injury and osteoarthritis that can give rise to healthy beliefs and behaviours.