Victory was sweet for Joanne Clifton and celebrity dance partner Ore Oduba when they won the 2016 Strictly Come Dancing final. But, as they lifted the trophy, 33-year-old Joanne was in such dreadful pain she could barely stand.
Although no one watching would have noticed, Joanne suffers from osteoarthritis in both knees — a condition she’d been diagnosed with the year before, aged just 31.
Fast forward nearly six years, her knees are now so stiff she can’t get out of her car without the aid of a special device to grip on to to lever herself out. She can’t run or jump and must be ultra-careful of housework that involves crouching.
Osteoarthritis, which affects 8.5 million adults in the UK, is where the protective cartilage at the ends of the bones breaks down. It is generally caused by wear and tear and while the first twinges begin in the over-40s, by 65 at least 50 per cent of Britons will suffer from osteoarthritis to some degree in at least one joint — most commonly, the knees.
Victory was sweet for Joanne Clifton and celebrity dance partner Ore Oduba when they won the 2016 Strictly Come Dancing final. But, as they lifted the trophy, 33-year-old Joanne was in such dreadful pain she could barely stand
But younger people can get it too due to obesity (which puts excess pressure on the joints), a sedentary lifestyle (which can stiffen joints, leading to wear and tear), genes or — as in Joanne’s case — from being very active.
‘The knee is one of nature’s most amazing structures — but most people don’t think enough about it until there’s a problem,’ explains Parag Jaiswal, an orthopaedic surgeon at the Royal Free Hospital in London.
‘Even knee experts like me can make mistakes. During lockdown, I increased my running to get fitter but I was wearing worn-out trainers so they had no shock-absorbing ability. I then had a lot of knee pain and swelling.’
By the time she reached the Strictly final, Joanne’s knees had taken the brunt of intense training with broadcaster Ore. Their final show involved leaping on and off drum tops.
‘I was a bit silly — I put a great idea ahead of my own condition,’ she told Good Health. ‘I’d been told when I was diagnosed in 2015 to avoid high-impact movements. We’d been practising jumping all week.
‘By the Friday and Saturday, I was really struggling. I look back on that dance now and think: “Ooh, for the sake of my knees, why did I choreograph all that jumping?”.
‘After our last dance, I could only hobble up to Claudia [Winkleman] to get our points. But winning was a great feeling despite the pain.’
Joanne left Strictly after the final, which also marked the end of her ballroom dancing career. She doesn’t say that arthritis forced her out but it’s hard to see how she could have gone on.
A downhill walk from her home to the station was agonising — on one occasion her knee seized up and she had to sit down ‘in tears’. She found a way of dragging her leg behind her and when pain struck, she ‘kept on going’
Now 38, she lives in South London and is still playing lead roles, recently beginning a tour of The Addams Family, starring as Morticia. Her parents, former world champions, and brother Kevin, 39, an ex-Strictly dancer who won the 2018 series with his now girlfriend, Stacey Dooley, are all Latin dance specialists while Joanne is a ballroom dancer.
‘Latin dancers dance on straighter legs and do hip actions,’ says Joanne. ‘I did 30-odd years of dancing with bent knees. They don’t have any arthritis whereas I know many ballroom dancers who’ve had knee replacements, because their cartilage is worn away by years of bent knees.’
Her knees first troubled her in her late teens. By 26, she says: ‘The pains were worse. My knees would make crackling noises. I used to laugh about it, I didn’t realise it was a medical condition.’ Called crepitus, the noise is caused by the rubbing of cartilage on the joint surface during movement.
After joining Strictly in 2014, Joanne suffered with bad knee pain on the 2015 tour but carried on until the day she woke ‘with a massive swollen knee’, unable to move.
‘I was in tears wondering if I’d get through it but I didn’t miss a show,’ Joanne recalls. She got through thanks to regular physiotherapy massages and strapping her knees.
Afterwards, a visit to a consultant and an MRI scan led to her diagnosis. She was told the cartilage in both knees was being worn away and she’d probably need a knee replacement one day. ‘I broke down in tears as dance was then my whole life,’ she says.
Warned to avoid high-impact movements, she was given exercises to strengthen muscles supporting the knee joints — including leg stretches, step-ups and knee squats. She was also told to keep moving (sitting makes joints stiff). Joanne discovered walking downhill hurt much more than going uphill as the forces on the knee are nearly four times greater.
A downhill walk from her home to the station was agonising — on one occasion her knee seized up and she had to sit down ‘in tears’. She found a way of dragging her leg behind her and when pain struck, she ‘kept on going’.
Pain is caused by the damaged cartilage losing its shock-absorbing ability so that the force is transmitted through the bone, which is rich in nerve endings. This is a ‘warning sign’ to seek medical help, says Mr Jaiswal, who also works at the private St John & St Elizabeth Hospital in London.
You should seek medical help for new hip or knee pain that lasts for six to eight weeks after injury or physical activity, he says. ‘We can potentially prevent osteoarthritis from getting worse with lifestyle changes and injections designed to repair the damage and guide patients to manage their pain. There is great evidence that eating a plant-based diet, cutting out processed foods, sugar and red meat, along with fizzy drinks, can help by reducing inflammatory proteins called cytokines, which are secreted from immune cells.’
Anti-inflammatory steroid injections may be a short-term solution for some — ‘to get professionals through acute episodes’, for instance — but are not a long-term solution because of the risks, chiefly infection.
Injections called viscosupplementation can be used to top up levels of hyaluronic acid, a natural part of the fluid that cushions joints, but are expensive (£260 to £350 per injection) and are not available on the NHS.
Another option is PRP (platelet-rich plasma), drawn from the patient’s blood and considered more effective than hyaluronic acid. The platelets secrete growth factors and trigger the repair process. It is available in some NHS hospitals, including the Royal Free.
‘The key thing is that there should be some cartilage in that joint,’ says Mr Jaiswal. In his own case, he said, implementing lifestyle and dietary changes helped, as did PRP injections.
An MRI scan showed he had lost some cartilage behind his kneecap and the area was painful and swollen, although he has not been diagnosed with osteoarthritis.
Joanne has found that devices to help arthritis sufferers are useful, including a special pillow for elevating her legs and a gadget called the Car Door Mate — a block-like device that wedges between the hinges of a car door so that the user can lean on it for support when getting out (she is an ambassador for the maker, Arthr).
When it comes to performances, with the Addams Family for instance, she is able to dance within the limits of her arthritis and avoid further damage.
‘I do a tango and if I feel pain I’ll tell my dance partner (Cameron Blakely, who plays Gomez) and we won’t go too low in the lunges,’ she says. ‘I’ll also tell the choreographer and we adapt it.
‘There’s a joke in the show when the grandmother says: “I’m 102, I’ve got shingles and arthritis.” I’m thinking: “Yes and I’ve got it, too!”
‘So many people think it’s only found in older people. I need to get the message across that it’s nothing to feel embarrassed about — but do follow the doctor’s advice. I just wish I’d known about my condition earlier and done things to slow down the decline.
‘I’m feeling much more confident about the future now I’ve switched to doing something I love — and which is gentler on my joints.’
n The Addams Family tour resumes on January 11. Tickets, visit: theaddamsfamily.co.uk
The surprising causes of head pain. This week: Processed meat
Cured meats such as pastrami and other deli meats that contain synthetic food preservatives known as nitrites are a common headache trigger.
‘One theory is that the additives may dilate blood vessels in the brain, which triggers headaches,’ says Dr Andrew Dowson, a headache specialist at King’s College Hospital in London.
These types of headache tend to happen two to three hours after eating nitrites, which can make it hard to identify the cause. About 20 per cent of headache patients are thought to be food sensitive, according to the Cleveland Clinic in the U.S.
If you suspect that certain foods are causing your headaches, keep a food journal to help discover patterns and triggers for your head pain, says Dr Dowson. You can take this to your next GP appointment to help further understanding of the triggers and to find the best treatments for you.