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Save your knees before it’s too late
04-06-2011, 09:43 AM
Post: #1
Save your knees before it’s too late

Save your knees before it’s too late
Dr Ravinder Chadha

Knee arthritis entails degeneration of the articular cartilage which becomes thin and rough, ultimately resulting in bone-to-bone contact. Synovium may produce extra fluid which results in joint swelling. Muscles supporting the joint become weak/wasted, leading to instability on walking.

Knee arthritis afflicts females more than males and black people more than white. Runners/jumpers are more prone to developing arthritis due to constant stress exerted on the joints.

Arthritis pain is generally due to the following:

  • Inflammation of the synovial membrane.
  • Pressure from knee effusion.
  • Stretching of the nerve endings.

Locking due to intra-articular loose bodies from the degenerative pieces of cartilage.

Symptoms

  • Pain and difficulty in walking.
  • Moviegoer’s sign-Individuals when sitting for prolonged periods while watching movie/sitting at a place of worship experience pain on getting up/walking.
  • Pain aggravates prior to rain as nerve endings become sensitive to pressure — respond to the drop of pressure which occurs before rains. Therefore, patients with knee arthritis can predict rain.
  • Swelling and restricted movement.
  • Crackling sound in the joint.
  • Stiffness resulting from rest/ inactivity which resolves post-activity.

Deformity vis-à-vis bowleg due to medial joint cartilage loss and narrowing. Due to pain on the inner side of the joint, patients tend to shift the weight on the outer part of the leg and foot which further increases bowleg deformity. Heel of the shoe on the outer part is generally worn out in such individuals.

Fifty to 70 per cent people above 65 years has evidence of osteoarthritis on radiographic examination. Hundred per cent people older than 75 years show evidence of osteoarthritis but about 50 per cent show such symptoms. Therefore, X-ray has limited relevance in knee arthritis.

Avoid the following:

  • Sitting for a long period.
  • Squatting, climbing (if required, then climb stairs with the good leg first and downstairs with the bad leg first can decrease discomfort)
  • Standing for long periods.
  • Low bed/chair/toilet seat.
  • Walking or jogging on hard/uneven surface leads to knee discomfort.
  • Jumping activities (encountered while playing badminton, tennis) should be avoided.

Treatment

Reduction in weight goes a long way in reducing arthritic pain.

Wearing sports shoes reduces load on the knee joint.

Knee braces are useful in cases of the unstable joint.

Elevate low bed/chair/toilet seat at the waist level.

Walking with aid/cane on the opposite side alleviates load on the knees.

Hyaluronic acid exists naturally in joint fluid and acts as a lubricant and shock absorber. Hyaluronic acid injections directly into the joint in a series of three to five shots can be given once a week. These injections improve the cushioning of the joint, decrease pain and enhance the range of motion of the joint.

Aerobic activity — Walking on soft regular surface is good. Brisk walking improves the flow of blood to the heart and also strengthens leg muscles.

In individual cases where knee bending is possible should be exercised. Stationary cycling is an ideal aerobic activity as it takes the load off from the knees. Precaution: While sitting on the saddle of the cycle, one should avoid excessive bending of the knee as that can irritate the knee cartilage leading to pain.

Knee arthritis, if managed early and effectively, can prevent agony/discomfort and disability later on.

The writer is a former doctor/physiotherapist, Indian cricket team. E-mail — chadha_r2003@yahoo.co.in

Source Link: http://www.tribuneindia.com/2011/20110406/health.htm#2"

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