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Aging & ArthritisImportant ConceptsJust PostedKneePain

DECREASE PAIN FROM KNEE ARTHRITIS

 

         Many people simply accept pain as a natural part of aging and having arthritis.

They also come to me to try to eliminate their pain, and this is usually not possible. If it were, then I would have discovered a cure for arthritis. We can only “treat” the arthritis. Kind of like we can only “treat” hypertension. We can’t cure it. Even a total joint replacement is not the end of the problem. Patients have become de-conditioned. They often do not recover from surgery as they expected. Younger patients undergoing total knee replacement, have expectations of being able to resume activities they did before surgery, like walk long distances, play tennis, and ski. And when they fail to achieve what they think it an acceptable recovery, they are often disappointed. In general patients who have total knee replacements aren’t as happy with the outcome of their surgery as those having had a total hip replacements. You could outlive your total knee replacement, which would require a revision, which are always more susceptible to complications and a poor outcome.

So why am I telling you this? To make you feel bad about your surgery or the decision you make to have it. No. I’m telling you this because I want you to hang on to your own knee as long as you can. You need to have convinced yourself and your surgeon that you’ve persevered with a conservative course of treatment and now the ONLY alternative is to have a total knee replacement. This surgery is not the first choice for treatment of arthritis. You have it after you have tried medications, injections, therapy, and yes…modification of the activities which cause your pain. You try to get old too. There is NO GUARANTEE that this surgery is going to allow you to return to the state you were in when you were 20, or even 50!

But there are other things you can do besides medications and injections. Here’s a short list of the things I advise my patients to do…or in some cases, not to do.

  • Of course, as always…stop doing squats, deep knee bends and lunges. Sometimes, simply doing this will make a huge difference in the pain you are experiencing. Just say “NO!” Stop that ridiculous exercise program that has you doing squats and jumping jacks. And these damaging exercises have a way of sneaking into even the most seemingly harmless dance programs.
  • Limit stair climbing. Everyone is always shocked at this recommendation. Stair climbing puts a lot of stress on the knee, so don’t seek out stairs as a source of exercise, especially if it hurts to do it! If you must climb stairs, then so be it. But when you are at the mall and want to go to the second floor, take the escalator. And let your grandchildren run upstairs to get things you need.
  • Get a handicap parking permit. Oh my gosh! She can’t be saying this. Walking is good for my knees, right? No. In my opinion, there is no exercise that is actually “good” for your arthritic knees, other than exercises to maintain flexibility. Exercise is good for you, but not if the exercise you are doing puts you under the knife. Remember, surgery is not without potential for complications. But bottom line. I would rather you save your walking steps for a vacation, or to do the things you absolutely need to do. Not for walking across dangerous parking lots. If you have arthritis, you only have X number of steps left in that knee, and when your last molecule of cartilage is gone, it’s time for an operation.
  • Spend time in water. Weightlessness is good. If you have access to a pool, a lake or a pond, just go float in the water for as long as you possibly can. Like until your skin gets all wrinkly and waterlogged. You don’t have to swim. Just get a little kick board or a noodle and float around, leisurely contemplating cloud shapes. You can kick a little or move your legs as if you were peddling a bicycle under the water. So, this is not a recommendation for water aerobics, which sometimes turns into a program of leaping off the bottom of the pool and doing underwater squats. Nothing wrong with nice, gentle water aerobics, but I’m specifically recommending a period of just weightless floating. Your aging body will thank you!
  • Bend and straighten your knees before you get up from a chair, especially if you’ve been sitting for a while. Believe it or not, your knees would like nothing better than for you to stay in bed or seated for the rest of your days. But it’s not time yet. If you’ve been sitting a while, your knees get stiff, and little rough bits of cartilage get a tad wonky in your knee. Then when you stand, a tremendous amount of pressure is put on the knee, and you feel it as you straighten that knee against gravity. It’s a common complaint, and often the earliest complaint in patients with arthritis. So just gently bend and straighten them a few times before you get out of bed in the morning and before you stand up. You will feel a difference. I promise.
  • Square up your movements. This is a term I use. It’s not a medical term. There is not acronym for it, so I’m making one up now. SUM. When you get up from a chair, get up straight in front of yourself. Don’t twist your body or legs. Stand up straight and THEN make your move across the room. Swing your legs around as you get out of your car. Then stand up. I often see patients who recall that their pain started when they just lightly twisted their knee getting out of a chair.
  • Don’t wear backless shoes, like flip flops and sandals without a strap around the heel. Your legs have to work overtime to hold them on. They’re more likely to slip and cause accidents, and your weakened knees are not as capable of compensating for this hobbled state as they were when you were young, and unafflicted! Ha! How’s that for a term for our aging state?
  • Get a simple knee sleeve and wear it when you’re doing a lot of walking, like when you’re on a vacation or something. Don’t wear it all day. Wear it only when you’re walking a lot. It influences a part of your brain that subconsciously controls all your muscles, and then that part of the brain sends a little extra umph back down to the muscles surrounding your painful knee. It doesn’t have to have copper or fancy hinges on it to work. Frankly, a piece of duct tape down the front of your knee would probably work just as well, but then say good-bye to hair and the top layer of skin.
  • Get a pair of hiking sticks and use them when you’re walking long distances. It will improve the quality of your exercise and will diminish the stresses to your knees. It has the extra benefit of improving your balance as well, so you’ll be less likely to fall down!
  • Slow down! That’s right! Don’t be in such a hurry. I’ve posted something on this already, and I feel strongly about this. Being in a hurry can result in injury, but it can also just overwork your aching joints.
18 comments
  1. Judy Miller

    My trainer at the gym still loves squats. Should I just tell her NO More? I think I will after reading this article. You’ve said no squats over and over for years.
    Thanks for the advice. I was surprised about the walking. Hmm.

  2. Carol tisdale

    Dr. Bergen, i have great appreciation for the personal time you take to speak to us about how to prolong our quality of life through proper care of our joints, etc. You dispel heresay and offer the most common sense approaches. Now that I am 68 – life is beginning to take its toll on my knees and back. I remember the first visit i had with you , you told me to think of surgery as the very last resort. I did the injections you recomended on my knees – that was about 5 years ago and my knees give me very little problem. Thanks for all the simple suggestions you give….I without guilt avoid stairs when i can, use knee wraps when we travel abroad and do so much walking, I am stretching before getting out of bed….I just know you have benefitted me immensely and I hope you will continue these “articles”. Your deep concern for the humanity of your patients is evident – I hate to say but that seems to be disappearing from much of the medical community. Wishing you the best!

    1. Barbara

      Carol,
      Thank you for checking out my blog, and saying such nice things about it. I do hope you derive benefits from my posts!
      blb

  3. Anne Davies

    I totally agree with you-keep away from the knife and from twisting.Use your quads rather than an arm Push-up to get into standing.
    I need advice to try to reduce pelvic rim pain seemingly caused by degenerative disc syndrome in most of my spine.This has caused my rib cage to rub along my pelvic rim and the highly acute pain is excruciating.10% Voltaren helps but does not have a lasting effect.I also wear a lumbo-sacral spinal brace when I’m doing activities.My diagnosis is Psoriatic Arthritis.I am very independent,living in my home.Much to my surprise,reciprocal walking up and down stairs reduces the pain.I am 81yrs.old and I’ve lost 51/2″ in height(very little disc in situ). Any suggestions will be gratefully received.

    1. Barbara

      Anne, you have a complicated problem, and it’s hard to give very individualized recommendations. We all start losing disc space as well as vertebral body height as we age. That’s party why our tummies seem to get bigger. It’s like squishing a marshmallow. Not sure why stair climbing helps. Can’t argue against your experience. Spend more time in water if you have access. Weightlessness is a good thing, as mentioned in my post.

  4. Nancy McKay

    Thank you, Dr. Barbara-~

    Would you be able to do a similar recommendation to address hip bursitis? Feeling like mine may become permanent and would like suggestions to deal with it. Love your “no nonsense” explanations!

    Nancy

    1. Barbara

      Yes! Read my posts on “Hip Bursitis” and “Sit Like A Man.” Some of the arthritis tips will help your hip as well. But read those other two posts. Thanks for following my blog!

  5. Maureen Firle

    Great advice! I also followed your advise for Sit Like A Man and along with massage therapy specific to both hips, my hip bursitis Is resolved. Now, when I feel my hip starting to tighten up…back to massage therapy and uncross those legs!

  6. Joyce

    I just want to thank you for making me laugh! You have a way of talking that is so refreshing!
    I have arthritis and bursitis of the hip and just had a cortisone injection. I pray it works. Sooo much pain.
    I will follow your instructions on how to help myself through this which is most helpful but I really do appreciate the humor!

    1. Barbara

      I’m glad you enjoy my posts, and find them useful. I love to laugh, and find that laughter makes a visit with the doctor feel better. It’s rare that I have a visit with any patient, when we don’t have a little giggle, laugh or even a belly laugh together. So I like to share that with my readers as well. It makes the read a little easier, I think.
      I too, hope your injection works. Remember, it just decreases inflammation. You must stop the mechanical forces contributing to your pain. So yes…keep slamming! And of course, getting your bursitis to hurt less, will not help that hip arthritis. Be certain, before ever considering a total hip replacement, that your pain is indeed coming from the hip. Lateral hip pain is usually bursitis pain, and hip arthritis usually causes groin pain. I hate it when I see patients who had total hip replacements as treatment for lateral hip pain, and the pain is not gone after replacing the hip. Sometimes they feel as if they shouldn’t have had the surgery.

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