Aging & ArthritisImportant ConceptsKneePain


         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 who have total joint replacements usually 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 walking long distances, playing tennis, and skiing. And when they fail to achieve what they think is an acceptable recovery, they are often disappointed. The pain after total knee replacements is greater, and because of that, patients often don’t achieve full range of motion. 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 this particular operation, 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 older 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, my mantra…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 just 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 necessarily 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. Pain getting out of a chair is 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 from sitting. 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! I prefer hiking sticks over canes. And they look a little sporty.
  • 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.
  • Sit Like A Man (S.L.A.M.™)
  • Raise the seats you sit on (toilets, couches and chairs). Get a comfort height toilet. Put cushions under worn out couches and chairs. Get them reupholstered if you can’t part with them. Add pieces of wood under the legs.
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