Knee Osteoarthritis? You Might Not Need a Knee Replacement After All
/Knee Osteoarthritis? You Might Not Need a Knee Replacement After All
Do You Really Need A Knee Replacement If You Have Osteoarthritis Of The Knee?
I saw a guy the other day here in Parnell, 5 years after I originally met him for his annual warrant of fitness. In his 60’s, an old rugby player who had had a couple of decent injuries to his knee and also fell off the roof.
He’d seen a knee surgeon who gave him the old line “i’ll see you in 3 years for a knee replacement” because he had knee osteoarthritis 5 years ago.
I’m sure there are things Physio’s say that annoy surgeons but that “see you in a couple of years for a knee replacement” is not true and not helpful. Yes the occasional one needs replacing but not as many as you think and not if you’re prepared to do a bit of work.
He had been favouring his knee for 2 years since seeing the surgeon. Which ironically had caused his other knee to blow up, combined with the opposite foot and back. His thought process was the less I weightbear on it the longer it will last. Making him look like the leaning tower of pizza.
Surely with Arthritis I need a replacement?
Not true! In fact a lot of the time you can live quite comfortably with knee or hip osteoarthritis. It’s been the 5th anniversary of the surgeon predicting his knee would need to be replaced. With a bit of hard work initially and some maintenance exercises weekly he was doing pretty damn good
We had a good laugh about it and he had forgotten which knee was the one to be replaced.
SO WHAT IS OSTEOARTHRITIS ACTUALLY?
It is a random joint disease that often begins with no real rhyme or reason. Did you know that Osteoarthritis is more common than high blood pressure and diabetes in people over the age of 65?
Osteoarthritis (OA) is a condition that affects joints. In a healthy joint, a layer of cartilage covers the ends of the bones. Cartilage is your shock absorber. It protects the ends of the bone, makes the bones of the joint play nicely and allows your joints to move smooth.
As we get a bit older, cartilage breaks down and becomes thinner. It happens in our 30’s and 40’s and is a normal age related process. As cartilage breaks down it leaves the ends of the bones unprotected, and the joint loses its ability to move as smooth.Unfortunately it’s kind of like gray hair or wrinkles. It means you are getting older and nothing more.
In OA as the cartilage becomes softer, it fibrillates in the areas of maximum weight bearing. You can also get bony spurs into the joint. This can lead to swelling, aching, weird noises and stiffness.
AM I AT RISK?
If you have had a serious joint injury such as rupturing your ACL in your knee or tearing the meniscus you have a 50% more likely chance of developing OsteoArthritis as you get older.
If you expose your joint to too much load: think of Rafael Nadel training 5 hours per day or NBA basketballers training for hours on hard courts every day with minimal recovery you can also be more susceptible to OA.
If you put on an extra few kgs your joints are forced to take more load which is a risk factor for OA.
Being a couch potato or desk workaholic doesn’t help your joints either due to lack of activity. Cartilage needs movement to keep the joint healthy. Too much sitting on your backside stops the load required to activate cells to repair cartilage and nourish your joints.
Some things we just can’t change like time!
The good news is studies have shown there is relationship between what youe knee looks like on an xray and pain!
Did you know they did a study and radiologists couldn’t tell from the images who had back pain and who didn’t. Quite often you can have a lot of arthritis and be in no pain. Quite often you could have none and be in a lot of pain. People wrongly call knee osteoarthritis "wear and tear" and state that my joints are “worn out”. This is not the case at all and it is dangerous terminology because it assumes if you keep moving you will wear them out more. You NEED movement to help!!!!
HOW CAN I HELP MYSELF?
NEUROMUSCULAR STRENGTH EXERCISES
It has now been shown that neuromuscular strength exercises (What we do as Physiotherapists) and physical activity can reduce risk of developing OA and improve your cartilage quality.
How do neuromuscular exercises help? Stronger muscles help to stabilize the joint. Training your muscles to work in the right order also keeps the joints in a happier healthier position leading to less compression and other forces that overload the cartilage.
Strength training grows our muscles. The stronger they are the less force goes through your joints.
LOSE JUST A LITTLE BIT OF WEIGHT
Losing 1 kg can reduce the load through your joint by 3 to 5 times. Imagine what would happen if you lost 5kg! See a dietician to create a plan to reduce weight.
Or check out this science backed app called NOOM. Chaz and I are hooked on it.
EXERCISE
Exercise or simply increasing your physical activity can be as simple as walking slightly more than you had the week before or cycling for 20 minutes. Moderate exercise e.g. 30 mins per day has been shown to be very beneficial to your cartilage.
Exercise also releases endorphins which is our body's natural pain killer.
Exercise increases your muscles efficiency and strength. This helps create less force through the joint.
In knee osteoarthritis the old “move it or lose it” is very apt.
So move regularly, exercise, look after your weight and consider strength training to keep your muscles strong and healthy.
There is some huge research studies being done internationally on this exact topic and if you want to read more click HERE.
If you are struggling with your joints at the moment feel free to reach out Book an appointment and we can give you an honest opinion on what we think you need, whether you’d respond to a program and pt one together for you. . You can book on line by clicking HERE