Tips on Reducing Pain in Arthritic Knees

Do you have nagging pain in your knee(s)? Have you injured your knee before from a sports-related mishap or trauma to the knee, and now suffering from its long term effects? Does your doctor told you not to burden your knees but 'forgot' to tell you how? Pain in a damaged knee can be so severe that it might wake the sufferer up from sleep or significantly disturbs his daily activities.

Pain in arthritic knees is caused by either direct rubbing of 'bare bones' against each other or as a result of production of irritant (inflammatory substance) in the joint space, causing pain and swelling in the affected joint.

Arthroscopic pictures of the knee in two patients; one with a normal knee cartilage (above) and another with a degenerated knee (below) where the cartilage has been worn out extensively giving rise to severe pain in the knee with activities.



How do you reduce the burden on your painful knee(s)? Here are some practical tips you can consider :

1. The more weight-bearing you do, the more likely that you increase the burden on your knees. This will in turn cause more pain. Try to reduce unnecessary activities that involves a lot of walking, jumping or running. If certain activities can be done in a non-weight-bearing position such as sitting, do it.
2. If you are overweight, shed some of it. Dietary restrictions coupled with exercises will help you achieve this. Monitoring calorie intake that matches your daily requirement does help. There are a number of activities that can be done to keep fit as well as your weight down without putting excessive burden on your knees (this will be explained further later).
3. Certain positions or activities put a lot of stress on your knees, such as squatting, standing with the knees bent, climbing up and down the stairs, and kneeling on the floor. Utilizing sitting-type toilets will minimize the stress on your knees. Take the elevator or escalator if you have a choice. Use a mop to clean the floor instead of rubbing it using plain cloth, where kneeling is a must.
4. If you want to exercise to keep fit and to reduce weight, perform activities that pose minimal stress on your knees. Swimming and static cycling are two examples of such activities.
5. Use of a walking aid. A walking stick is a social stigma to some people and is considered cumbersome to some, but it is an excellent 'off-loading' device that helps to reduce the load on the knee joint.
6. Do regular 'weight-less' (not weightless) muscle strengthening and joint movement exercises. Static muscle strengthening exercises for the knee (e.g. repeatedly elevating a straight leg off the horizontal plane in a lying position) helps in coordinating and providing support to knee joint movements and helps to reduce pain in the joint. Arthritic joints could easily stiffen from disuse, therefore range-of-motion exercises for the knees are needed to prevent stiffness and contracture.

A straight-leg-raising exercise

For more information, please contact your orthopedic specialist or email to DocNiz at neezlan@yahoo.com

Avoiding Injuries in 'Weekend Warriors'

Injuries can occur from inadequate preparation of muscles and tendons of our body for occasional strenuous activities - the so-called 'weekend warriors'. These injuries can be so disabling that they can either disturb normal weekday activities or completely disrupt them. Worse still, the sufferer may end up admitted to a hospital due to the injury. This will subsequently affect his or her sports activities, productivity and, if prolonged, quality of life.

Futsal is one the common games that may inflict injuries especially among weekend warriors. 

So, what are the common injuries among  these unfortunate 'I-wanna-be-active-but-have-limited-time-for-it' individuals? 

1. Tendinitis - which means inflammation of tendons (the structure which connects muscles to bones). The areas which are prone to this conditions are the heel, elbow, shoulder and knee regions.

2. Sprain - where tissues (such as the muscles or ligaments) are bruised but not torn - most commonly affects the ankle but they may also involve the knee, shoulder and back.
3. Ligament tears - the knee and ankles are most commonly affected by this injury. Complete ligament tears will result in instability in the joints affected, hence will commonly result in permanent pain and instability (sensation that the affected joint 'gives way' during activities) unless they are treated, most commonly through reconstructive surgery where the torn ligament will be replaced by a 'substitute' ligament. Tears may also involve the tendons (e.g. the Achilles tendon at the back of the heel) and meniscus (the 'impact absorption tissue' in the knee).
4. Cartilage injury - cartilage is the lubricating surface in our joints that functions to provide a smooth and congruent movement during activities. Injury to the cartilage can occur during a fall, during an awkward landing from jumping maneuvers, and also from direct hit to the joint (e.g. from a violent tackle during a soccer game). Again, the knees and ankles are the most commonly affected areas. Cartilage injuries are difficult, cumbersome and also expensive to treat, with relatively poor results (compared to other types of injuries) and subsequent sequelae of joint damage and disabling pain.

   

How do we (as weekend warriors) avoid getting these injuries?

1. Do a proper warm-up and stretching routine before starting any strenuous exercises. These two routines are invaluable in avoiding unexpected injuries. Warm-ups increase the heart rate gradually and thus will lead to steady increase in blood supply to the muscles. Stretching will prepare the muscles for fast, alternating contraction and relaxation that usually occurs during exercises and thus minimizes the risk of muscle sprain and tears.
2. Increase the frequency of exercises that include weekdays as well. As the activities get more frequent and evenly-spaced, the body can withstand more strenuous activities with minimal risk of injuries. 
3. Avoid high-risk sports such as contact sports, high-impact sports (where jumping is done repeatedly), and also pivoting sports where sudden change in directions are needed such as soccer, futsal, basketball and racket games. Swimming and static cycling are two examples of low-risk activities that can be done safely and at the same time allow us to maintain fitness as well as strength.  
4. In situations where high-risk sports cannot be avoided, frequent muscle toning and strengthening exercises will help avoid these injuries. Strong and well-toned surrounding muscles will ensure a more stable joint and thus minimize the risk of injuries to that particular joint.
5. For runners, good shoes with proper arch support and soft heels will help to reduce the impact on the joints of the lower limbs and also protect the ankles from abnormal loading that frequently causes ligament sprains.