Do You Really Need A Knee Replacement If You Have Osteoarthritis Of The Knee?
Do You Really Need A Knee Replacement If You Have Osteoarthritis Of The Knee?
I saw a guy the other day 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.
What kind of answer is that? Really? In 2021?
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 weight bear on it the longer it will last. Making him look like the leaning tower of pizza.
DO YOU REALLY NEED A KNEE REPLACEMENT BECAUSE YOU HAVE KNEE OR HIP OSTEOARTHRITIS?
Not always! In Fact a lot of the time you can live quite comfortably with knee or hip osteoarthritis. It’s been the 4th anniversary of the “oracle” surgeon predicting his knee would need to be replaced.
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.
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. s.
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. 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!
That was all rather depressing. However THE GOOD NEWS IS STUDIES HAVE SHOWN THERE IS NO RELATIONSHIP BETWEEN WHAT YOUR KNEE LOOKS LIKE ON AN X RAY 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!!!! Read on to find out why movement is absolutely crucial to feeling better.
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.
If you are struggling with your joints at the moment feel free to reach out. We are more than happy to answer any questions. Just email us at hello@connectstudio.co.nz
If you are struggling with your knee joints at the moment, live on Waiheke Island and need a Waiheke Physio read below
THE 8 WEEK BULLETPROOF YOUR KNEE PROGRAM
We created this program based on the GLAD hip and knee osteoarthritis study used on over 10000 people suffering from OA of the knee. The results were amazing just as they have been with us. During the Bulletproof Your Knee Program you will include neuromuscular exercises that target stabilizing the knee joint, relieve pain and build trust on your affected side. Loading the joint the best possible way.
From our work and that from the GLAD program participants experience significantly less pain, have improved physical function and a better quality of life. People also took fewer pain killers.
You can book online HERE. Make sure to write in the notes that you want the 8 week knee program.
Nick