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
The Legit Benefits Of Infrared Sauna Use As Proven In Scientific Studies
When the idea of having an infrared sauna was floated by Chaz I initially thought “great, another wellness gimmick” because “wellness is so hot right now”.
I’m a sceptic and had this drummed in at university that everything must be evidence based.
The throw away line I heard was “it releases toxins” and I thought yip that’s what sweat does… go for a run…
However, some pretty switched on scientists started harping on about the benefits of sauna so I thought I’d do some research. Can sitting on your backside in a hot room listening to Spotify, Netflix or the Calm app really be good for you???
Interestingly a lot of the research comes out of Finland. I know it’s cold there, but they really do have a thing for saunas. The studies they do are pretty big but the results are actually incredible. Here are some of the findings in case you were tempted to indulge yourself but need a reason to actually pursue it.
People that use saunas 2-3 x per week are 22% less likely to die from a sudden cardiac event e.g. a heart attack or stroke
Regular users (4 x per week) are 63% less likely to experience a sudden cardiac event. Yes that’s right 63%
Using a sauna 2 x per week led to 22% less chance of developing high blood pressure (sauna use stops hardening of the arteries)
Using a sauna 4 x per week led to a 46% less chance of developing high blood pressure. So for a non drug intervention I reckon that is pretty significant
Reduces chronic inflammation markers in your blood reducing chronic inflammation
Using the sauna 4 x per week led to a 65% reduction in risk of developing Alzheimers disease
Reduced depression in healthy patients using 2 sessions per week
When I started to read these benefits I couldn’t get in the sauna fast enough. Thinking of the long term gain if I could reduce any of the above, I’m all in.
On a personal note the things I’ve noticed the most since using the sauna 3 x per week are
I’m a lot more relaxed in both mind and body
The days I use the sauna I sleep like a baby!
A post swim sauna is epic. One of our clients times his sauna use with full tide. Genius!
So if you are interested in trying our sauna we have an intro offer of 3 sessions for $70 as well as a number of options including concession passes and memberships on our website
https://www.connectstudio.co.nz/book-now
Cheers, and see you soon!
Nick
How to Offset the Effects of Sitting to Improve Posture and Reduce Pain
Sitting! One of the biggest contributors to our generation of people suffering from bad posture and back pain! In Western society, everything has been engineered to have us sitting with our hips at 90⁰ - chairs, toilets, cars, etc which leads to our hips being so used to that position that they become stiff and the muscles around them shorten, creating a vice-like effect. We therefore lose mobility into other hip positions and consequently the surrounding muscles can’t do their jobs properly either. This is why we often hear of health practitioners telling us things like our “glutes aren’t firing” or we are “quad dominant”. So how do we offset the effects of sitting? Hopefully this blog can give you some simple tips to reverse the damage!
One useful tip is to evaluate the amount of sitting you do during the day, and aiming to offset this at the end of each day. Be honest with yourself and take into account driving, working, sitting on the couch watching a movie, eating, etc. From there, for every hour of sitting (hips in a bent up/flexed position), aim to do one minute of work on hip extension (i.e. stretching the front of the hips and strengthening the hip extensors such as Glutes and Hamstrings).
Other than offsetting the sitting, working on hip extension is hugely beneficial for everyday life. These muscles are responsible for having good gait and ensuring we are walking and running efficiently. They play a big part in getting up off chairs, out of cars, off the floor, and so when they are a little sleepy our body compensates and uses other muscles which can often lead to some of the common back and hip pain we see. As humans we really only have about 15-20degrees of hip extension (how far you can take your straight leg behind your hips keeping your pelvis and lower back still), however if we don’t have the ability to do that, every time we take a step we find the movement somewhere else such as hinging at the lower back, which puts it under unnecessary load. The hip joint is the biggest joint in the body so we need to make sure it’s working well so that all the other little joints in our knees, feet, spine etc, don’t have to compensate and overwork! Take a look at the video for ideas on hip mobility and hip extensor strength, and remember movement is medicine!
Benefits Of Infrared Sauna Use As Proven In Scientific Studies
When the idea of having an infrared sauna was floated by Chaz I initially thought “great, another wellness gimmick” because “wellness is so hot right now”.
I’m a sceptic and had this drummed in at university that everything must be evidence based.
The throw away line I heard was “it releases toxins” and I thought yip that’s what sweat does… go for a run…
However, some pretty switched on scientists started harping on about the benefits of sauna so I thought I’d do some research. Can sitting on your backside in a hot room listening to Spotify, Netflix or the Calm app really be good for you???
Interestingly a lot of the research comes out of Finland. I know it’s cold there, but they really do have a thing for saunas. The studies they do are pretty big but the results are actually incredible. Here are some of the findings in case you were tempted to indulge yourself but actually looking for a reason to!
People that use saunas 2-3 x per week are 22% less likely to die from a sudden cardiac event e.g. a heart attack or stroke.
Regular users (4 x per week) are 63% less likely to experience a sudden cardiac event. Yes that’s right 63%
Using a sauna 2 x per week led to 22% less chance of developing high blood pressure (sauna use stops hardening of the arteries)
Using a sauna 4 x per week led to a 46% less chance of developing high blood pressure. So for a non drug intervention I reckon that is pretty significant
Reduces chronic inflammation markers in your blood reducing chronic inflammation
Using the sauna 4 x per week led to a 65% reduction in risk of developing Alzheimers disease
Reduced depression in healthy patients using 2 sessions per week
When I started to read these benefits I couldn’t get in the sauna fast enough. Thinking of the long term gain if I could reduce any of the above, I’m all in.
On a personal note the things i’ve noticed the most since using the sauna 3 x per week are
I’m a lot more relaxed
The days I use the sauna I sleep like a baby
A post swim sauna is epic. One of our clients times his sauna use with full tide. Genius!
So if you are interested in saunaing you can try out our intro offer of 3 sessions for $70 by clicking HERE
Or you could get a 10 pack by clicking HERE or if you just know you are sold then try a membership allowing you either 2 or 4 sessions per week HERE
Most people like to book the room for themselves to chill but if you want to bring a friend let us know about some options by clicking HERE.
I've Just Had A Muscle Strain! What Should I Do?
One of the most common phone calls I get from people is, "Help, I've just had a muscle strain. What should I do?"
You could be playing a game of touch, and then bang, your hamstring goes. You could be crossing the road and a car's coming, so you push off a little bit harder and you feel a pull in your calf. You could be doing hill sprints and all of a sudden you have hit the deck with a torn muscle. Asking someone for a lift or hopping home. It's a pretty scary thing, particularly the first couple of days, because you literally can't walk. So I just wanted to go through that initial phase of management so that you can get back to what you love doing asap.
Managing an injury well in the first 48 hours can make a phenomenal difference to your outcome.
OK so you've just pulled a muscle, but you need to go to work that day. In that scenario, I would work from home or have a sick day and literally sit on the couch for the first day or two. Chill out feeling sorry for yourself. Don’t rush around, use this time to minimize the damage. They've done research where the less you do for that first couple of days the better your outcome is. Why? because you do less damage to the muscle that's just been torn or strained. So protect the area.
I like the acronym POLICE for management over the first 48 hours.
Step one, PROTECT. For that first 24 to 72 hours you're not going to do much walking at all. Put some Tubigrip or COMPRESSION bandage over the top of it. wear this durung the day and take it off at night. ELEVATE your leg on a couple of pillows on the couch to help drain any swelling out of your leg.
Next up is OPTIMAL LOADING. after the first 48 hours you actually need load in order for that muscle, or ligament to heal. Optimal load doesn't mean go for a 20K walk but it does mean start gently walking on it. Unless something is broken, being on crutches for a week can actually be really detrimental to your recovery because your injury hasn’t been loaded enough!
We actually see more problems from people that just do nothing for a couple of weeks than we do with those that started to get moving after that first two days.
Should I take voltaren or neurofen?
Most people are taught that racing for the Neurophin or Voltaren helps reduce pain and inflammation. But that actually is a bad idea, because what it's doing is it's delaying your scar tissue. And in this scenario we actually want scar tissue, because that's what our body lays down to repair muscle. So don't use Voltaren or Neurofen if you have strained a ligament or muscle. If it is really bad, use ice or Panadol to help kill the pain.
So to summarise
Step one: take some time at home to chill for a day or two to reduce more bleeding.
Step two: use compression bandage to reduce the swelling
Step three: elevate your leg on a couple of pillows on the couch
Step four: optimally load your injury after the first 48 hours to start to help strengthen the new scar tissue
Once we have set up the muscle strain to recover well most muscle strains return to sport from 8 to 28 days with the right Physio rehab program. We will normally get you jogging within 5 days for hamstring injuries, 7 days for calf strains and quadricep strains at day 7.
So if you have injured yourself. Come in at day 3 and let’s get you back to training asap!
You can book an appointment at our Waiheke Physio clinic in Oneroa HERE
Help I've Got Lower Back Pain! What Should I Do?
It all begins with an idea.
Lower back pain can be very frightening. It can strike as simply as picking up a towel off the ground, getting up from gardening or getting out of bed in the morning after intense exercise the day before. Picking up a kettle bell to start your gym session or the last rep of the last set of the day. BUT the pain can be terrifying. You literally can’t walk. The questions begin, is this me for life? will I ever recover? Do I have sciatica? Will I need a wheel chair?
The reality is the majority of people get better with the right advice and some Physiotherapy. You also need to know that 85% of us at some point in our life will get an episode of back pain like this, so you're not alone.
I’ve put together a few tips on what to do when you first get back pain to help keep you moving, keep you calm and get you out of pain faster until you can see us.
Tip 1 Keep Moving
Lower back pain can be so painful that it feels like you should just stay in bed for three days. But I want to encourage you to keep moving.
Now, it can be so sore that you literally just can't get out of bed, but as soon as you can, I recommend that you get out of bed and start moving. They've actually done studies where they compared people that stayed in bed versus those that got moving, and the people that kept moving had less pain and recovered faster. Go for a walk regularly, even if it's just around the house for five minutes. Ideally, if you could get around the block a couple of times a day, that's even better, but just keep moving regularly.
Tip 2
The second tip I've got for you is change positions regularly. For example, if you were sitting down and you still had to do a bit of work, then I would get up go for a quick walk then sit back down again. Or stand and do some work/ reading. If you need to make a call do it in standing rather than sitting.
Choose to sit in a harder chair rather than on the sofa. It tends to put you in a more hunched position which actually makes your back worse. Lie on your side rather than sit on the couch.
Tip 3: Do this little exercise routine
Try this little exercise routine that I've put together. Doing this exercise routine a few times a day can be really good at just keeping you moving. Make sure there is minimal pain with each exercise and if you feel one or two are making your pain worse than DO NOT keep doing them. I would do them at least 3 to 4 times per day.
Tip 4: Chill!
Your brain has gone into protection mode or the fright or flight nervous system response. In this state you feel more pain, you're more anxious and your muscles guard more. So instead chill, downloading an app like Calm or Headspace, and do one of their guided meditations. Calm even has some specifically for pain. Even just taking some deep breaths and trying to calm your nervous system is a start if meditation isn’t your thing. Getting back into the parasympathtic nervous system response or chill mode will relax your muscles, reduce your pain and help you recover faster.
I hope those tips have helped. Try the exercise routine I've given you. You will most likely need some help from us with lower back pain so click HERE to book. Our Waiheke Physio clinic is located at 3 Tui Street in Oneroa. Know someone that has hurt their back? click the share button and give them this info. Look forward to meeting you soon.
3 Tips To Reduce Your Knee Pain Today
It all begins with an idea.
One of the things we see coming into summer is an increase in knee pain, particularly at the front of the knee. This type of knee pain isn't caused by a fall or being tackled. Quite often it involves too much running, sport or walking.
Most of the time it's caused when your kneecap is not tracking very well with the bone underneath (your femur). Imagine a train on a train track and the train's just slightly coming off the train track. This is essentially what is happening to your knee cap.
Common symptoms are pain going up and down stairs. It can feel like it's giving way. You can start running and your pain increases 3kms into a run. It's a really common injury and there are three things you can do to get your pain under control.
Isometric exercises can help settle your pain and wake your muscles up
An isometric contraction basically means, you contract your muscles without moving. It's a nice, safe contraction that should be pain free. You can hold them anywhere from 10 seconds to 45 seconds and the goal is to do five to six reps and do at least a couple of sets to get that pain under control.
Tape Your Knee
Taping the knee, can help get the “train back on the track” therefor reducing your pain and waking up your quadricep muscles which the knee cap sits in. Tape the knee for at least 1 week reapplying the tape every two days. If it is itchy take it straight off. There is no point getting a nasty skin reaction over it!
Reduce Your Stride Length
The final tip is to reduce your stride length. A lot of the time with this injury, it's caused by people that have a big stride length or over stride where they walk or run landing quite hard on their heel. This increases the ground reaction forces or your body weight through your knee and not through the rest of your body. So a simple hack is simply reducing your stride length. You can do this by slightly increasing your foot speed or just being conscious to not over stride. It is impossible to do this for an entire run so focus on it for a couple of minutes and then going back to your normal running or walking style. Do another couple of minutes and then change back.
That should be enough to improve things. As always this condition needs a proper rehab program, we need to film your running or walking technique and modify if needed. There can be other things contributing tot he problem also. So click HERE to book an appointment or shoot me a message HERE and I can see if we can help. If you know someone that just can’t get their knee pain under control, click the share button below. Nick