My background in professional football at Barnet Football Club, professional skiing in Val d'Isere and athletics has given me insight into how to look after knees. And 30 years later I am seeing these young knees become less young.
Here are some tips to get on top of your knee problems
The knee is one of the largest and most complex joints in the body making it extremely vulnerable. One in four adults are affected with knee joint problems most of them being over 50 years old. It is common for knees to degrade as we get older.
Some may well need surgery but recent research has shown that there is little difference between the effects of surgery and exercise.
What really doesn’t help and is adding to this problem is our increasingly sedentary type lifestyles, weight gain and generalized poor exercise regimes.
As a physio I have treated thousands of knees over the past 30 years and here is my advice to help keep your flared up knee joint in check:
Exercise
Exercise can be the last thing on your mind if you have joint pain and building the muscles around the knee could be the best way to slow the worsening of you joint flare up.
A study (1), published in the Journal Arthritis and Rheumatism, found that 60 per cent of people with significant arthritic changes in their knees on X- rays, had no symptoms whatsoever.
So from a Physio standpoint this doesn’t necessarily mean that the joint needs surgery or an injection. It could simply be the muscles around your knee joint need strengthening especially your thigh and buttock muscles.
Studies (2) have shown that quadriceps/thigh weakness can make knee pain more likely, and knee pain can lead to quadriceps weakness
In addition If you spend much of your day sitting, your buttock muscles can become weak and these are critical in stabilizing the legs
Plies.
Stand with feet apart, toes turned out, and one hand resting on the back of a chair. Slowly bend your knees (keeping them pointing in line with your feet, heels on the floor, without leaning forwards or allowing your bottom to stick out).
Lower yourself just a little at first, then squeeze the buttocks and slowly return to the standing position. Repeat regularly, aiming to gradually deepen the bend over time.
go walking or cycling
.
Pace yourself
Increase your endurance by building up periods of gentle walking or cycling until you can keep going for 20- 30 minutes at a time, two to three times per week is ideal.
Pace yourself throughout the day and consider breaking this up into bite size chunks This may mean breaking up your 30 minute walk into 3 chunks of 10 minutes. Use pain as your guide to monitor your levels of activity.
Knee Brace
A recent study by Arthritis Research UK(3) found that a knee brace can help improve pain, knee stiffness, muscle strength and function.
But don’t rely on a brace for support as it’s no substitute for good strong muscles around the knee joint.
Footwear
Knee pain can be helped by wearing cushioned shoes such as trainers.
Varying your footwear can have a positive impact as it can adjust the loading through your knee, although very high heels will alter the angle of your hip knee and big toe joint putting more strain on them.
Hot or cold packs
Ice packs can reduce pain and ease inflammation for the first 36 hours of a flare up. Keep ice packs in the fridge rather than the freezer to make them more tolerable.Or use the Deep Freeze Roll on.
Hot packs can help increase the circulation and ease stiffness and muscle spasms once the flare up has settled.
Heat sprays such as Deep Heat rubs and gels can have a similar effect,
But don’t use heat on an inflamed knees as this could worsen the flare up.
Weight management
Being overweight doesn't necessarily cause knee problems but losing even a small amount of excess weight can have a significant impact.
There is a huge body of research which shows that for every pound of weight you lose, you can reduce the loading on your joints four-fold
The simple act of walking puts a load three or four times your body weight on your knees
Losing just half a stone can be enough to help alleviate knee pain. (3)
Painkillers Anti inflammatories and Supplements
Painkillers can help settle the joint pain to keep you going but they don’t repair any joint damage. The best time to use these is when the flare up is very bad and in some cases when exercise to strengthen the area has to be carried out.
Patients are often concerned that they may be ‘masking the pain’ so getting the balance right between keeping going and not overdoing it can be tricky. Keeping normal function going is important as pain may cause you to move in a way that is unhelpful for the rest of your body.
Paracetamol is usually the most well tolerated painkiller but make sure you take the right dose.
Combined painkillers may be helpful for more severe pain.
Over-the counter non-steroidal anti- inflammatory such as ibuprofen, can also help but need to be taken with extreme caution esp in the over 70 year olds
Your chemist can advise you and supply paracetamol and some low-dose tablets and creams without a prescription.
Anti-inflammatory creams and gels
Anti-inflammatory creams and gels can be applied directly and they’re extremely well tolerated as very little is absorbed into the bloodstream. If you have trouble taking tablets then anti- inflammatory creams are a particularly good option to try. You can decide if they help your pain within the first few days of trying them.
If you’re already taking NSAID tablets, speak to your doctor about non-NSAID creams (for example capsaicin cream) to avoid taking too much of one type of drug.
Make sure you speak to your or pharmacist.
Supplements
I am a huge fan of supplements such a tumeric,ginger,rosehip and bromelain. The research is varied in this area but my exposure to anecdotal evidence of patients having huge benefits from using supplements is overwhelming.
It is very personal so try it and see.
I'm trying Ginger at the moment and it seems to be helping with my morning stiffness!
Sources
Miller ME, Rejeski WJ, Messier SP, et al. Modifiers of change in physical functioning in older adults with knee pain: the Observational Arthritis Study in Seniors (OASIS). Arthritis Rheum. 2001;45(4):331–339. [PubMed]
2 http://www.ncbi.nlm.nih.gov/pubmed/26821917
4 http://www.ncbi.nlm.nih.gov/pubmed/26784732
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