Knee pain surgery

Ageing Knees? Don’t go weak in your Knees

Ageing Knees

Don't go weak in your knees

Do you hear a sudden click in your knee while bending down? Do your knees hurt while squatting? Well, your knees are trying to convey their ageing story. It may not be wise to ignore the click sound, minor pain or swelling once you have crossed your 50's.

Osteoarthritis (OA) is common among ageing population and one of the leading causes of disability. It is the second most common problem & the most frequent joint disease with a prevalence of 22% to 39% in India.

In Knee OA, the cartilage in the knee joint gradually wears away and it becomes frayed & rough and the space between the bones decreases. Arthritic knee usually begins with symptoms of joint click, pain and swelling that worsen in the morning. Knee arthritis can make it hard to do many activities such as walking and climbing stairs.

If unattended; the joint may become stiff & swollen, making it difficult to bend & straighten the knee. The knee may “lock” during the movement. It may creak, click, snap or make a grinding noise (crepitus). The pain can cause a feeling of weakness or buckling in the knee. Weather changes usually aggravate the symptoms - You may notice increased knee pain during rainy & cold weather.

Since OA is a degenerative condition; the damage occurred cannot be reversed. But timely intervention in the form of regular exercise and early Physiotherapy can arrest degeneration & maintain joint integrity.

Easy ways to manage OA knee :

  • Manage your Weight
  • Keep a check on your Calcium & Vitamin D levels
  • Avoid offending movements like squatting
  • Do not delay : Address the signs of pain in time
  • Specific knee exercises

We have some very easy and convenient tips to manage arthritis pain on our website. Read Here

Obesity and Knee Pain

Are our knees paying the price of Obesity?

According to the World Health Organization (WHO), obesity is one of the most common, yet among the most neglected, public health problems in both developed and developing countries . According to the WHO World Health Statistics Report 2012, globally one in six adults are obese and nearly 2.8 million individuals die each year due to overweight or obesity. Due to the increased risk of morbidity and mortality, obesity is now being recognized as a disease in its own right. Additionally, obesity is strongly associated with other metabolic disorders including diabetes, hypertension, muscular problems, dyslipidaemia, cardiovascular disease and even some cancers. The risk for these disorders appears to start from a body mass index (BMI) of about 21 kg/m. Obesity is generally classified as generalized obesity (GO) and abdominal obesity (AO). Individuals with obesity have higher rates of mortality and morbidity compared to non obese individuals.

India, with 1.2 billion people is the second most populous country in the world and is currently experiencing rapid epidemiological transition. Undernutrition due to poverty which dominated in the past is being rapidly replaced by obesity associated with affluence.

In a study done in India, the prevalence of obesity was 72.5% among women and 1.1% among men.Obesity is much more than a cosmetic problem, as its associated health problems is increasing.

Link between obesity and Knee OA:

Despite the multifactorial nature of musculoskeletal disease, obesity consistently emerges as a key and potentially modifiable risk factor in the onset and progression of musculoskeletal conditions of the hip, knee, ankle, foot and shoulder. A recent World Health Organization report on the global burden of disease indicates that knee OA is likely to become the fourth most important cause of disability in women, and the eighth most important cause in men. It suggests that primary prevention of knee OA should become a major aim of health care. Several investigations of risk factors for knee OA have been reported previously. Most common important risk factors include obesity, previous knee injury, selected physical activities, the presence of hand OA, and a family history of the disease.

Under normal conditions, articular cartilage provides a near frictionless surface, aiding in the distribution of pressure loads within the joint. OA has a logical link to obesity: The more weight that’s on a joint, the more stressed the joint becomes, and the more likely it will wear down and be damaged.

Weight plays an important role in joint stress, so when people are very overweight, it puts stress on their joints, especially their weight-bearing joints, like the knees and the hips. In OA, there is an imbalance of the anabolic and catabolic processes of the chondrocytes(cells which protect the surface of the joints), leading to damage of the structural and functional integrity of the cartilage and adjacent bone and other joint tissues. Excess weight has been identified as an important risk factor for OA of the knee. Obese individuals have 1.5-2 times the risk of developing knee OA than their leaner counterparts. While the link between excess weight and higher risk of knee OA is well accepted, the mechanism of association is debated.

Carrying extra body fat may also lead to the releases of a hormone called leptin, which some experts think may play a role in the development of osteoarthritis. In addition, body fat can release substances that promote inflammation in your body.

Ways to Recover from Knee pain:

Get a consultation.If you have knee pain, discuss types of activities with your physiotherapist that might be safe for you.

Exercise. Those who think they have no time for bodily exercise will sooner or later have to find time for illness. Good types of exercises for heavier people include walking – even for just a few minutes when you’re starting out – bicycling indoors or outside, and strength training to build stronger muscles under the supervision of the physiotherapist.

  • Diet modification.Plays an important role in reducing and achieving healthy lifestyle, thereby reducing the load on the knees. The “stoplight diet,” can be followed one does not forbid any foods but instead stresses an appropriate balance of high-, medium-, and low-calorie foods. In this diet, “green light” foods contain 20 fewer calories per average serving than standard food in that group, “yellow light” foods contain not > 20 calories above the standard for food in that group, and “red light” foods contain > 20 calories above the standard for food in that group and should be eaten infrequently.

As obesity and musculoskeletal problems are linked to each other, one must pay attention to their muscular flexibility, strength and weight parameters for longer healthy functioning of their knees. The fitter the body the better the life.

So appropriate weight and healthy knees go hand in hand.

De Quervain tenosynovitis

All About DeQuervain’s Tenosynovitis

There are two stages of the treatment for De Quervain’s syndrome or De Quervains tenosynovitis. It is a painful condition affecting the tendons on the thumb side of your wrist. In case of acute stage, when there is inflammation the goal is reduction in inflammation and preserving movements. Subsequently, once the inflammation subsides the goal is improvement in function.

Acute stage treatment

  • Splint to support the thumb and the wrist and which provides support and helps healing procedure.
  • Help identify aggravating activities and suggest alternative postures
  • Cryotherapy (e.g.: cold packs, ice massage) to reduce the inflammation and edema
  • Therapeutic Ultrasound (i.e. phonophoresis) or electrically charged ions (i.e. iontophoresis)-Ways in which a medication can be driven into the soft tissues through skin and promote faster healing.
  • Plan and suggest activity modifications to correct abnormal position of the hand in a particular activity.
  • Corrective exercises: Help in maintain the correct postures of the hand and thus enable better healing, promote faster rehab and aid in the prevention of further complications.

Second stage treatment (once inflammation subsides):

The goal is to work on the range of motion, Flexibility, Strengthening, Preventing recurrence

  • Thermal modalities to promote and aid in healing.
  • Transverse friction massage to break the adhesions.
  • Therapeutic exercises – starting with Range Of Motion (ROM) exercises, and as the patient progresses, adding strengthening exercises
  • Ergonomic workstation assessment as needed (Design work place to prevent further injuries after assessment of the same)
  • Educating the patient to either avoid or decrease repetitive hand motions, such as pinching, wringing, turning, twisting or grasping..
  • Rehabilitation exercises to prevent recurrence.
  • A home-exercise program for the maintenance of the goals achieved by the physical therapist and hence aid in faster recovery of function..

Physiotherapy treatment DeQuervains

Ultrasound therapy for wrist

 

Exercises for wrist and thumb rehabilitation
 

What is deQuervain’s Syndrome ?

It is the tenosynovitis (inflammation of the fluid-filled sheath called the synovium that surrounds a tendon and helps them glide easily) of the two tendons that control movement of the thumb. Inflammation results in pain, swelling and constricted movement of the tendons within the tunnel on the side of your wrist (Base of thumb). The swollen tendons and their coverings rub against the narrow tunnel through which they pass. The result is pain at the base of the thumb. At first, the only sign of trouble may be soreness on the thumb side of the forearm, near the wrist. If the problem isn’t treated, pain may spread up the forearm or further down into the wrist or both and thumb and limit your range of motion. As the friction increases, the two tendons may actually begin to squeak as they move through the constricted tunnel. This noise is called crepitus. It is pai nful especially when you turn your wrist, grasp anything or make fist..

 

Wrist Pain

Wrist Pain on movement

 

 

What causes deQuervains ?

de Quervain’s tenosynovitis is basically a combination of overuse, repetitive movements e.g.; racket sports, hammering and poor hand on wrist posture. It can be idiopathic (has no specific cause).

Common causes include:

  • Repeated hand and thumb motions such as grasping, pinching, squeezing, or wringing may lead to the inflammation of tenosynovium.
  • Holding your hand at an angle to your wrist creates a compression point that excessively rubs the tendon.
  • This inflammation can lead to swelling, which restricts the smooth gliding action of the tendons within the tunnel.
  • Scar tissue from a previous injury can make it difficult for the tendons to slide easily through the tunnel.
  • Arthritic diseases that affect the whole body, such as rheumatoid arthritis, can also cause tenosynovitis in the thumb.
  • Arthritic diseases that affect the whole body, such as rheumatoid arthritis, can also cause tenosynovitis in the thumb.

 

Wrist injury

Text Thumb

Benefits of physiotherapy:

  • Physiotherapy treatment reduces inflammation and accelerates healing.
  • improve strength, range of motion and endurance and correct postural and muscle imbalance which in turn prevents recurrence of condition.
  • Ergonomic corrections and activity modifications prevent various other injuries of hand and wrist along with deQuervains.
  • Physiotherapy rehabilitation exercises helps to restart all activities early.
  • Recovery is rapid if you start treatment in early stages. Chronic condition takes time as lot of changes like adhesion formations, Muscle weakness take place. But one can expect full recovery with the rehabilitation program completion.

INTERESTING FACTS

Pregnant ladies and post-delivery mothers are affected more often. Contributory factors may include hormonal changes, fluid retention and – more debatably – lifting (baby).

arthritis joint pain treatment

Arthritis – Do your Joints Pain?

The disorder commonly affecting the knee and other joints is called as Arthritis.

We commonly see our mothers or grandmothers groaning in pain when they try to do simple activities like getting up from the floor or climbing steps. Daily simple chores seem very difficult for them. They dread even the pleasant rains and winters as they are likely to experience increase in their aches and pains with the fall in temperature.

Arthritis is an inflammation of one or more joints. It is common in adults 65 and older, but it can affect people of all ages. There are many types of arthritis but most common types of arthritis are osteoarthritis and Rheumatoid Arthritis.

1. Rheumatoid Arthritis : It is an autoimmune disease in which the body immune system attacks the lining of the joint capsule, a tough membrane that encloses the joint parts known as synovial membrane. It is characterized by fluctuating course, with periods of flares and remission.

2. Osteoarthritis : It is a chronic degenerative disorder involves wear and tear damage to the joint’s cartilage. Enough damage results in bone grinding which causes pain and restricted movement and joint effusion.

Symptoms of Arthritis

The most common symptoms of Arthritis include pain, redness in the area, swelling,  limited movement & stiffness in the joint.

Unpaid attention to these symptoms can lead you to be under the surgeon’s knife.  But timely attention to the soft ringing of bells of your joints can help you deal effectively with your joint pain.

 

Arthritis, Joint pain : Facts, symptoms, Physiotherapy treatment

Treatment 

Physiotherapy is key to the treatment and management of arthritis.  It can help you to maintain independence through improving your mobility, strength and flexibility.

Used along with medication it can also help to minimise pain.

Physiotherapy for arthritis focuses on the reduction of pain and stiffness as well as increasing the level of movement and range of motion for the individual.

Our experts at ReLivaTM use a combination of modalities, manual therapy techniques and exercise and movement programmes to suit your specific condition. They will aim to reduce the swelling in the affected area along with making a strategy to control pain and stiffness. They will also devise simple exercise programmes that you can practise at home to help you build your strength and flexibility.

Physiotherapy uses a mix of Modalities

  • Heat treatments : These treatments produce heat within your body tissues. The application can be directed towards superficial or deeper parts of the body. The most common types of treatment used are infra-red radiation (heat lamps) and hot packs for superficial treatments.
  • Electrotherapy : These treatments produce electrical stimulation of your body tissues. They may be extremely useful in the treatment of both acute and chronic arthritis, where pain, swelling and muscle spasms are present. Physiotherapy exercise for Arthritis, joints pain
  • Exercise : A balanced programme of rest and exercise, and careful attention to joint posture is an important part of pain management, joint protection and maintenance of your joint function.
  • Manual therapy: Mobilisation and manipulation techniques are passive movements applied to a joint or soft tissue by the therapist in a specific manner to help restore full movement to a joint that is painful and restricted. Manual therapy is often useful in the chronic forms of arthritis and is often successful when other methods such as heat therapy and exercises have given little or no relief.
  • TENS : Transcutaneous electrical nerve stimulation (TENS) therapy is a commonly used electrostimulation method for relieving pain in rheumatoid arthritis.

 

Simple Tips to help avoid pain and stiffness:

  • Avoid staying in one position for long.
  • Avoid positions or movements that place extra stress on sore joints.
  • Avoid sitting on floor.
  • Modify your activities to make them easier.
  • Take proper rest when your symptoms are on a rise.
  • Try to lose weight if over-weight, as it reduces pressure on joints and alleviates pain.
recovery from knee pain

Dreams come true!

Painful knees are a very common occurrence among the elderly and so was with Mr Narayanaswamy. He continued to live with painful knees which eventually hampered his everyday activity. There was chronic pain and despite medication his walking and general movement began to decline. He continued to console himself that the reduced activity and stamina was owing to his increasing age.

But after a prolonged period of about two years, by when he was bed-ridden and almost totally inactive – he underwent total knee replacement as advised by his doctor.

After an initial rehab of knee replacement, an average person usually reports significant improvement in walking and other movements. Unfortunately Mr Narayanaswamy was not showing any signs of recovery. Instead he consistently suffered from fever and weight loss. Eventually a TB infection was diagnosed that had affected the TKR implant too. So a revision surgery had to be performed on him shortly, thereafter.

It is at this stage that I got to meet Mr S. Narayanaswamy – who had gone through so much in the last two years. Not just being physically weak he was feeling mentally drained too. He recalls “After I came from the hospital, I was very low on physical as well as mental strength. I was depressed also.  Even the slightest of movement made me breathless.

I was to be his home visit Physiotherapist from ReLiva. On his initial assessment, I realized that it was not just his stamina, he was even having difficulty balancing himself while standing. He had been bed-ridden and completely inactive for more than a year.

As a physiotherapist, I identified that his immediate goal was to improve his balance, regain strength and thereafter build up his stamina. All of these eventually will help him regain self-confidence.

Together we worked hard day-in and day-out. I would visit him regularly at his place and work on his goals through a combination of therapy and exercises. Gradually he showed signs of recovery and began to stand properly on his own. We systematically progressed to the next set of exercises. Now I had prescribed him several movements to be done on his own during the rest of the day. The committed and sincere person that he was, he would do those home exercises diligently on most occasions. We were moving from one strength to another.

It was at the end of another session of physiotherapy when he broke the news with a beaming smile that he was thinking of visiting his daughter abroad!

We had come a long way. Here was a man who was completely bed-ridden for a year and a half and could not even speak on the telephone for more than a minute and NOW – he wanted to travel overseas! He was daring to dream and together we shall have to make his dream come true! We now worked towards a deadline when he could walk independently to take this long journey on his own.

After another bout of intense physiotherapy, he reported, “my energy level has gone up, I have regained my emotional strength, there is no depression, no breathlessness! I am walking properly and climbing stairs.”

Last, I saw him the day before he was to take his flight and he walked on his own with his walking stick. We did some strengthening exercises which he would continue doing on his own while he was away. He told me that “I am a happy individual now. I am back to life!” … what he didn’t realise was : What a happy and delighted therapist he was leaving behind in me watching his dream come true!

As shared by Dr Shrutika Parab (PT). Dr Shrutika is a home visit physiotherapist with ReLiva Physiotherapy. She is immensely popular among her clients for her enthusiastic and positive approach. You can contact her directly at ReLiva (+91 9920991584) or email to her at contact@reliva.in.

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