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

Knee Replacement Surgery – Care & Exercise

You are about to have Knee Replacement Surgery (TKR). A lot of the long term results of knee replacements depend on how much work you put into it following your operation. Patients who prepare for surgery and actively take part in their care can recover in less time and with less pain. This guide has general information along with tips for things to do before and after surgery to help you make it a success.
You may get different instructions from your surgeon, doctor or physiotherapist. Always follow the directions of your care team. This guide is meant to be used under the direction of your physiotherapist.
Caution: If you have too much pain in your knee to exercise, or if any of the exercises cause more pain or swelling in your knee, stop. Tell your physiotherapist or doctor. If your whole leg becomes swollen or hot, tell your doctor right away!

General Guidelines: Before Surgery                  TKR- Total Knee replacement recovery

If you exercise before surgery you can have a faster and easier recovery. Exercise helps to:

  • Maintain the range of movement of your knee
  • Make your muscles strong
  • Control your pain
  • Build your knowledge of how to exercise after surgery
  • Improve your sleep

Do activities that put less stress on your knee. Try cycling on a stationary bike (upright or seated) for 5-10 minutes, walking in water (water level should be atleast thigh deep). It is best to do specific knee movements and strengthening exercises (in guidance of physiotherapist).

  • Always warm up before exercising. Your physiotherapist may tell you to:
  • Apply moist heat to the front and back of your knee for 5-10 minutes OR Have a warm shower or bath

General Guidelines: After Surgery

Exercise after surgery will help you recover and regain the movement and strength of your knee. Exercise also helps to:

  • Reduce swelling
  • Prevent blood clots (Thrombosis)
  • Control your pain
  • Prevent constipation
  • Improve your sleep

Tips to help you make the most of your Knee (TKR) surgery

DO’s

  • Take your recovery and rehab seriously. Exercise regularly as per the programme charted by your physiotherapist.
  • Continue with your knee replacement rehab programme for at least 3 weeks after surgery, probably 3 months of physiotherapy guided knee exercises to get the best result from your knee replacement.
  • Follow-up regularly with your surgeon, to monitor internal recovery.
  • Walker or crutches should be used until discontinued by Doctor or Physiotherapist.
  • Change knee position at least once an hour, while awake, to avoid stiffness.
  • Home exercises should be performed 3 times everyday unless advised differently by your Physiotherapist.
  • Walking is an excellent activity and you are strongly encouraged to gradually increase your walking distance after you leave hospital.
  • Walk outdoors as long as sidewalks are dry. Consider going to a mall to walk when the sidewalks are wet and slippery.
  • Swimming or walking inside swimming pool (where water level is at least till your thigh) is a very good strengthening exercise that prevents jerks and unnecessary strain on the knee.
  • Stay positive and committed. Don’t give up, and do what you can to keep a good attitude.

Don’ts : For 6-8 weeks after surgery, avoid:

  • Any pivoting (twisting) on your knee 2.Kneeling down 3.Squatting
  • Avoid high impact activities that cause jerk and stress on the knee joint, example running, jogging, rock climbing etc.
  • Avoid unnecessary stress on your knee by lifting very heavy objects. This can cause damage to your new knee.
  • Avoid using Indian traditional toilet, instead use a Western Commode (WC) or toilet chair.

Immediately after surgery, you can continue to do the following in bed :

1. Deep Breathing and Coughing Exercises : Knee replacement rehab - Pump your ankles
Until you are up and moving well, take at least 10 deep breaths, followed by a cough, every hour that you are awake.
2. Pump Your Ankles :
When lying down, move feet up and down and in circles. Repeat 10 -15 times every hour you are awake.
3. Buttock Contractions
Tighten your buttock muscle and hold for a count of 5 seconds. Repeat five to ten times, three to four times each day

Moving your new knee :

It is important to move your knee soon after the operation unless your surgeon or physiotherapist tells you not to. This will minimize stiffness, pain and swelling, and reduce the formation of scar tissue. Check with your physiotherapist for guidance about the best way to warm up your new joint.

To Keep Pain and Swelling under control, once you are home:

1. Rest Your Joint          TKR - Rest your joint

  • Change positions often (every 20 minutes) when you are awake. Try sitting, standing, and walking.
  • Pace yourself. Take things easy and slow.
  • Lie down 3 times a day for 30 minutes on your bed.
  • Put your leg up and support it with a rolled towel or with pillows (as shown).

2. Use Ice
Ice your knee when it is hot and red, painful and after exercises. (If your knee is very stiff and painful, check with your physiotherapist before icing
Follow these steps:

  • If your scar is not healed, cover it with a clean bandage and clean plastic wrap
  • Put a damp hand towel over your knee
  • Put a flexible gel pack, or plastic bag with crushed ice on your knee
  • Leave the ice ON for 10 minutes. Take it OFF for 10 minutes. Put it back ON for 10 minutes. Repeat 4-6 times a day
  • DO NOT use ice if your doctor has told you that the circulation to your legs is poor and that you should avoid using ice or heat

3. Use Pain Medicine
Use your pain medicines as prescribed by your doctor. Tell your doctor if the pain is too much or not improving.
4. Use Walking Aids
Use the walking aid that your physiotherapist has measured and recommended. Do not change or stop using the walking aid until your physiotherapist or surgeon tells you to. Walkers, crutches and canes help to:

  • Reduce the stress on your knee Reduce pain Improve your balance and reduce falls
  • Remember it is better to have a good walking pattern using two crutches than to limp and risk losing balance.

5. Sleep : It helps with rest and recovery. It is normal to have some sleepless nights up to 12 weeks after your knee surgery.

Consult an expert at ReLivaTM Physiotherapy & Rehab to learn more about rehab, Mobility Techniques and tips to make your Total Knee Replacement (TKR) Surgery a success.

knee pain

Five Ways to check your Knee health

Whether you are walking, running, cycling or exercising; you are likely to be using your knees a lot. While the common sense says that the more you use the joint the more mobile or lubricated it will remain. The better sense says that it will all be worthwhile only if you know how NOT to ruin them instead.

The knee joint is particularly vulnerable to damage and pain because it takes the full weight of your body and any extra force when you run or jump. You’re more likely to experience knee pain as you get older, and people who are overweight or do lots of sports have a higher risk of damaging their knees. And it’s not just athletes who suffer. Knee problems can happen to anyone.

It’s difficult to strike the correct balance between mobility and stability. The knee needs to move back and forth, twist a little, and pivot too. The knee’s ligaments can tear, its tendons can swell up, one may get osteoarthritis, and even everyday wear and tear can ruin a perfectly good set of knees,” says Dr Shreya Sahasrabudhe, the Musculoskeletal specialist at ReLiva.

Ask yourself the following five questions and find out if you’re being nice to your knees.

  1. How much weight are you carrying?

If you’ve ever loaded your car’s trunk with heavy objects or driven with four adult passengers, you may have noticed that the ride wasn’t as smooth. Your car’s shock absorbers probably didn’t soak up the jolts from the bumps and the potholes as well as they would have with a lighter load. Similarly, if you’re carrying too much weight on your body, your knees may also be in for a rough ride.

Every kg of excess weight exerts about 4 kg of extra pressure on the knees. So a person who is 10 kg overweight has 40 kg of extra pressure on his knees; if a person is 100kg overweight, that is 400kg of extra pressure on his knees. So if you think about all the steps you take in a day, you can see why it would lead to premature damage in weight-bearing joints.

  1. Are you exercising?

In case your knee hurts, whether due to an injury or due to a chronic condition like Arthritis – Exercising the knee may seem counterintuitive, but regular exercise can actually lessen — and even relieve — arthritis pain and other symptoms, such as stiffness and swelling.

There are several reasons to exercise with knee arthritis. For example:

  • Exercise maintains the joint’s full range of motion.
  • Exercise strengthens the muscles that support the joint.
  • Strong muscles help the joint absorb shock.

“If all the benefits of exercise could be put into a single pill, it would be the most widely prescribed medicine in the world,” says Dr. Neelam Patel, a Physical therapist specializing in sports injury.

  1. Are you overusing some muscles and joints?

The quadriceps muscles (front of the thigh) and the hamstring muscles (back of the thigh), which straighten and bend the knee respectively, are susceptible to strain (“pulled muscles”).

If your work requires you to frequently sit low or climb up and down stairs or stand, you are more prone to overuse. Initially your may feel fatigued. If this fatigue is not resolved prior to your return to work the next day, or shortly thereafter, microtrauma may occur. Microtrauma is when small soft tissue tearing occurs from overuse. Eventually your muscles and tissues become more traumatized, resulting in pain and loss of use.

  1. Is your body properly aligned?
    body alignment
    Is your Body Properly aligned?

Anyone who’s ever driven and maintained a vehicle is likely to have dealt with an alignment problem. The effects of a minor collision may create a misalignment that’s not immediately obvious. Our bodies are very much like these vehicles, and we may not realize that our own alignment is off until an ankle sprain leads to knee trouble or certain random ache develops into a chronic pain. When we lose proper alignment, we see knee joints begin to break down or wear out. This is due to uneven weight distribution.

  1. Are you wearing the right shoes?high heels for knee

Shoes with very high heels or those that lack the arch and heel support that your feet require, can place added pressure on your knees and throw them out of alignment. This, in turn, can cause pain under and around your knee. Wearing the right shoes when you exercise, go to work and for other daily activities, will help prevent knee discomfort.

Be Good to Your Knees Now

Arthritis of the knee is common, but it is not necessarily a compulsory consequence of aging. Taking care of your knees now will cost you a lot less time and effort than rehabilitating them down the road.

REMEMBER: When in doubt, rest and have your pain checked out. It’s better to spend a little time and money seeing a qualified physiotherapist than to be sidelined for months by an injury that you could have prevented or minimized.

Contributed by Dr Manali Jain (PT), consultant Physiotherapist at ReLiva Physiotherapy & Rehab. She has an avid interest in knee and knee conditions and looks forward to extend her knowledge to put to use for every common man.

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