Avoid Knee Replacement from Osteoarthritis

[00:00:00]Knee pain people, a little arthritic pain.

[00:00:02]>> Ooh, are you okay?

[00:00:03]>> I think I'll be fine. Yep.

[00:00:06]Not bad for acting, eh? So, we're going to [laughter] go over knee fixes, things you can help correct knee pain with. Dr. Joann is here, Mike is here, we're all putting our input into this for you.

[00:00:17]>> Bob and Brad, >> [music] >> the two most famous physical therapists on the internet.

[00:00:26]>> All right, the first one, very simple, common sense, is simply avoid things that irritate your knee. So, if it irritates it, don't do it as much or put it off the list of things to do. It's not always easy, but don't go with the theory of no pain, no gain.

[00:00:43]>> I would agree. Um The next thing we're going to look at is walking. So, if you walk often and your knee is bothering you, one thing you can do is try to implement using an assistive device. You can use a cane, a walker, whatever you have. Most people say, "I don't want to be seen with that thing." But, it can really take some pressure off of your knee, maybe shorten your walks as well.

[00:01:05]If you happen to walk on roads and they have a cambered side or where the water goes off into the sewer lines there, uh make sure to stay on the same side because when you come back, you're going to be walking at an angle and when you come back, if you stay on the same side, you're going to be walking on the other angle. So, you get even uh I was going to say wear and tear on both knees, but even walking mechanics cuz we're not wearing and tearing.

[00:01:31]>> Yeah, so if you can avoid walking on roads at all and stay on sidewalks or inside where the ground is flat or the floors are flat, that's the way to go.

[00:01:40]>> Another thing to look at is your footwear. If it's really bothering you to walk, maybe getting some new shoes will help.

[00:01:47]>> Dr. Joann, what did we miss so far?

[00:01:50]>> I think that's good. Um >> What about the cane?

[00:01:52]>> You want me to demo this?

[00:01:53]>> Yeah, show people what to do.

[00:01:55]>> So, say my left knee hurts. Uh the cane is going to go with that same leg. So, when you step with that left knee. So, cane and injured leg go together, which a lot of people want to do the opposite, but this is actually going to help take some of the pressure off of that knee. And the nice thing is is this is temporary, right? So, this is not you have to use a cane because you're old.

[00:02:19]>> [laughter] >> This is you have to use a cane because you're having some pain. And once that pain improves, you can get rid of this and go back to your normal walking.

[00:02:27]>> Very important concept.

[00:02:29]>> Tip number three is looking at your walking mechanics. Now, most people when they walk, they do a heel strike. Their foot goes far out in front of them, and you're getting a lot of impact forces going through your joints this way, including your ankle, your knee, hip, and low back. So, what we want to do is take shorter steps and land with a bent knee, and notice my foot is more flat.

[00:02:50]Some people may land with a forefoot, and then the heel comes down. It gets a little complicated. I just say to most people when they're first learning how to look at their walking mechanics is take your shoes off inside. You can wear slippers or grippy socks if you need to, and walk. If you heel strike, this feels very uncomfortable on your feet. You're naturally going to walk with a more knee bent flat foot pattern. So, try walking like this cuz it can take a lot of pressure off of your knee joint. If it doesn't feel better, and it makes it feel worse, you don't have to do this, but if you notice a big difference, just try it out. It does take time for your body to get acclimated to that walking mechanic and get a little quicker pace.

[00:03:30]Um, but just give it some time, and before you know it, it becomes more natural.

[00:03:33]>> Yeah, it's one of those things where I've seen now with personal pain as well as with patients, they change the to the forefoot walking to the soft knee walking. Pain immediately goes from say a eight over 10 down to a three over 10 right then. It's a really good way to convince yourself. fancy >> I just want to point out, I also can have fancy socks, Brad.

[00:03:54]>> Yeah, well, [laughter] yeah. I got to get the toe socks like that.

[00:03:58]The next thing, non-weight bearing exercises. You want the joint to move, but often times when you put weight through the joint because the arthritic flare-up is going on, it irritates it.

[00:04:10]Dr. Trahan, you want to give us some examples they can do simply seated in a chair?

[00:04:14]>> Seated in a chair, you could do just some straightening out those knees and we're going to work on this.

[00:04:21]If this is comfortable, you could always even add a little bit of weight here.

[00:04:26]>> So, around the ankle.

[00:04:28]>> Yes, weight around the ankle.

[00:04:29]>> Not around your wrist.

[00:04:30]>> [laughter] >> And some people, you can even do a little bit of knee bending like this.

[00:04:35]It's more of a marching in the hip, but it does get your knee to flex as well.

[00:04:39]And you can work on bending back this way underneath your chair, too. But we we have to work this out.

[00:04:45]>> Well, I'm I'm also going to add to straighten the knee out.

[00:04:48]>> Oh.

[00:04:48]>> Well, here you can No, if you're >> I would agree.

[00:04:50]>> a stool is going to be too tall, it might be difficult, but on a chair you can simply straighten and actually bend it so you get full range of motion.

[00:04:59]And do this if it doesn't hurt. Should feel good the more you do it. If you want to get some motion with those legs, more of an exercise for longer term non-weight bearing, this device right here works very nice. It's called the Fit Glide and there's very little resistance and people say, "It's not enough resistance. How are you going to get stronger?" We don't want the knee to necessarily get stronger. We want motion to get the the synovial fluid in. It does have a stilt so you can go at an angle this way emphasizing quadriceps strength and then you turn it around and this one actually works the hamstrings a lot more than I ever anticipated. It's called the Fit Glide.

[00:05:43]We'll have a link for that below. Really good for people who really don't tolerate walking much, but want that motion on a regular basis.

[00:05:51]>> Right, that motion's going to help lubricate those joints to help reduce that arthritic pain.

[00:05:56]>> All right, if you're a heat person and your knee responds really well to heat, we'll go through some good options.

[00:06:03]Uh your typical gel pack, the type that you can put in the microwave, there'll be instructions right on it. Don't overheat it. And simply, I always recommend a pillow on a recliner or situation like this. So, it's nice and comfortable, slight flexion in the knee, and put that hot pack on there 15 to 20 minutes. Now, there are a few steps up from that. big thing I like about this one is it's actually a wireless or cordless hot pack that heats up from electricity. Wrap it around the knee.

[00:06:36]You can adjust the heat. It can go for 20 minutes. And the big advantages of it, if you're watching TV and you got to get up to use the restroom, you leave it on and you can walk around the house with it. It stays warm. You can do chores with it and it stays on. So, it's a really nice advantage and this is something I haven't seen. Uh well, in the last year we came up with this. So, that will be in the link below. And then, if you really want some deep heat, some far infrared, Mike has one wrapped around his leg right there. It's the platinum model, the Thermotex. And how deep does it go?

[00:07:13]>> 2.36 in. So, it can actually kind of get into the joint itself and warm it up versus just superficial like most hot packs. Uh they are a bit spendier in comparison to a conventional hot pack.

[00:07:24]So, just be aware of that. But this platinum model, as you can see, it's not going to hinge on my knee. It's meant to be used anywhere on the body. Comes with a couple straps, but it's a nice option, very easy to use. Just plug it in, one button, and that's all there is to it.

[00:07:38]>> Right. So, there's three panels on there. So, you got one on each side of the knee, and it's going in over 2 in on each side. That's 4 in across the section. That's incredible amount of deep heat, and it will not overheat and burn you.

[00:07:52]>> Now, the next thing we want to talk about for knee pain, if you notice you have knee pain behind your knee, the back of the knee, and you don't have a big cyst back there or something like that, like a baker's cyst, those are a little more obvious to some people, but it could be a small muscle back there popliteus. They can get kind of tight on people after an injury or surgery.

[00:08:17]So, in order to massage that area, you actually want to go back there, and you'll feel if you're feeling back there there's a really tender spot, that's normally where you massage.

[00:08:26]You want a slight amount of bend in the knee. You don't want a full amount of bending, but to kind of get in there, and you can play with it how straight or bent it is.

[00:08:35]To do a release by a professional, they usually have you lay on your stomach, and they shove their thumb in there.

[00:08:41]But, if you wanted to be able to do it yourself, you can use a massage gun to get in there. You can use your thumb if you don't have a massage gun. You just kind of hold it on that trigger point for about 60 seconds or so. But, the massage gun kind of works well. Just I would use a more soft head because there's a lot of tendons and bones in this area, so you don't want to irritate it too much with a hard plastic head.

[00:09:03]>> Another thing you can do is talk to a doctor about getting like a specific brace that can unload the area that you're having that arthritis.

[00:09:12]And often times it's on the inside, not always, but they have specific braces you can get measured for, and they can fit you for them to give kind of some pressure unloading on on the inside of the knee, which can be very helpful, but they do they can be tricky, right? Because they slide down the leg at times. What were you going to say?

[00:09:33]>> So, if a person has, if I might say, one-sided knee pain, it's more on the inside or maybe it's more on the outside, then that brace will take the pressure off of the sore side.

[00:09:46]>> Off the sore side. You're right.

[00:09:47]>> they work.

[00:09:48]>> Yes.

[00:09:49]>> And from what I've read, I haven't used them a lot with patients, but it sounds like there's a 50/50 chance or so that it's going to work. And if it does, you like it. If not, >> Yep. And I've had mixed results with patients. But again, the hard thing is keeping it in place. So, probably having that brace directly on skin and following the manufacturer's information on that. Um another thing, do you want to lay on your back just for a minute, Mike? I'll show kind of a similar thing that the brace does. Obviously, you couldn't do this while you're like doing functional activities like you could with a brace. So, I'll have you lay on your back.

[00:10:22]>> I'm laying on my back.

[00:10:23]>> Yep. And then we're going to put this um underneath that knee, and then you can kind of hold that.

[00:10:28]>> Okay.

[00:10:29]>> Um and actually, I'll have you pull with this or pull leg down. So, um you can let go of towel, and then grab ankle and pull down there.

[00:10:39]>> Oh, yeah.

[00:10:40]>> And what you're doing is just adding a little bit of um pressure relief in that knee. And the thickness of this towel um can kind of help increase. So, if you get a thicker towel, it'll provide a little bit more relief. But you can start with a a thin towel. Um and that just >> Some people do this even seated position if they can reach okay.

[00:11:01]>> Yeah. Yep.

[00:11:03]>> can sit up and do the same thing.

[00:11:04]>> Just to help get some of the pressure off of that.

[00:11:09]>> like this. But if you're uncomfortable this way, you can certainly do it lying on your back.

[00:11:13]>> Yeah.

[00:11:13]>> There you go.

[00:11:14]>> Now, what's the bonus option, Brad, that your mother had done when she was >> Well, this is very nice. You know, a therapist, we don't always think about this cuz we don't do it, but simply injections. There are different types of injections. Actually, we did a video on three common injections. Uh you talk to your doctor about it. In my mother's case, she was 85 years old. Uh her knee pain was to the point where she could not walk very well without limping.

[00:11:42]Uh and uh she was not going to be able to do exercises in her condition. So, uh they simply put an injection in there and uh it worked. She was pain-free with her knee for 3 more years and >> Wow.

[00:11:54]>> Yeah.

[00:11:55]>> That's great.

[00:11:55]>> Yeah, it was just like I was so happy because I didn't know what else we could do with her and and uh it was a simple injection, too. I watched them do it and she was not in pain when it happened and after that, within a week, she was pain-free and never heard about it again. So, >> Woo.

[00:12:11]>> they don't always work that way, but when they do, it's a good deal.

[00:12:14]>> Yeah.

[00:12:15]>> So, those are our 10 options of things you can try. Obviously, you don't have to do all of them, but do which ones feel good for you. Now, if you want to check out a video more specifically on strengthening strengthening your arthritic knee, I need to annunciate uh you can click the video link on the screen.

[00:12:33]>> There you go. Best five exercises to stop that nasty arthritic pain.

[00:12:39]>> Well, nasty wasn't in the title. You just embellished there.

[00:12:41]>> [laughter] >> Well, I know, but it feels that way.

[00:12:43]>> Okay. Thanks for watching.

[00:12:53]>> Bob and Brad, [music] the two most famous physical therapists [music] on the internet.