Can Surgery INCREASE Your Risk Of Getting Arthritis?

Here’s What You Should Know…

  • The meniscus is a cartilage cushion between your femur (big leg bone) and tibia (smaller leg bone)
  • The meniscus can get damaged or torn in traumatic and sports related injuries or it can get “worn down” resulting in a tear from chronic degeneration
  • Surgery is a typical course of action to repair the damage
  • New research suggests that this popular surgery “may increase the risk of osteoarthritis and cartilage loss” for some people

knee-meniscusMeniscus Surgery and the New Research

The very short summary is that the researchers “found that patients without knee osteoarthritis who underwent meniscal surgery had a highly increased risk for developing osteoarthritis and cartilage loss in the following year compared to those that did not have surgery, regardless of presence or absence of a meniscal tear in the year before,” Dr. Roemer said.

Note the language: “Highly Increased Risk”

Having a meniscus repair surgery does not necessarily CAUSE osteoarthritis.

It does however apparently increase your risk of developing arthritis and cartilage loss.

All surgeries have risks associated with them.

This research simply points out another one to be aware of.

Deciding your course of action is best done when you have good information.

Read on to find out how to decide what to do…

RELATED: SUFFER FROM HIP OR KNEE ARTHRITIS?

The Cost-Benefit Analysis of Meniscus Surgery

Meniscus tears come in all shapes and sizes.

And as is true with most injuries the amount of pain and disability associated with the problem varies from person to person.

So what should YOU do if your meniscus is torn?

I’d highly suggest you work with an orthopedic surgeon that specializes in your type of injury and that you trust.

Find out what YOUR options are. Discuss the pros and cons of each.

Then decide (together with your doctor) on the best course of action based on YOUR situation and needs.

And then – just as importantly – follow through with your plan.

If you – for example – decide to have physical therapy for your meniscus tear and knee pain… Then make sure you:

Find a Physical Therapist that has experience and expertise in treating meniscus tears.

Make sure that they are skilled at treating this injury PRE-SURGICALLY.

Many physical therapists have a lot of experience with post-surgical care for a meniscus repair…

But this is NOT the same as treating a torn meniscus that has been surgically repaired.

Commit to the physical therapy treatment plan.

That means both going to your scheduled physical therapy office visits AND doing what is prescribed for you at home.

It is VERY common for me to prescribe exercises (to help decrease pain and inflammation) that should be done 3 to 5 times per day.

Each mini-session of physical therapy exercise takes 5-15 minutes and is designed to help you heal as fast as possible.

Be consistent and Be patient.

Proper healing takes time and diligence.

Invest your resources (time and money) so that your knee injury can fully heal.

This will ensure the best outcome – and possibly help you avoid surgery.

Do You Have A Wristband Activity Tracker?

activity-tracker-wristband-researchLately I’ve noticed that more and more of my physical therapy patients are wearing activity tracker wristbands.

Devices like Jawbone and FitBit.

You may have seen them too…

Or maybe you OWN one.

Today I came across a journal article that examines the automated feedback provided by these devices and the behavior change techniques associated with them.

The research paper is titled: Behavior Change Techniques Implemented in Electronic Lifestyle Activity Monitors: A Systematic Content Analysis

If you are deeply interested in the topic I’d suggest you have a look at the research (just click the link above).

But if you are interested to know more about these wristband devices – things like

  • What they do

and

  • How they work

Then check out my summary of the findings…

Wristband Activity Devices: Summary of Findings

1. Several Behavioral Change Techniques (BCTs) are used by these devices including things like self-monitoring, adding objects to the environment, feedback provision, and goal-setting.

2. These BCTs are “evidence-based” (supported by research as being efficacious… in other words – the scientific community gives them a thumbs up).

3. Even though it’s great that these devices utilize valid behavior change techniques – what’s most important is that the features of the device you choose match YOUR preferences and needs.

So if you like to swim – make sure the device is waterproof. And if you get motivated by social sharing – then make sure the device supports that function.

4. And if you are involved in a physical therapy program – then an activity tracker might help you get better outcomes. “Electronic activity monitors have the potential to significantly improve objective measurement of physical activity for people with chronic diseases and disabilities who receive physical therapy, occupational therapy, and other types of rehabilitation services.”

Great News For Runners!

HERE’S WHAT YOU SHOULD KNOW…

  • Running – as a physical activity – is associated with benefits like improved heart health
  • If you don’t already have knee arthritis then running is a safe activity (i.e. it doesn’t appear to be harmful to the knees)
  • Runners DO have other injuries to worry about
  • Improved biomechanics (aka running technique) can help prevent running related injuries
  • New technology in the Runsafer system gives runners real-time feedback to help them adjust their running technique and possibly reduce the incidence of running related injury

runner-good-newsRunners Beware?

If you run you’ve probably wondered if you are damaging your knees and putting yourself at risk for degenerative arthritis.

In other words – you may have wondered if running causes knee arthritis.

After all running IS a “high impact” activity. That thinking led to the growth in popularity of “low or no impact” exercise equipment like elliptical machines and recumbent exercise bikes.

And while those other forms of exercise are great – you have to either (1) join and go to a gym to use them OR (2) have enough money to buy one to have in your home.

One of the great things about running is that it is an anywhere and anytime form of exercise.

So what’s holding people back?

The “high impact” therefore it’s “bad for my knees” argument.

This research, however, kills that argument.

As long as you don’t already have osteoarthritis in your knees…

Running Appears To Be Safe For Your Knees

So let’s be clear… What this study is saying is that running does not appear to cause degenerative arthritis in your knees.

It’s not saying that running is an injury-free activity.

In addition to other possible injuries to your knees every year runners suffer from a large variety of running-related injuries such as:

  • Plantar fasciitis
  • Runner’s knee (aka Patella Femoral Syndrome)
  • Shin splints
  • Strained muscles

Each of these injuries has the potential to not only cause pain (which sucks!) but it can prevent you from exercising for quite a while while you heal.

So the old adage “an ounce of prevention…” really does apply when it comes to avoiding running related injury!

Technology To The Rescue

Running related injuries can arise from trauma (like a slip or fall) but more common are injuries from repetitive stress. So using good bio-mechanics (aka your running technique) is a key area to focus on if you want to stay injury free.

And new technology – a device that’s built into your running shoe – can provide real-time feedback about your running technique.

The Runsafer System transmits info from sensors embedded in the running shoe to your smart phone. So while you are running it can tell you how to adjust your technique to avoid injury.

And if you are in imminent risk of injury it literally warns you to stop running… How cool is that!

If You Are Already Injured or Having Pain…

And if you live in or near Arvada – then give us a call at 720.222.9669. We have worked with professional and Olympic-caliber level runners to help them get out of pain, heal fast and get back to running.

Robot Helps Humans Regain Ability To Walk

robot-physical-therapy-walkingI’ve been working as an outpatient physical therapist for well over 15 years. As such I haven’t worked with any patients that are recovering from a stroke or spinal cord injury in quite a while.

But I read this article today and had to write a post on it.

Because this is just cool…!

This comes straight from the article: “A team of researchers has invented a novel robotic walker that helps patients carry out therapy sessions to regain their leg movements and natural gait.”

If you’ve never worked with a person right after a stroke or spinal cord injury (or other such neurological insult) to help them walk – you may not appreciate how cool this really is.

One of the biggest challenges for the physical therapist is to provide enough physical support during weight bearing. That means having enough strength to hold an adult up. The sooner you start the process (and usually sooner is better) the less weaker the patient is. So strength REALLY is an issue for early intervention.

And for the patient it means having full confidence in the therapists to hold them up. Even when the patient is using assistive devices like parallel bars or a walker – confidence is always an issue.

The support provided by a robot would help with both challenges.

I’m excited to see how this technology develops over the next several years. It’s awesome to think about how many people can be helped to regain their independence faster and better after such a life altering event.

Suffer From Hip or Knee Arthritis?

Here’s What You Should Know…

  • DO go and see your doctor and get your usual care
  • ALSO go see a physical therapist that specializes in manual therapy and therapeutic exercise
  • The combination of these forms of care are very effective at helping to decrease pain and dysfunction caused by hip and knee osteoarthritis

no-arthritis-painA Typical Scenario

I want to share a typical scenario with you…

It’s what many of my patient with arthritis do when their pain gets bad enough or when they notice that it’s interfering with their life.

Follow along and see if this sounds familiar to you.

John Goes To The Doctor

The first thing John does is go see his primary care doctor.

If the doctor has not already given John a diagnosis, the doctor will examine John and perhaps order (or take) an x-ray of the painful joint.

John’s doctor will use all of the information gathered (from the exam and the x-ray) to figure out if John has osteoarthritis.

Let’s suppose that the diagnosis is positive… That means that the findings suggest that John does, in fact, have osteoarthritis (which is also referred to as degenerative joint disease).

In an attempt to get rid of (or at the very least manage) John’s pain the doctor might suggest that John:

  • Temporarily stop doing activities that increase the pain
  • Do some light stretching exercises (as indicated)
  • And take some medications such as
    • Pain medication
    • Anti-inflammatory medication
    • Muscle relaxants

John Goes Home

Let’s pretend that John is the perfect patient. He listens to all of the doctor’s suggestions and immediately fills his prescription(s). He then takes the medicine(s) as prescribed for the suggested period of time.

But unfortunately the suggestions and the medicine don’t do enough. John is still in quite a bit of pain and his quality of life is still not very high.

He can’t sleep very well and wakes up frequently and he can’t sleep in certain positions.

He wakes up very stiff and it takes a while for him to “warm up” enough to get going for the day.

He can’t participate in his usual activities (such as perhaps taking his dogs for a walk, or playing golf, or going to the gym).

So John goes back to the doctor. At this point it’s common for the doctor to recommend and prescribe Physical Therapy.

John Goes to Physical Therapy

Here’s where I’m going to break from our “typical scenario”. The reason for this is that the amount of variability in types of treatment you might get at a physical therapy clinic is very broad.

Some physical therapy treatments focus mainly on the use of “modalities”. This means that a part of the treatment session would include things like:

  • Hot packs
  • Ice packs
  • Ultrasound
  • Electric Stimulation
  • Therapeutic Lasers

Other physical therapists focus on exercises done on weight machines (like you might find at a gym).

Some physical therapy clinics specialize in things like Pilates or massage.

And still others are experts in manual therapy and low tech (i.e. things you can do at home with very low cost equipment) exercise.

Related: Exercise For Hip Arthritis

The type of physical therapy that John gets depends on where he goes.

But in any case (back to the scenario again) it’s at this point that John will typically abandon the suggestions his doctor made (i.e. he stops taking his medicine) and instead focuses on just physical therapy.

And The Results Are…

At this point John has probably gotten “fair” results.

If he got lucky and was able to find an excellent physical therapist then he may experience excellent results.

But he most likely just got average results… And in my opinion that’s not good enough.

So what, you might ask, could John have done better? I’m glad you asked because there is…

A Better Way: Medical Care PLUS (excellent) Physical Therapy

In my experience and according to new research the best combination is traditional medical care and excellent physical therapy done at the same time.

Go and see your doctor and follow their recommendations.

And talk with your doctor to find out if they think physical therapy might be helpful.

If so make sure you locate a physical therapist that specializes in treating arthritis AND are experts in therapeutic exercise AND do manual therapy.

Physical Exercise For A Better Brain

physical-therapy-exercise-brainScience proves once again that if you want to improve your brain functioning then you gotta exercise.

In this most recent study (1) the participants were “older adults” – ages 65 to 76 or so.

The findings showed that all forms of physical activity done over the course of an 8 week period improved cognitive function.

The great news is you can do any kind of exercise and get the benefits of improved brain function! So if you prefer cardio… Go for it! Or if you want to do strength training that works too.

Here are the keys to any good exercise program:

1. Be Consistent. Whatever you decide to do be sure to do it regularly. Aim to do at least 3 exercise sessions per week EVERY week.

2. Challenge Yourself. Walking on a treadmill at 2 miles per hour while talking on the phone just won’t cut it. If you decide to do aerobic exercise you have to do it with enough intensity that it counts are exercise. Check out this video on how to gauge your exercise intensity.

3. Use Progression. Once you get good at your exercise program you’ll find that it gets easier. And that’s good! However when that happens you have to bump up the intensity to continue to challenge yourself. So increase your speed on the treadmill or bump up the incline. Pick up the next set of higher weight dumbbells or do some more repetitions. For more tips on ways to increase your exercise intensity check out this article.

Maybe this all sounds great… But perhaps you aren’t able to exercise because pain or injury are holding you back. If that’s the case then it’s time to do something about it!

Some common problems people over 50 experience that prevent them from being able to exercise are:

  • Joint Pain – Arthritis can cause pain and inflammation in nearly every joint of the human body. When it comes to limiting exercise the usual suspects include knee pain, hip pain, back pain and shoulder pain.
  • Balance Problems – As you age you may notice your balance is getting worse. Hearing loss and/or decreasing eyesight and/or joint pain and problems can all impair balance.
  • De-conditioning or Fatigue – If it has been a while since you’ve been involved in a regular exercise program you are probably pretty out of shape!
  • Muscle Aches – Similar to and probably related to joint problems.
  • Don’t-Know-What-To-Do-Itis – Starting an exercise program can feel overwhelming and you might be intimidated by the machines.

Here’s how physical therapy can help with each of these problems:

  • A Physical Therapist can help you get rid of and manage joint pain. Arthritis is generally a chronic problem – which simply means that if you are 50 or older it has probably been a problem for a while. If you decide to go to physical therapy be sure the clinic specializes in orthopedics and chronic pain.
  • Physical therapy is very effective in diagnosing and correcting balance problems. There’s a very easy to do assessment called the Berg Balance Test that a Physical Therapist can administer. This test can help identify problem areas that might contribute to your balance problems. Physical therapy sessions will then focus on treatments and exercises to correct these problems. Be sure your Physical Therapist has experience with Balance and Fall Prevention.
  • Some Physical Therapists are experts in exercise and conditioning programs. If you are de-conditioned and don’t know what to do (i.e. what exercises to do, how to use the machines, how to build an exercise program) a Physical Therapist with training in exercise therapy and conditioning can help.
  • Physical therapy can very effectively treat muscle pains and strains. We use a variety of techniques in my Arvada clinic to help people with acute and chronic muscle pain. This includes manual therapy (soft tissue work), electric stimulation, kinesiology taping techniques and therapeutic exercise.

If you live in or near Arvada and are interested in physical therapy – give us a call at 720.222.9669.

Reference:

1. Nicolas Berryman, Louis Bherer, Sylvie Nadeau, Séléna Lauzière, Lora Lehr, Florian Bobeuf, Maxime Lussier, Marie Jeanne Kergoat, Thien Tuong Minh Vu, Laurent Bosquet. Multiple roads lead to Rome: combined high-intensity aerobic and strength training vs. gross motor activities leads to equivalent improvement in executive functions in a cohort of healthy older adults. AGE, 2014; 36 (5) DOI: 10.1007/s11357-014-9710-8