In this video I'm going to answer the question “Is walking actually good for bone-on-bone
Knee Joint Pain?” It depends on what category you fall into. If you have bone-on-bone knee joint
problems, there are three categories. And I'll be covering all three categories in detail today,
so that you can determine which category you fall into. And then you can decide
for yourself if you should be walking if you got a bone-on-bone knee joint problem.
My name is Dr. David Middaugh and I'm a specialist physical therapist at El Paso Manual
Physical Therapy. And this channel is dedicated to helping people stay healthy, active, and mobile,
while avoiding unnecessary surgery injections and pain medications.
Please consider subscribing to our channel so that you don't miss out on any of the helpful videos we
post every single week. So, let's get into it. The first category is a severe bone on bone knee
joint problem, if you are in this category, you've lost a significant motion in your knee
joints. In other words, if this is your knee, you can't fully straighten it out, it doesn't go
all the way straight like it used to or and or it can bend all the way it just stops shy of
what you could go. Usually, people can bring their foot whenever they bend it near there.
But within an inch or so I'm sorry, within a foot or so about 12 inches, oftentimes even more,
but if you feel like you can't bend it as much, especially as much as the other side,
then you've lost significant motion in your knee. And the most important one for walking is being
able to strain it out if you can't straighten out all the way. And that's probably a severe bone on
bone knee joint problem. Other signs of having a severe problem are not being able to tolerate more
than about five minutes of standing and walking. You might also have pain most nights of the
week. If you feel like four or five or six or more days out of the week,
you're suffering from pain at night in your knee wakes you up you can't go back to sleep because of
it, you're having to take pain medication at night in order to sleep because of the knee problem.
That's also a sign of having a severe bone on bone knee joint problem that when morning comes and you
wake up, stiffness is pretty bad in the morning and being able to walk around and loosen it up
is just it takes a while it takes usually an hour or even more to be functioning to be able to get
around and cook a meal or get ready for the day. Usually, people have gone to the doctor by this
point. And they've had an x-ray, or an MRI and I've been told that they
have a bone-on-bone knee joint situation. So, it's been confirmed to the X ray the MRI. And
oftentimes a doctor will start to recommend having a knee replacement or some surgery like that.
They usually don't tell you to wait. They don't say to get it in a year or in several
years. They say you should get it at some point soon. They'll also recommend pain medication,
sometimes injections as well. And usually when people get pain medications and they're in a
severe bone on bone knee joint situation, the pain medications or having an injection just
takes the edge off, it doesn't really fix the problem, it doesn't really get rid of the pain.
The experience that people have when they're in a severe situation
is it just barely lessons of pain, but they're still waking up at night. They're still having
difficulty in the morning walking and standing and it's just a tough situation to be in.
Now make sure to watch to the end of the video I'm going to tell you if you should be walking
for exercise. If you're in this situation. Let me just cover the other two categories.
The next one the second category is having an irritated bone on bone knee joint problem
it's different from a severe bone on bone knee joint problem. The main difference is that you
can tolerate walking up to about 30 minutes or so people with an irritated problem have
good days and bad days are not all bad days. They'll have some days where they feel like
they can do quite a bit they can take care of the house they can maybe do a little bit of exercise.
But after about 30 minutes he started to get more pain sometimes we'll get swelling
if they really push it and they will need to sit down and rest for a while to feel better.
If it's not way too irritated. People in the situation sometimes get pain
at night usually will have like a day or two per week especially if they are on their feet more,
they have a busier day at the that night after they have a busy day will be painful. Sometimes
we'll even take pain medication for it. And you bet stiffness happens in the morning with
these individuals. If you got a painful knee joint, it's been irritated the day before.
The next morning typically, it's stiff it doesn't bend or straighten as good,
and it takes up to 30 minutes to freed up in order to get back to normal again. Sometimes
people go to the doctor at this point sometimes they don't and if they go to the doctor the X
ray and the MRI will definitely show there's a bone on bone knee joint situation the doctor will
show them the X ray and just to show you on the skeleton with the extra look like
you see this space right here my fingers at and on the outside right here.
If you've got a bone-on-bone joint situation the X ray will look like there isn't a space,
there. The Bones, we'll be touching each other almost touching each other, either on this side
or this side on the outside the inside of the knee and as the outside, or both will be down together,
that's of course a worse situation to be in. Oftentimes doctors will say you don't need
a knee surgery right now, like in the replacement surgery, but they'll say,
well, in a few years and five, maybe if you're lucky, last 10 years, you'll probably need a knee
replacement at that point. So, doctors will often say and then in the meantime, they'll
recommend taking pain medication, either oral pain medication by mouth, or they'll recommend
giving an injection to get some pain relief. In the short term right now, people that
end up taking pain medication, either injection or by mouth,
in this situation do get some significant relief. But it isn't long lasting at most, a couple of
months, if you've got an injection, if it's done correctly. And if you're taking pain medication,
whatever they recommend, as far as you know, you get six hours of relief or eight hours of relief.
It will be effective for that time, maybe not 100%, but enough for you to get by enough for
you to do what you have to do for the day or to walk as much as you need to. And you still
end up with the stiffness and the pain the next day, if you're if you're busy,
even though you've taken the pain medication. The third category is in non-irritated bone on
bone knee joint situation. Now the way that you'll know that you've got this going on,
as you had that X ray, you've had that MRI, you've been to the doctor because you've had
a knee problem, usually people are trying to avoid a severe situation. At this point,
they may have had family history, you know, parents or grandparents
that had a bone-on-bone knee joint situation that had a history of arthritis.
And maybe there's some pain that's lingering. And maybe there's been a bad day,
you know, a particularly bad day or a bad week where the pain got really bad, you had to sit
out from doing normal things for a time, and then it got better and you're back to normal.
If you go to the doctor and they told you that you had a bone-on-bone knee joint situation,
in this situation, you can typically walk for almost as much as you like it does bother you.
The more that that you are on your feet, the more that you're walking, and then the next day, there
could be some stiffness and it typically goes away within the first 20 minutes after waking up
and you don't have a loss of motion, you can move your knee straight and bend it as far as you
is as far as you want. It may hurt a bit to go to the end in bending it or in straightening it. But
there typically is minimal to no loss of motion. As far as pain tonight, it's occasional,
it's typically a couple times a month, like two or three times a month, and is highly responsive
to pain medication. If you take like Tylenol, or an Advil and ibuprofen, something like that, it
typically will lessen and allow you to go walking or go do whatever you want to do for the day.
Without being too painful. Getting an injection for this pain typically clears
it up. It's not resolving the root problem, but it's masking the pain enough for you to be able to
walk and stand into your activities. Or each day. without too many problems. The doctor
doesn't typically recommend surgery right then and there. It's rare that they'll do that. But
they'll say hey, in 10 years or in five years, you're going to end up needing a surgery.
I like a knee replacement potentially if this problem worsens way too fast. So those are the
three categories just to review them. We've got a severe bone on bone knee joint problem
in irritated bone on bone a joint problem and a non-irritated bone on bone knee joint
problem. And just to differentiate the last two, the irritated and the non-irritated,
they can look the same on an x ray. And you might go back and forth between
those two categories, you know that you're not irritated. When you're feeling good. When you feel
like you can walk around like you can do quite a bit, you might still have some pain at night or
maybe throughout the day if you're busier. But generally, you're quite active, you're your
normal self, but you know that you've got a bone on bone and joint problem versus irritated. It's
an act of irritation. You can't walk right now you can't bend and straighten your knee and you're
headed towards a severe knee arthritis problem. If that keeps happening. You're not doing the
right things to keep it under control and make sure that it's healing. Now I'm going to talk
about if walking is good for you in which category you should be walking in which one
you shouldn't. But just a quick side note that that's important for you to know in case you've
got a bone-on-bone knee joint situation I get asked this question all the time is will it ever
heal? Can it heal? And the answer is it can become less irritated, and it can theoretically heal.
Now the cartilage does not regenerate because we're talking about a loss of cartilage or a
compression of the cartilage in the knee joint. And if you've got a bone on bone
knee joint situation, which you're looking at, if you can see this, this knee joint right here,
this is the foot this is the right knee, that red spot right there might be where the cartilage is
worn down and usually it's a pencil head or smaller sites that the cartilage has
actually been worn down in the end of the bone. It could also be in the back of it kneecap.
And if you can walk correctly, if you can get stronger in the right muscles, then you can
take pressure off that side. And even though the cartilage won't grow back, that spot can heal,
you got to differentiate the differences between healings. And regeneration is a whole branch
of medical field of the medical field that is developing and isn't 100% certain yet, you know,
as far as stem cells, PRP injections, we've got more content on that'd be check out our channel.
But healing is your best bet. Currently, you can lay down some scar tissue in that area, then you
might actually be able to escape having a knee replacement surgery and get back to functioning
extremely well, despite having an x ray and MRI that showed that you had a bone on bone,
knee joint situation, what isn't typically happening unless you're in a severe bone on
bone joint problem is all the cartilage is gone. You got to be careful when you visit the doctor
because they typically don't explain this what I'm about to say right now,
they don't explain that the entire surface of the end of the thigh bone right here
is covered in cartilage. And you probably have only lost a percentage of it not 100%,
maybe like five at most 10% That's enough to cause some pretty bad pain and limitations in your knee
motion and tolerance was standing and walking. But losing all the cartilage on there. And
on the back of the kneecap is rare. And typically, there's severe losses in motion
with associated with that. And it's been going on for years, likely even decades at this point.
So, if you if you're able to walk if you're able to bend and straighten your knee,
you probably have not lost 100% of the cartilage, you probably have a good chance at rehabbing
this problem and rehabilitating this problem. You've just got to do the right things which
I'll catch you up on here next. Right let's answer the question now. Will walking help your situation
out if you've got a bone-on-bone knee joint problem? If you fall into the severe category,
absolutely not, you should not be walking to help your problem. I mean, if you can't tolerate
five minutes of standing and walking, it's just not going to help you even if you're offloaded.
Like if you're using a walker, or a cane or crutches, there's also therapy devices out
there where they hook you up into an unloader and anti-gravity things, those things are not going
to help your knee joint situation, chances are you've got a severe muscle imbalance.
Usually, the quadricep muscles in the front of the thigh are just way too strong glute muscles are
way too weak. And any type of walking even if it's unloaded is going to eventually worsen the knee
joint situation. If you're in a position where you're looking to avoid getting a new replacement,
then you've got to begin to strengthen your glutes without putting weight on your legs. Aquatic
physical therapy might be beneficial for you. But even land-based exercises that we cover
here in this channel will be super beneficial for you. In fact, I've got two playlists full of tips,
advice and exercises linked down in the description below. One is focus on knee
cartilage problems, and the other one is focused on the arthritis problems. Go check those out
to figure out which situation fits your problem the best and which exercises and
advice you should begin to use so that you can get some healings get some get your pain
under control if you've got a severe problem. And it actually might be best for you to talk
to the surgeon and consider a knee replacement. If that's your case, because getting full range
of motion is not that possible, it's typically more of a permanent loss. If you've had this,
especially if you had the loss of motion for more than a year. Getting more motion back is you got
slim chances, you can try it out, I recommend you actually go try out some of the stretches.
But if you're not making progress within the first week or two of gaining motion,
then there's probably a low chance that hammering your knee into fully straight or bending all the
way is probably not going to happen and talking to a surgeon might be a really good idea.
But if you're looking to wait on surgery, and you want to exhaust all your other
options and go check out our playlists, apply everything that we talked about there and see
how you benefit if you are making improvements. And fantastic you might be able to get out of that
severe category and go down into the irritated and non-irritated categories and eventually walk with
support so that you can bend so that you can heal your knee cartilage and benefit in the long term.
Now if you've got an irritated bone on bone knee joint problem, then it depends on if
you should be walking or not. It depends on how much you can tolerate. If you can tolerate at
least 10 minutes of walking, pain free during the walking and also without having
side effects afterwards like swelling or achy Enos that lingers in within the first 10 to 30
minutes afterwards and definitely into the next day. Then You're in a good situation.
Now, I got to give a little bit of a caveat, if you walked for 10 minutes,
and you got an irritated bone on bone knee joint problem, and it didn't hurt you,
then that's a really good sign. Now, if you had some lingering symptoms afterwards, what I
recommend you do is don't give up on walking yet, pay attention to how long those symptoms last.
If they clear up within 12 to 24 hours, they're not severe,
you can still be active as far as doing your daily activities or doing your work, then you're
in good shape. It's just very irritated. And what you've got to do is keep walking, but keep it to
10 minutes or less, or whatever timeframe you use, if you did 15 minutes of walking,
and then you had some irritation later on. That's still good. But now if your irritation
lasted for more than 24 hours, it went into two or three days, then it's too much. And you've
got to reduce how much walking you're doing. You might even just start with
a few minutes of walking maybe up to five minutes, see how you tolerate that there should be no pain
during the walking. And then you don't want to have symptoms that lasts more than a day.
If you can walk five minutes, and you don't have any symptoms that lasts more than a day,
then you can extend that time to 10 minutes or move it up appropriately as you see fit.
But if you're getting symptoms that last a day or more than you've got to shorten how much you're
walking, or maybe even do some other exercises, like I mentioned in the severe arthritis group,
you might need to hang out on those exercises for a bit before you go attempt a walking for
exercise. And another side note here that I'll go into more details you got to walk correctly,
there's more, there's more to that. Now if you're in the non-irritated bone
on bone knee joint situation, then a walking is probably going to benefit you tremendously.
Of course, you don't want to irritate it further, if walking is hurting you,
you might be the exception we're walking, this hurts you no matter what, then don't do that.
But if you have been walking, you've been doing your daily activities, you've been on your feet
throughout the day, and you have good days, then this is good, you have the potential to heal
your cartilage in your knee and make sure that your bone on bone situation doesn't get worse,
and you have potential to walk the rest of your life just fine. As long as you're doing
it correctly. This is what I want to stress. And we've got a video that talks about this.
So go check it out. It's linked in the description about how to walk correctly
the correct technique and the correct muscles to use. Because chances are,
if you have a bone-on-bone knee joint situation, you've been doing walking incorrectly and you've
been using the wrong muscles. And you've got to fix that so that walking can now benefit you and
it's not making your knees swell or making your bone on bone and joint situation worse.
So go check out that video learn how to walk correctly, just to give you a little
preview of it, you've got to use your glutes, right you've got to position your feet correctly.
And then what I don't talk about in that video that you need to pay attention here
is the timeframes, just like I said with the irritated group. If you're not irritated,
and you're going to go walking, don't overdo it. If you can tolerate walking 15,
20, 30 minutes or even an hour, that's great, but pay attention to your symptoms afterwards.
If you don't want to have any lingering aching is pain or swelling. That is more than a day.
If that's the case, you've got to follow the same rules I just mentioned, you got to lesson
how much you walk and find the sweet spot find the right amount of walking that you
can do without having symptoms that lasts more than a day. And that rule is if it's
most people, but you might be the exception. You might even say I'm not going to have any
symptoms at all. If that fits you best, I can do that too. But what I found here in practice
is a little bit of pain that lingers afterwards is tolerable and we can work with that you'll
still get better, but you don't want it to last more than a day. That's what we found
best fits the majority of people. Guys, I hope this video was helpful
for you. Give us a thumbs up if you benefited. If you have any questions,
drop it as a comment below here and we'll see you in the next video. Have a great day. Bye.