♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
(claps)
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical Therapist.
- Here we are, the most famous physical therapists
on the internet.
- In our opinion of course, Bob.
- Today Brad, we're gonna talk about seven big lies
about treating knee arthritis you should know.
- There's a little controversy, we'll talk about it
as we go through it.
- Sure.
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- Absolutely, Bob.
- So this is a study that was first done in 2009.
I shouldn't say study,
they looked at hundreds of studies, Brad.
This is the Royal College,
Royal Australian College of General Practitioners.
So they got this huge group,
they look at hundreds, maybe thousands of studies.
- Sure.
- Regarding knee arthritis, and actually hip arthritis too.
- Okay.
- They first did it in 2009, they redid it in 2018.
So it's guidelines for non-surgical management
of hip and knee arthritis.
Today I'm just going to talk about knee arthritis.
Since that's what the title is.
What they do is they do various degrees of recommendations,
like they'll say strongly against or conditionally against.
Which is not as severe.
And they also go strongly for or conditionally for.
- So there's that gray zone?
- Yeah right. - So to speak.
- So lets start of with the first one Brad,
'cause I get a lot of people that ask me this.
Should I use Glucosamine and Chondroitin?
- And what'd the study say?
- They said they were against the use of it.
They didn't see any benefit to it,
concerning the cost.
- So it's strongly against?
- I'm sorry I don't remember,
'cause I just put recommended against,
I didn't do the conditional ones on those.
- I don't think with those,
there's any particular bad side effects
from taking that product - No.
But again they're like, why do things
that aren't going to help basically.
- Right, right, they're scientists.
- The second one is going to even maybe surprise you
a little bit.
Recommended against use of an ice pack.
To me, it always makes sense,
because I mean a lot of times arthritis is inflammation.
- Mhmm.
- So you think you wanna put ice on it,
but the thing is it generally,
they found out a lot of people with arthritis,
they like the heat.
- Sure. - Feels a lot better.
They recommended against use of an ice pack.
- I have to admit I had a patient
that had severe, severe knee arthritis.
Couldn't even walk, and she did not like heat.
And she was very alert, and she kept ice packs in her room.
And would put it on, so there's-
- There may be exceptions to the rule there so.
- Right.
- This is the biggest one, I think, of the seven, Brad.
- Okay.
- They recommended against arthroscopic, meniscectomies,
cartilage repair, all these surgeries.
Unless the knee was actually locking.
- So a mechanical clarity- - Yeah.
And you say, well how can they recommend,
I'm having a lot of pain.
They found out that if you had the surgery,
like five, six months later,
you're back to right where you were before.
- Okay. - So.
- We're not talking about knee replacements though.
- Not knee replacements,
we're talking about just arthroscopic surgeries,
or where they go in and replace or trim off the meniscus
and all that. - Right.
- This is a big one, 'cause a lot of people,
I think they still do recommend,
you'll find doctors that do recommend this.
- Right, go in there and clean it up a little bit
and see how things hold off. - Yeah.
But I have to be honest.
A lot of the people that I know that did have it done,
yeah, they were back to square one fairly quickly.
It's a little discouraging.
- They wouldn't go to the therapist if it worked.
(laughs)
- No, and that's the thing.
You always wanna recommend conservative things to try first
- Sure.
- Before you try things like that.
- Right.
- They recommended, I kind of threw three of them together
here on number four.
They recommended against acupuncture, kinesiotape,
and topical capsaicin.
I just heard of it, I've never used it, topical capsaicin.
It's just a rub, I believe. - Yeah, here.
I get some kinesiotape on here.
- Yeah, we got the kinesiotape.
You see it, very popular.
You see the Olympic athletes wearing them.
Everybody thinks, oh boy, that's really cool.
But the studies have just not held up on these, sorry.
- And we have people comment
that they love their kinesiotape,
it helps. - Yep.
- I personally, if it works, and you really think it helps,
I don't think there's any negative side effects to using it.
- No, it's a placebo effect sometimes.
And if it's a placebo, it works, placebo.
- It's better than taking pain pills
if it does that. - That's right.
Alright, that was the things they-
Well they had a whole bunch of things
they recommended against.
Those are the ones I kind of singled out.
- Sure.
- But here, I'm gonna give you some things they recommended.
- Okay.
- And unfortunately with the knee, you are limited.
There's not a great amount of things.
They strongly recommended land based exercises.
What is that?
That means versus water based exercises.
So, they thought it was better that you actually exercised
out of the water than in the water.
- So, walking.
- Walking, muscle strengthening, and tai chi
was really high in the recommended, or was recommended.
- Okay, so that's a slow form of exercise.
- Do you know how to do it at all?
- No, it's a martial art, I train in a different style,
quite a bit drastically different,
but from what I understand,
you go through movements very slowly.
- Very slow and controlled. - Which makes a lot of sense.
It's gonna help with your balance,
range of motion, strength. - And your strength.
Give that a shot, but definitely the walking.
Also, number six, they recommended, and this makes sense,
just shock absorbing footwear. - Mhmm.
Put something in your shoe and no high heels.
'Cause you know, that's gonna put great stresses
on there. - Right, yep.
- So you're gonna stop wearing high heels, Brad?
- No, not me.
(laughs)
- Stick them right on.
- You're gonna stick with your fashion.
(laughs)
- Alright, number seven, no surprise here either.
Recommended weight loss.
And while you're trying to lose weight,
sometimes this is a motivator,
you could use a cane or a crutch or a walker.
My wife was having some knee pain,
and it was to the point where, at first she said,
"There's no way I'm gonna use a cane or a crutch."
But she ended up using a crutch
because it was so bad that she was limping so bad,
she couldn't walk.
- So with the crutch, it was much better.
- Yeah, this was actually the one she used.
I actually got some padding for her.
- Right. - 'Cause
Under the arms gets really sore,
and your hands get really sore from using it all the time.
- That was very nice of you. - Yeah it was.
- Bob, to do that for your wife.
- But after awhile, it calmed down.
And now she's back to walking.
And it's not an issue. - Sure.
- I did some manual things on it too.
- Well, we don't have to get into that.
- What are you talking about? (laughs)
- Just saying, let's go on.
Let's carry on. - So that was it, Brad.
That's number seven,
you gotta try to take some of the weight off of it,
so you can use the cane or a crutch or a walker.
- Well, I did wanna say one thing.
I wanted to back up a few steps.
I'm really surprised that the water exercise
wouldn't be good for it because it's-
I think most people would question it.
- Yeah, I'm surprised they talked about it.
I don't remember if they actually recommended against it
or if it was a recommendation,
but it was a lesser recommendation.
- Right.
- I think there's something
about actually taking the full weight through the leg,
and the effect that it has on the knee,
and creating some of the oil there.
- You lost everybody.
- Yeah, I lost it, I lost my thought.
- (laughs) That's okay.
- I'll get chopped off anyway.
- I'm saying if you got a swimming pool,
and it feels good to get in there and exercise,
'cause I recommend that to my patients,
but the problem is it's very few people
that have that option.
- Right, and I think that's part-
They take into account everything.
- Sure. - They take into account
the convenience of it, the cost of it.
So they'll recommend things that are a lot easier to do.
- Right. - You're more likely to do.
- Sure, that makes sense.
- So right.
- Then I concur.
- Alright, well we welcome all your comments.
And sorry for the little pause there I had (laughs).
Thanks for watching. - Enjoy.