♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical Therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the most famous
physical therapist on the internet.
- In our opinion, of course, Bob.
- I'm try to have better posture then Brad today.
- Posture.
- So the question today is can my knee arthritis get better?
And again, I'm not talking about my knee arthritis,
I'm talking about your knee arthritis.
And we'll try to answer that question today.
- That's right.
- So this is a typical scenario
that I would see in a clinic.
Person would come in 50, 60, 70 years old,
and they were having some knee pain and it's not going away.
So, they went and saw their doctor and he orders,
or she orders, some type of imaging tests.
Maybe x-rays, MRI, cat scan.
- Sure.
- Lo and behold, they find something.
- Yeah.
- There's some big deterioration that went on.
- Right, they'll show you the gap on one side
or the other knee and it's narrowing,
and that means the cartilage is wearing out.
so, can you get it back?
Can you fix it?
- Well, now the patients gonna go,
well, now we know what is causing my pain.
So then they try injections and they try medications
and maybe even surgery.
When the fact is no one's told them the truth, Brad.
The fact is, if they took a scan of the other knee,
they might find out it's even worse.
And yet they may not have any pain in that knee.
- Right.
- And we see this all the time.
This is coming out at every joint shoulder, hip, knee.
- Figure out where you're pointing.
- Yeah, and in all these cases,
they'll do x-rays of one side versus the other side.
And the one side might look worse,
and we've seen this many times in patients,
but they're not having any pain.
- Yeah, so, do you do you do surgery on
the one that looks first or the one that hurts worst?
- Right, so, what's causing your knee pain?
Is it that the deterioration?
Yeah, maybe affecting it,
but really quite often it might be your daily habits
or weakness in the knee or tightness in the knee.
- Sure.
- So we want to make sure that you're,
try some therapy first,
change these things,
and then see if you get any relief from it.
- In one way or another, If you have tightness
or you're doing some,
you're walking in a fashion that irritates it,
you want to correct those things
before you'd have surgery anyways,
because the results of the surgery are gonna be much better,
faster, et cetera, so.
- Yeah, so, if your knee is stronger
it's going to do better with surgery.
If it's moving better it's going to do better with surgery.
So there's nothing to lose here.
- Right.
- And everything to gain.
So five concerns that people bring up
about their knee arthritis.
Let's go with number one,
it's going to continue to get worse, so I'm, you know,
I might as well have surgery
because it's going to just get bad.
- Right, it's like the rest of this, you know,
if you think of a cartilage as rust
- It's wearing out.
- Its gonna rust and get worse,
but not necessarily the case.
- No, studies have shown now that they can remain the same
or they could even get a little better.
And again, I'm gonna bring up my wife as the example,
three years ago she had a flare up of her knee joint
to the point where she was on crutches.
Couldn't even walk without them.
That was over three years ago.
She's now back to running.
Like I was telling Brad earlier,
she ran around the lake this morning
and that's 3.7 miles.
- Good.
Was she running away from you?
- Oh, I'm sure that helps as some motivation there.
So, the second thing we hear a lot, if people say,
well, you know what,
I wore all my knees due to years of doing fill in the blank,
a lot of times it's milking cows.
- Right, we did a lot of, you know,
work in rural areas
and you know, you're kneeling on concrete, you know,
that's an understandable concern.
- But it could be running, hiking, roughing,
and the fact is that's usually not true.
The fact is the more you're moving your joint
and using your joint, the better it's going to be.
The worst joints tend to be the people who are inactive.
Like if you sit all day,
your joints are going to tend to be worse than if you run
or hike or something like that.
- And we're talking about within reason,
there are some activities that put a tremendous amount of
stress on the knee and maybe that's understandable,
but you know.
- Yeah, there's always exceptions to the rule.
Number three, I don't want to make my arthritis worse,
so I'm going to rest my knee.
Well, that's not how knees work.
Unfortunately, beyond resting the knee for maybe a day
or two is fine, but joints love movement.
The more movement you get,
the more synovial fluid you get built up.
- More circulation within the joint.
- Which is kind of the...
- Lubrication.
- Lubrication, right.
- Exactly, again, you know, within reason,
but we do want to, and we have exercises
that are specifically for people
who have sore arthritic knees.
Obviously you're not going to put a hundred pounds of weight
on your shoulders and do squats.
We're talking about range of motion
and exercises that are appropriate for sore knees.
- And the exception would be,
is if your knee arthritis has advanced so far
that it's just, you know,
you've had these patients Brad where (Bob imitates ripping).
- You can hear it.
You can clearly feel the joint.
- And all you do is move it a little.
- Yeah, and everything is rougher than rough.
Yeah, that is clearly an exception.
- That was my grandpa.
He didn't have a replacement of the hip and he should've.
And he got to the point where he couldn't walk anymore.
And there was nothing he could do.
I mean, it was just terrible, so.
Number four, my mom had arthritis
and she's suffered with it for years.
So that's going to happen to me.
Well, some of the arthritis do have
an inherited...
- Genetic component.
- Yeah, but it's amazing how the body can adapt
if you do make the changes that we talked about.
The range of motion strengthening.
So you can overcome your genetics if there are some.
- Right.
- And the other thing is arthritis is really common.
The fact that your parents had it,
that doesn't mean anything
because just about everybody gets arthritis.
- Yeah, as they age.
And there's a number of components,
as far as, you know,
some people think diet has something to do with.
- Right, right, inflammatory foods.
- Right, exactly.
- Good point, Brad.
- Number five,
I'm going to eventually need a knee replacement
so might as well do it now.
Now that's true, especially if your health
is a little bit questionable
and you're worried that maybe five years from now,
you won't be able to tolerate the surgery.
- Right, right.
- But if possible, and you're in decent health,
we usually like to hold off as long as possible
so that the knee replacement lasts what, maybe 15, 20 years.
So if you're only in your forties or fifties,
you might have to get another one, you know.
- And it's harder to do a revision or another one.
I don't know, maybe in 20 years from now,
maybe they'll have it figured out
and they'll have a better way to do it,
but still they have to remove the old hardware,
put new stuff in that it gives you less,
the doctors, less to work with.
It's definitely a discussion you want to have
with your surgeon and they will.
And again, if you're not happy with your doctor,
your surgeon, because you just don't have a good rapport,
it might be a good idea to get a second opinion.
- I think in most cases you should,
because they'll give you a different perspective.
And you know, it's an important surgery, major surgery.
So, and you know, 15, 20 years from now,
you know, it's going to be harder to tolerate a surgery.
I can tell you that already.
(Brad laughs)
- Sure.
- You're in your fifties
and suddenly you're in your seventies.
Take it from two people that know.
- Yeah, and you know, if you're our age,
you realize that every decade you typically,
this is more challenging than when you're younger.
One way or another.
- All right, we've gone on long enough, Brad.
- We continue to babble again.
- All right, thanks everybody for watching.
- Be careful what those knees.