(upbeat music)
- We've all heard the statement,
nothing is certain in life except for death and taxes.
Well, we could just as easily amend
that statement to say nothing is certain
in life except for death, taxes, and arthritis.
If you live long enough, you are gonna get arthritis.
Unfortunately, you know, who does the bell toll for?
It tolls for thee.
So let's just start off with some quick anatomy of the knee
so we understand what we're talking about.
Okay, I don't imagine we need to spend much time on this
because most of you could care less
about what the anatomy looks like,
but maybe it might be helpful in treating the knee.
Here is my friend, Napoleon. Napoleon has a knee.
What you have here is the femur,
which makes the upper part, the upper bone,
the tibia, the fibula, and in between is the knee joint.
Now in that knee joint is actually some cushions
which we call meniscus.
Now those meniscus, with arthritis, can start to wear out
and you get a actual, I'm gonna bring this up closer to you.
Here's another knee.
What you actually get is the,
a narrowing between the two bones.
That's what they see on X-ray.
This, actually, is a meniscus.
A small meniscus, not a real one,
but it's one from this model.
And I pulled it out.
You can see it's kind of a horseshoe shaped,
and it's not very thick.
And as it begins to wear out, even gets thinner.
But, eventually, that meniscus can be completely gone
and you can get what is called bone on bone.
And that, my friend, is painful
and that, my friend, leads you to a knee replacement.
But before we get to that point,
there's things you can do to help treat your knee.
Okay, before we discuss the three secrets
to treating knee arthritis, what it might be helpful
to understand is the nature of arthritis.
Arthritis is such that it tends to be very temperamental.
One might refer to it as a temperamental woman.
It tends to get upset and it tends to calm down.
Now I would not refer to it as a temperamental woman
because I have been married for
(drums beating)
(cymbal clinking)
25 years.
So what I will refer to it as a volcano.
Volcano tends to erupt, it tends to calm down.
The same with your knee.
Understand this because you're gonna say,
"Oh my God, it's so bad. I can't tolerate it."
When the fact is maybe you're just going
through a high point of pain and it is gonna calm down.
What we're gonna try to teach
you is the ways to calm it down.
The other thing I want you to understand
about arthritis is this.
Arthritis, knee joints, and joints in general love movement.
And I first discovered this when I heard
a presentation by a colleague given
when I was at the Mayo Clinic.
She was talking about a study
in which they had little rabbits, little bunny rabbits.
Now I don't have a bunny rabbit and I don't even,
couldn't even find a little, fake, stuffed bunny rabbit.
So I have this little bear.
Or no, I'm sorry, this little lion
from "The Lion King", I'm sure.
And just as a demonstration here,
what they did with these little rabbits,
these little rabbits had arthritis.
And 1/2 of the rabbits,
they actually immobilize their joints so they couldn't move.
The other 1/2 of the rabbits,
they put 'em in a little machine that kept the joint moving.
Okay, which one, which set of rabbits do you think
the arthritis actually got better?
Bingo, if you said
(drums beating)
(cymbal clanking)
the rabbits whose knees were moving.
They love movement. Joints love movement.
You're gonna get more blood flow into it.
There's also a thing called synovial fluid in your knees
that actually seems to increase with movement.
So we're gonna want,
this is one of the things we're gonna go over today.
You're gonna want to have movement
in the knee without stress on the knee.
That's a key point.
Okay, the first secret to treating knee arthritis is to,
one, avoid putting additional stress on your knee.
So let me give you some
of the helpful hints for doing just that.
One, during this period of time,
you wanna avoid using stairs, if you can.
Don't, you know, use the elevator
or just try to avoid 'em as much as you can.
Every time you're on a step,
it's gonna increase the stress on your joint,
increase the stress on the arthritis,
and cause the, you know, increase the flare up.
The other thing which I'm gonna suggest,
and this could be probably one
of the most important things you could do
to try to help calm down your arthritis,
and I can also guarantee you that most of you will not do
it because I run into this every day with my patients,
and that is to use a cane.
Everybody thinks that using
a cane is gonna make you look old
and somehow limping along like this, you look young.
So I just tell people,
think of it as a fashionable walking stick.
But a cane can help probably be one of the number one things
you can do to help decrease your stress right now.
And I hear all the excuses all the time.
You know, I'm gonna forget it somewhere.
It's gonna fall over. Whatever. It's not true.
As regard to that it's not inconvenient, it will help you.
So let's just go over a few things about a cane.
First off, how do you measure a cane to fit you?
A cane should, if you, if I put my hand forward,
and the cane, the handle of the cane
should hit me just about on the wrist.
If I have my hand just slightly forward,
should hit me right on the wrist.
That way, my elbow is just slightly bent when I put it down.
Now, where do you want the cane
to be placed when you are walking?
Well, if you use it,
let's say the pain is in your right knee.
You can have it in, the cane in your right hand also.
I just want the cane to follow along with the knee.
So if the leg goes forward, the cane goes forward.
So right when I'm stepping, the cane is there.
So you can also put it in the opposite hand.
Put the cane forward.
And when the leg is forward,
there it is providing the support.
You know, other things.
The other suggestion I have is that ladies and their purses.
Oh my gosh.
I can't tell you how often I've had ladies come
in and they're looking for their insurance card.
The first thing they do is they pull
a purse out of their purse, which I don't understand.
But the second thing is,
I've seen this one lady, she comes in,
and it was like watching the little clown car at a circus.
You know, where the little clown car pulls
up and the clowns keep coming out.
That's just what it was like at her,
you know, the things that were coming
out of her purse, I couldn't believe it.
Anyway, the weight of her purse must have been,
you know, 60 to 70 pounds.
I may be exaggerating.
But the thing is that every, you know,
pound of weight that you are carrying
is putting additional stress on your knee.
So please, you know, lighten your load,
carry less of load.
Men, too.
You're carrying briefcases or whatever else you're carrying.
Make sure you lighten it as much as possible
'cause every pound that you're carrying
is increasing the stress on your knee.
The second secret to treating knee arthritis is movement.
As I already alluded to earlier
with the little rabbit story,
remember keeping their joints moving.
You're gonna wanna do the same thing.
The key though is to keep it moving without weight bearing.
That means not walking. That means not running.
Those are are movement,
but they're pounding the knee joint along with it.
So what good thing, what things are good?
You know, probably elliptical trainer is not bad,
cross country skiing wouldn't be bad,
biking or a stationary bike would be great.
Now let's say you don't have any of those things
and you just wanna try something at home,
this works out great.
All you gotta do is put a towel on the floor,
especially if you have a wooden floor or a tile floor,
and all you're gonna wanna do
is go back and forth like this,
getting some movement in the knee.
If you don't have a tile floor,
you can just put down a pan,
a sheet, a cooking sheet like I did here,
and you can go back and forth.
Now you're getting a little bit of strengthening
and you're getting some movement in the knee,
and it's making that knee healthier.
It's making it, the synovial fluid is increasing.
The blood flow is increasing.
You can sit here and eat bonbons
and drink pina coladas while you're doing this.
But this is a great way to just get some movement
while you're watching TV.
Here at physicaltherapyvideo.com,
we will make suggestions as to a piece of equipment
you might try to help, you know, maintain your health
or to treat certain maladies such as arthritis.
And this is one that I hardly endorse.
This is a piece of machine, a machine that we actually use
in all seven of the clinics that I own.
And what I like about this
is it's actually fairly inexpensive, but it works great.
It's an elliptical motion machine.
And if you look at my website when you get off this video,
it'll be linked to the site where you can purchase one,
and it's also under our product section.
What's nice about this is that it's very smooth.
It's very portable.
I mean, it's a little bit heavy, but,
and the way it was designed, actually,
to use is that you were supposed to stand on it.
But we have everybody sit down and we,
in order to put it at the right angle,
we actually put a couple two by fours
underneath the front part of it.
And you can put your feet on here.
And this thing works very smooth.
It's very easy to use.
You can watch TV again while you're doing,
while you're using it.
There is, you can actually increase the stress,
but I don't know that you need to.
But this is a great way to get movement
in the knee without putting stress on the knee.
We have had, many of our patients have purchased these.
Again, we have, you know,
nothing to do with that part of it.
We just go ahead and make the suggestion.
They tend to run.
I don't know, I've seen them anywhere
from between 85 and $100.
Generally, it's $100 total with the shipping,
but it's a great purchase.
Again, I'm not a big fan of maybe standing on it.
Kind of dangerous.
But it is a great way for low level conditioning
and for getting movement of the knee
with arthritis and the hip.
Okay, we've already discussed the first two ways,
the first two secrets to treating your knee arthritis.
Number one, try to decrease the stress on the knee.
And number two, try to keep the knee moving.
Keep it healthy.
The third thing you may try is basically
what I would call medicines and modalities.
Medicines, again, I'm not qualified to speak about that.
You know, these are pharmacological entities.
You know, you're gonna want to try
and speak to your pharmacist about it.
I do like that word though, pharmacological.
But generally, as a rule of thumb,
you know, when talking to pharmacists,
it just seems like most of them want you to try some type
of anti-inflammatory and ibuprofen
or something along that lines
that's gonna help calm it down.
As far as modalities, there is such things as, of course,
heating pad and ice packs.
Generally, the rule of thumb is if it feels stiff and sore,
you might want to use the heating pad.
A lot of people with arthritis tend
to respond better to heat, it seems, than cold.
If it's swollen, you might try the cold.
You really can't go wrong with either.
There's really nothing that says
that you can't try one or the other, or both.
Some people do heat before an exercise and ice afterwards.
The other thing some people try
are what we call the counter irritants.
Now these are the things like Bengay and what,
the one that we kind of often recommend
is Biofreeze, Aspercreme.
These are what you would refer to as counter irritants.
They're really, I'm gonna tell you right now,
they're not gonna make it better.
They're not gonna treat it.
All they're gonna help you do is get by.
But if that's what they do and you're comfortable with that,
by all means go ahead and use it.
I also wanna mention that I did put a recipe
for creating your own ice pack on the website.
This, a lot of patients have found this
to be quite helpful and have made their own.
It's cheaper and it works quite well.
Remember, always, with an ice pack,
that cold can damage your skin, you know.
So you wanna be careful with it.
You know, usually not leave it on for 10 to 20 minutes
and then, and quite often you're gonna want
to have a towel in between your knee and the ice pack itself
so that it won't get so cold to damage the skin.
Right, that's all Napoleon and I have for you today.
Remember the three secrets to treating arthritis,
to get it to calm down.
One, try to decrease the stress on the knee.
Two, keep the knee moving.
And three, you know, try the modalities and medicines.
If those don't help,
go see your friendly doctor and physical therapist.
I'm sure we can help you or they can help you.
And if that doesn't help, then we may be looking at the,
you know, is it time for the knee replacement?
Which, by the way, I'm always told that you'll know
when it's time for a knee replacement.
When you're not sleeping and, you know,
when it gets to the point where you're just sick of it.
But I'd like to also say, you know, we love your comments.
So please send them, put 'em on our website,
and go ahead and email me at the address on the website.
And I can't make specific comments about your condition,
but I can make general comments.
So thanks for joining us and we'll see you again.