Dr. Sharad Purohit

Staying healthy involves a wholesome state of being where the mind and body are in perfect sync. A less than properly functioning body can leave you in a state of potential depression after a certain point of time, while a depressive mind can leave you feeling less than stellar where you end up imagining and experiencing pain. The health of your bones and joints is one such area that requires even more care as you start growing older. Wear and tear is just one of the reasons for degeneration while fractures and injuries can lead to a sudden halt of normal functioning of the bones and joints too.

So how can you ensure bone and joint health in the long run? Follow our tips!

1. Eating Right: Pick calcium rich food like dairy products that have a low fat content, including milk and yogurt. Also, have a daily dose of green, leafy vegetables and plenty of citrus fruit and juices for your fill of calcium. Further, food like eggs and soybeans which have lots of vitamin D can also help in retaining good bone and joint health. Vitamin C rich fruit like watermelon, oranges, squash and tomatoes also help in natural tissue and cartilage repair. And finally, get plenty of vitamin K to retain good bone density for a prolonged period with ingredients like leafy green vegetables, eggs and cheese.
2. Exercise: This is the key to good bone and joint health. Much like machinery and tools, the bones and joints of your body can also wither with disuse and prolonged inactivity. Make sure that you indulge in exercises like long walks and muscle strengthening exercises which will give your joints and bones good amount of strength as well. Remember to speak with your doctor before you start a new exercise regime so that you avoid anything that may be harmful in case you have any other ailment. Low impact exercises will strengthen the spine, while fat burning and weight loss exercises will ensure that there is less pressure on the knees and lumbar area. Swimming and resistance building exercises can also be practised for these purposes.
3. Abstinence: A major factor in promoting better bone and joint health is abstinence from all those things that can create problems in the long run, like smoking, drinking excessively and even too much consumption of caffeine and fatty food. All these things can create depletion of the natural bone mass. Also, switching to a lower heel for everyday wear footwear and changing your position during your time at your workstation are a few things that will go a long way.

Take care of your bones and joints the right way today, for a healthier tomorrow.

Arthritis is a very painful disease. It restricts you from doing a lot of the activities you would love to engage in. However, there are steps you could take to reduce the chances of it happening to you.

Here are some tips, which help you in preventing Arthritis:

1. Take Omega-3 fatty acids: Research proves that the regular consumption of omega-3 fatty acids, present in fish, result in decreased risks of rheumatoid arthritis. Omega-3 fatty acids are also found in foods such as olive oil and walnuts.
2. Take Vitamins and olive oil: Vitamins are crucial, especially A, C and D. Vitamin A can be found in carrots. vitamin D can yet again be found in fish while vitamin C can be found in strawberries, mangoes, pineapples and oranges. Olive oil is also useful because it contains polyphenols which reduce the chances of developing arthritis.
3. Eat ginger and broccoli: Ginger and broccoli are two of the most therapeutic foods for various reasons and the chances of getting arthritis are also proven to reduce due to these foods.
4. Avoid injury: Although this is very hard to do sometimes, avoiding injuries do reduce your chances of getting arthritis.
5. Control your weight: This is very important, especially for your knees. It has been proven by researchers at John Hopkins University that if you are 10 kg overweight, then 30 to 60 extra kilograms of weight fall on your knees.
6. Exercise: Strengthening your muscles around your joint decreases the pressure on the joint. If there is less pressure on the joint, then the chances of arthritis are reduced. The best way to decrease pressure on the joint and strengthen your muscles is to exercise. In case you have a concern or query you can always consult an expert & get answers to your questions!

Your knee is guarded and cushioned by a cartilage known as meniscus. A meniscus tear, therefore, is an extremely painful and discomforting situation. It occurs very frequently and has emerged as one of the most commonly occurring cartilage injuries. What makes a meniscus tear an extremely common phenomenon is the way it can tear that is all it takes is a twist of the knee for it to happen.

People involved in sports mostly face the brunt of this form of injury. The risk of getting meniscus torn increases with age and tends to occur at the slightest change of direction of movement. 

Symptoms 
Some of the symptoms of a torn meniscus are:

1. Pain and inflammation: It goes without saying that an internal injury of the cartilage or tearing away of it would inevitably result in extreme pain and inflammation near the knee.
2. Immobility: The extreme pain and inflammation, which follows will inevitably make it difficult to move. Since the pain occurs in the joint, you will have difficulty in walking and any forceful movement will only aggravate the pain.
3. Locking of the knee: Locking of the knee refers to a situation when you are unable to move your knee. This occurs most commonly after you have your meniscus torn.

Treatment
Notwithstanding its frequency of occurrence, there are several ways, by which you can treat a torn meniscus. Some of the ways are:

1. Apply ice: In order to get some relief, applying ice is a suitable option. If you apply ice every day for some time, it wonders in reducing swelling and the consequent pain.
2. Use a bandage: In order to control the swelling, it is important that you cover your knee with an elastic bandage.
3. Change the posture: It is important that you keep the affected knee in an elevated plane, in order to ensure an efficient blood supply and a consequent relief from pain.

Some Medical Treatments
There are many things to consider when deciding how to treat your torn meniscus, including the extent and location of the tear, your pain level, your age and activity level, your doctor's preference, and when the injury occurred. Your medical treatment choices are:

1. Nonsurgical treatment with compression, elevation, and physical therapy. This may include wearing a temporary shoulder brace.
2. Surgical repair to sew the tear together.
3. Partial meniscectomy, which is surgery to remove the torn section.
4. Total meniscectomy, which is surgery to remove the entire meniscus. This is generally avoided, because this option increases the risk for osteoarthritis in the shoulder.
5. Whenever possible, meniscus surgery is done using arthroscopy, rather than through a large cut in the shoulder. If you wish to discuss about any specific problem, you can consult an Orthopedist.

Knee replacement is a procedure where the weight-carrying surfaces of knee joint are replaced surgically to ease the pain or any disability. People suffering from osteoarthritis, rheumatoid arthritis or psoriatic arthritis undergo knee replacement. All these conditions revolve around stiffness and painful knee. This surgery is usually performed on people aged over 50.

Surgery Types: 
Knee replacement is mainly of two main types:

1. Total knee replacement where both the sides of knee joints are replaced
2. Partial knee replacement where only single side of the joint is replaced

Procedure: In case of partial knee replacement with minimal invasion, a smaller incision, which is 3 to 5 inches, is required. This leads to minimal tissue damage and the surgeon can work between the fibres of the quadriceps muscles. Here, an incision through the tendon is not required. This may result in less pain, recovery time is reduced, and motion is better as scar tissue formation is less.

In total knee replacement, four steps are performed:

1. Removal of damaged cartilage surfaces, which is at the ends of the femur and tibia, with a small quantity of underlying bone.
2. Replacement with metal components, which help as a recreated surface of the joint
3. Incision of knee cap with a resurface made of a plastic button, which is optional based on the case
4. Insertion of a medical grade plastic spacer amid the metal components. This creates an effortless gliding surface.

After general or spinal anaesthesia, an incision of 8-12 inches is made in the front part of the knee. Joint part which is damaged is removed from the surface of the bones. The surfaces are then formed in a way to hold a metal or plastic artificial joint. The thigh bone shin as well as knee cap is attached to the artificial joint with either cement or a special material.

After Effects of the Procedure: After the surgery, patients may stay in a hospital for three to five days. Post surgery, notable improvement can be seen after a month or later. The patient is gradually relieved from pain with the construction of new gliding surface during surgery.

There will be slow progress in the movement. In the beginning, one may walk with a support of parallel bars and then with the help of crutches, walker, or cane. After full recovery in about six weeks, people can enjoy normal activities except running or jumping.

Presently, over 90% of total knee replacements function well even after 15 years of surgery. Hence, knee problem is no problem at all! If you wish to discuss about any specific problem, you can consult an Orthopedist.

Rare forms of bone oriented tumours are giant cell tumours, which are mostly found in the bones that are long. This tumour is mostly found in young people between the age of 25 to 40 years and is more common in women than in men. The slow progressive growth of this tumour is more like a lesion rather than a mass, and it causes significant pain. It can also lead to bone destruction. Let us find out the various facets of these tumours including causes, diagnosis, treatment and prognosis.

• Causes: The actual cause of this condition is not yet known, although many orthopaedic specialists tend to associate it with Paget disease, which is a chronic bone disorder. The main symptoms of this disease include enlargement and deformity of the bones. Giant cell tumours are not associated with injuries, genetics or environmental factors. 
• Symptoms: There are many symptoms that can point at the presence of the giant cell tumour. These include pain in the joints surrounding the bone on which the tumour is growing. Also, inflammation and fractures might be caused due to this growth. The surrounding joints may face difficulty as far as movement goes, and fluid retention might also take place.
• Diagnosis: The diagnosis of the condition is usually done by an orthopaedic specialist who will conduct an x-Ray to study the area surrounding the bone. This will help in throwing up images of the tissue, bones and other organs in the area. The doctor may also carry out a biopsy during which tissue samples will be procured for further examination under a microscope, so as to determine whether or not the growth is a malignant one. Also, radionuclide bone scans may be conducted to find out if there is any bone change due to other bone diseases and this tumour.
• Treatment: The treatment of this condition will depend largely on the patient's age and medical history where the doctor may take stock of any other ailments and diseases which may or may not interfere with the chosen path of treatment. One of the ways of treating this condition is with surgery that will help in removing the damaged bone. In very severe cases, amputation may also be required. Further, bone reconstruction surgery can also be followed for treatment.
• Prognosis: Local recurrence is a risk as far as giant cell tumours are concerned. A CT scan of the chest, abdomen and pelvic area should be carried out in a routine manner for at least two years after treatment.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Sometimes children suffer from conditions where their feet may not be in proper shape or size, something that can affect their posture. Most of the times the disorders get corrected themselves as children grow up, but there can be situations where medical attention is required. These conditions can be normal variations in the anatomy as well which don't essentially require treatment. Some of the common orthopedic disorders found in children include:

1. Flatfeet: While most babies are born with flat feet which develop arches as they grow, in some case the arches remain underdeveloped even after they grow older. Their feet may turn inwards while they walk due to their flat nature. There is no inherent problem in this condition unless it becomes painful. Doctors may recommend special footwear with arches inserted for support to reduce the pain.
2. Toe Walking: Toe walking is not a disorder while your child is just learning to walk. Toddlers who continue to walk on their toes after the age of 3 may require medical attention. Toe walking on one leg or persistent toe walking can be due to other medical conditions like muscle weakness, cerebral palsy or autism. It is advisable to take your child to a therapist for casting the foot and ankle which can help stretch the muscles.
3. Pigeon Toes: In toeing or pigeon toeing is common among babies when they are first learning to walk. Sometimes children above 3 years walk with their toes inwards which can be due to femoral anteversion. This happens when upper part of the leg bends more than it naturally should, causing inward rotation of the feet. Specially designed shoes and braces can help to correct this condition. Usually, the condition corrects on its own with age and does not interfere with sport activities which involve running.
4. Knock-Knees: It is a common tendency among children aged between 3 and 6 to develop knock-knees (genu valgum), since their bodies go through natural shift in alignment. Usually, treatment is not required as the legs straighten out eventually. Knock knees on one side or persistent knock knees may require medical attention. Children with this disorder may suffer from pain hence in some cases surgery is recommended after the age of 10. If you wish to discuss about any specific problem, you can consult an orthopedist.

Muscle contusion is a condition that is characterized by bruising in the muscles. It generally tends to occur in athletes who play a lot of contact sports. Repetitive blows in any part of the body may cause damage to the underlying muscle tissues. These blows may lead to internal bleeding, resulting in blood clot formation. The most common site where it occurs are the quadriceps.

The various causes of this condition are:

1. Direct repetitive blows to a part of the muscle in contact sports such as football
2. If you fall on a hard surface 
3. It may also occur if the muscle comes in contact real hard with sports equipment like soccer balls

The symptoms of a muscle contusion are:

1. You may experience swelling of the muscle
2. Excessive pain
3. Decrease in range of motion in the concerned body part
4. It may lead to leaking of blood vessels
5. You may also experience hematoma where a lump is formed over the affected spot
6. Symptoms of broken bones, dislocations and fractures may also occur

Complications: This disorder may also lead to various complications such as compartment syndrome, which leads to compression of blood vessels resulting in pain. 

Treatment: The basic treatment for this condition is the RICE protocol which is rest, ice, compression and elevation. You should rest the muscle, then apply ice to the affected area to reduce the pain. You can also take NSAIDs (non steroidal anti-inflammatory drugs) to reduce the pain. In severe cases, the doctor may drain the lump surgically.

It is advisable to not return to your normal sports routine in order to allow the muscle to recover. If you carry on with your regular routine, it may result in further complications like the formation of scar tissue. You may undergo various stretching exercises to relieve the pain and make a gradual return to your normal sporting activities. If you wish to discuss about any specific problem, you can consult an orthopedist.

Runner's knee is a painful condition that is usually encountered by athletes who indulge in varied exercises like running, jumping, walking, biking and more, on a regular or professional basis. The kneecap is a region that gets affected with aches and pain when a person is suffering from Runner's knee. This condition can occur due to a fall or constant bending of the knee, which can lead to misalignment of the knee joints and knee cap. Also, weak muscles and lack of balance during physical activities can add to the risk of contracting this condition.

Here's how you can deal with it.

- Give it Rest: Literally! Suffering from Runner's knee could also mean that your body is trying to ask you to slow down. Wear and tear from excessive levels of physical activity can lead to Runner's knee, and in such cases, the best way to come back to peak physical form is to take some rest so that the knee is free of activity and consequent pain until it is ready to take on exercise again.

- The Only Way is 'Up': When you are suffering from pain in the region behind and around the knee cap due to Runner's knee, the best way to alleviate the pain is to place your knee in an elevated position. Get yourself some comfortable cushions and pile a few of them up before placing your knee on top. This position will give support even as blood circulation increases and inflammation, if any, decreases.

- Anti-inflammation Medication: See your doctor for chronic Runner's knee and find out if you are suffering from inflammation which may require the help of medication. This medication can bring down and gradually eliminate the inflammation or swelling, to give you relief from the pain. Remember to check for side effects before you take these medicines, though.

- Strengthening Exercises: A sure shot way of dealing with chronic pain is to do some muscle strengthening exercises as prescribed by your orthopaedic specialist or a physiotherapist. Doing these exercises will give your muscles the strength to support your knees in a better way while you indulge in athletic activities. Remember to substantiate these exercises with a calcium and protein rich diet as well.

- Cold Compress: In case you have had a fall or suffered an injury which has led to Runner's knee, you can make use of a cold compress or an ice pack to relieve the pain for some time. Ice is a well-known treatment for acute and sudden pain.

Runner's knee is a condition that needs care, rest, and medication if it is persistent. If these methods do not help, you should consult a doctor for scans and tests.

Rheumatoid arthritis is a painful disease of the joints, mostly affecting older people. It mostly results in swollen, aching joints that make movement extremely challenging. Rheumatoid arthritis results in receding and tenderness of the synovial membrane. This leads to a decline in flexibility, causing intense distress, thus hindering daily activities.

Steps to manage the discomfort caused by it

1. There is no complete cure for Rheumatoid arthritis. The discomfort however, can be controlled to a certain extent with regular exercises, change in diet and medications.

2. Regular exercise can help in increasing the flexibility, maintaining the synovial fluid between joints that help in lubrication.

3. Home remedies including use of medical oils to massage the affected joints on a regular basis. In this case, there are several herbal or Ayurvedic oils available, that can provide temporary remedy.

4. It is important to increase the intake of vitamin D. This can be done by spending a short while out in the sun every day. Vitamin D supplements are also available in the form of capsules.

5. A decrease in the alcohol consumption is highly recommended to people with bones and joints disorders.

6. Swimming is an excellent exercise as it causes minimal labour on the joints. It is extremely beneficial to all people.

7. It is important to lose excess weight, so as to lessen the pressure on the joints.  For example, heavy and wide waist structure can affect the knees in the long run. It can help increase your energy level and help you function efficiently.

8. Smoking and drinking affect almost all organs of the body eventually and lead to a painful death or physical abnormalities. It has been found that overindulgence in alcohol and tobacco can also flare up chances of rheumatoid arthritis.

9. It has been found that rheumatoid arthritis mostly affects women. Therefore, women need to be exceptionally cautious about their daily exercise schedule and diet.

Frozen shoulder is a condition where the patient encounters continuous shoulder stiffness and pain. It could last for several weeks. Inflammation around the shoulder increases the inability to move or stretch properly. This happens when somebody is recovering from an injury. Frozen shoulder can also occur when somebody is wearing a sling or a cast. It also occurs if someone is recovering from surgery or experiencing joint pain. It may also be experienced as a symptom of thyroid, joint disorders or diabetes.

Some of the causes and risk factors for creating a frozen shoulder are as follows:

1. If you are 40 years or older, your chances of a frozen shoulder are higher than others
2. Recovering from a damage or surgery
3. Hormonal imbalance
4. Ladies are more prone to a frozen shoulder
5. Cervical disc infection that influences the nerves around the shoulder
6. Not moving your arm because of other pain or wounds
7. Having a previous medical condition like diabetes or other heart diseases
8. Open-heart surgery or spinal surgeries
9. Poor diet and unhealthy lifestyle

The most widely recognized symptoms of a frozen shoulder include:

1. Stiffness around the shoulder usually happens in one shoulder at a time (not both) and will probably return in the same shoulder. Muscle, joint and bone agony in and around the shoulders or arms may be experienced.
2. Restricted scope of movement
3. Having difficulty moving and using the shoulders or arms ordinarily, (for example, experiencing difficulty in getting dressed, driving, holding objects before you, and gestures.)

Treatment:

1. Stretch the Shoulder: Before beginning shoulder exercises for a frozen shoulder, try to warm up your shoulder by doing a few warm up exercises. This will improve the blood supply in the affected area and avoid future injuries by making your body more comfortable with the motion. The best approach is to extend and warm up the shoulder by applying heat for 10 to 15 minutes, scrubbing down or showering with Epsom salt.
2. Non-intrusive treatment: While these activities mentioned above can be easily performed at home, if pain continues and makes it difficult to move around or work ordinarily, see a physiotherapist who can appoint particular activities and can enhance your scope of movement, flexibility and strength.
3. Acupuncture: Acupuncture is considered one of the best treatment choices for any joint and nerve related problem. The treatment is based on focusing on the trigger points of the pain and putting pressure on them via needles. The treatment is not painful and is known to produce good results in the long run.
4. Dietary Supplements: Various supplements can be taken with the recommendation of a doctor, in order to improve recovery. Alfalfa (horse feed) and turmeric are two of the most regularly recommended elements that relieve swelling and repair the tissue in the shoulder.