Three Ways to Protect Your Knees

The knee is known as the largest and one of the most complex joints in the human body, and also one of the most vulnerable, as it supports the weight of the entire body. The knee joint is made up of several elements including the knee cap, meniscus, connective tissue, tendons, ligaments, cartilage, and muscles. Damage to any part of the knee can cause chronic pain. So how can you protect your knee from damage and injury? Take a look at these three points!

Dealing with Load: Weight is a big one. Carrying around extra pounds and kilograms can be detrimental for your knees in the long run. Your knee is not equipped to handle the excessive weight. It already supports three to five times your weight when you get up and walk around or indulge in some mild jogging. One must be careful of those extra pounds to take the load off the knee and keep it from falling prey to damage.

Exercise: Moderate to intense exercise is prescribed for one and all. This, of course, depends on one's overall health and age. If you are already suffering from joint pain, then you may want to go easy on the exercise with a focus on building muscle strength and foundation. If you are healthy, then some amount of daily exercise as a routine will keep those knees in prime working condition and well lubricated as well. Inactivity and a sedentary lifestyle can affect the knees very badly.

Do not Ignore: Warning signals such as chronic or acute knee pain should not be ignored. Remember to see a doctor or an orthopaedic specialist to find out if you have contracted an infection or if you may have suffered a fracture due to an injury. Also, it is important to take a bone density test regularly, especially after the age of 40 or for women going through menopause, as this will point to any deficiencies and even warn you in case there is any trace of osteoporosis.

Rest, exercise, and food should be kept in fine balance for a healthy body. These are a few measures that one can take to keep knee pain at bay. Yet, it is also advisable to speak with a doctor at length regarding measures to protect your knees.

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Three Ways to Protect Your Knees

Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain. 

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

Patient Controlled Analgesia (PCA): This method is also known as  Pain Pump . An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery.

Multimodal Pain Relief After Total Knee Replacement

Knee pain or injuries are very common and have numerous causes. Knee pain can emerge from delicate tissue wounds like ligament sprains and muscle strains. Bone conditions like knee joint pain, Osgood Schlatters, and biomechanical dysfunction can also cause knee pain. Treatment can include basic knee mobilization techniques, taping, massages or knee strengthening exercises completely through a careful recovery method after knee replacement or reconstruction.

Physiotherapy can help you overcome the pain and increase your strength and flexibility. A physiotherapist can suggest you a number of treatments and also help you understand your issue and get you back to your everyday routine. Physiotherapists are said to be successful in getting rid of the source of the knee pain by diagnosing a cause. This includes tightness around the knee and treating it with stretching and exercises.

Following are some of the exercises a physiotherapist might generally recommend for knee pain:

Hamstring stretch: Stretching keeps you flexible and increases your scope of movement, or how far you can move your joints in different directions. It additionally helps you reduce your chances of injuries and pain. Continuously warm up with a five minute walk first. Lie down when you are prepared to stretch your hamstring. Circle a bed sheet around your right foot, use the sheet to pull the leg up and hold for twenty seconds and then lower the leg. Repeat twice and switch legs.
Calf stretch: Use a chair for balance. Bend your left leg. Step back with your right leg and gradually straighten it behind you. Press your left heel toward the floor. You should feel the stretch in the calf of your back leg. Hold for 20 seconds. Repeat twice and then switch legs.
Straight leg raise: It helps build muscle strength to give support to the weak joints. Lie on the floor. Twist your left knee, foot on the floor. Keep the right leg straight, toes pointed up. Tighten your thigh muscles and raise your right leg.
Quad set: With these, you don't raise your leg. Just tighten the thigh muscles, also called the quadriceps, of one leg at once. Begin by lying on the floor. Keep both legs on the ground, loose. Flex and hold the left leg tense for five seconds and then relax. Do three sets of ten repetitions. Switch legs after every set.
Cushion squeeze: This move strengthens your legs from the inside so that they can support the knees. Lie on your back, both knees facing inwards. Place a cushion or a pillow between the knees. Press your knees together, squishing the cushion between them. Hold for five seconds and then relax. Do three sets of ten repetitions. Switch legs after every set.
Heel raise: Stand tall and hold the back of a seat for support. Lift your heels off the ground and rise on the toes of both feet. Hold for three seconds. Gradually lower both heels to the ground. Do three sets of ten repetitions. 

Knee Pain - How Physiotherapy Can Heal Knee Pain?

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.

Symptoms and Treatment of Torn Meniscus

The knee is the largest joint in the human body and is a complex structure formed of bone, muscle and cartilage. Development of pain in the knees can be caused by numerous factors such as aging, injuries, diseases, dietary deficiencies, etc.

Arthritis is the most common cause of knee pain and usually affects the elderly and aged. It occurs due to an inflammation of the joint and causes pain, swelling, redness and inflexibility of the knees.

What are the factors that determine treatment method?

Diagnosis for knee pain varies from patient to patient as each case is different and must be approached differently. Some of the factors that determine the treatment method are as follows:

- Cause of the problem
- Nature and intensity of pain
- Age of the patient
- Medical history of the patient
- Diet and lifestyle of the patient

There are a number of different types of arthritis which can affect the knees in different ways and, consequently, require different types of treatment methods.

What are the various treatment methods for knee pain?

1. Conventional Remedies - These are used in case of conditions that are not too severe or chronic. It includes keeping on bed rest, using an ice pack, taking a painkiller and anti-inflammatory medicines, wearing knee braces, etc.

2. Physical Therapy - There are many stretching and strengthening exercise routines that help alleviate knee pain and treat the condition. Recovery is achieved by making the muscles around the knees stronger and increasing stability and flexibility.

3. Injections to the Knees - A number of anti-inflammatory substances and supplements, as well as lubricants, can be injected into the knee joint which helps reduce pain and makes the joint more supple.

4. Stem Cell Therapy - This involves drawing platelets from the patient's blood and injecting it into the knee joint for repairing damage caused to ligaments, tendons or cartilage.

5. Surgery - Surgical procedures for treating knee pain include partial or complete knee replacements.



What kind of treatment does your knee pain require?

Causes and symptoms of knee pain

Knee pain is characterized by a feeling of pain in the knee joint caused by injury or overuse. The knee joint consists of small bone structures, the kneecap, supporting ligaments and cartilage of the knee. This joint bears the full weight of the body, which makes it very vulnerable to injury.

Causes of knee pain

Knee pain is usually caused by injuries to the knee such as exposure to a direct force on the knee, abnormal twisting of the knee or falling on your knees. Some causes of knee pain are -

Knee strains and sprains - Overworking the knee joints can damage the tissues of the knee joint resulting in knee sprains and strains

Osteoarthritis - it is condition where the protective cartilage around the kneecap is damaged, resulting in knee pain

Bursitis - Excessive movement of the knee or kneeling down for extended periods can irritate the bursa (a fluid sac below the skin above the knee joint) that causes swelling and pain, thereby giving rise to this condition

Gout - This condition is characterized by the accumulation of uric acid in crystal form around the knee joint, causing inflammation and pain

Tendon disorders - Tendons connect the muscles to the bones, and overworking the knee can cause the tendons around the knee to become sore and painful

Kneecap dislocation - Injuries may cause the kneecap to shift out of its position, this causes swelling and pain in the knee joint

Symptoms of knee pain

Severe knee pain can restrict movements such as walking or standing. The symptoms vary according to the extent of the damage suffered by the knee. Most common symptoms of knee pain are problems in climbing stairs, inability to extend the knees, limping and swelling of the knee joint. In some cases, knee pain may also cause fever.

Causes and Symptoms of Knee Pain

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