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Overview

Shin Splints: Treatment, Procedure, Cost and Side Effects

What is the treatment?

Medial Tibial Stress Syndrome

How is the treatment done?

Shin splints, also called Medial Tibial Stress Syndrome refers to pains occurring below the knee either on the outer frontal part of the shin, or in the inner back calf muscles. When occurring on the frontal part of the leg, it is called anterior shin splint, and when occurring on the inside, it is called medial shin splint. Shin splints are most commonly seen in athletes, dancers, footballers, etc. who are involved in a lot of leg exercises.

Shin splints are caused due to a number of factors. The most common is overpronation or overexertion which is very commonly seen in athletes who try to improve their running performance too quickly or start running on a hilly tract from a plain one. Other causes for shin splints include lack of adequate stretching before exercising or running, wearing old worn out shoes, improper running gait that causes one leg to be stressed more than the other, etc. Running daily on the same track can also cause shin splints.

Treatment for shin splints include some simple and easy to do exercises for the lower leg, elastic wraps, and medication only in rare cases. Regular stretching for the leg muscles is also advised.

Who is eligible for the treatment? (When is the treatment done?)

Treatment for shin splints principally involves complete rest for a period of about three to six weeks to let the stretched muscles heal. Simple stretching exercises are advised. One of them involves kneeling on a mat on the floor and slowly sitting back on the calves while keeping the legs together and toes flat and pointed back. Once the shin muscles feel tensed, the position is to be held for 10 seconds, relaxed, and repeated. Another exercise involves sitting down on a chair and tracing the outlines of the alphabets on the floor with the toes. Another exercise is walking at a normal pace regularly for 30 seconds, followed by walking on the heels for another 30 seconds. These are also good preventive exercises.

Ice pack may be applied on the inflamed muscle groups and pain relieving ointments also help. Wrapping the lower leg in elastic bandages help to keep the tendons close to the muscles and prevents stress.

Who is not eligible for the treatment?

Athletes, runners, footballers, dancers, and others who regularly use the leg muscles in high intensity work may be prone to develop shin splints. Runners who do not stretch adequately before a run are very vulnerable and may be eligible for treatment. Wearing worn out shoes and running on hard terrain also contribute to the condition and make people eligible for treatment.

Are there any side effects?

Other conditions affecting the lower leg are sometimes mistakenly diagnosed as shin splints. Pains on the outside of the leg can be a symptom of compartment syndrome which is treated very differently. Lower leg pain can also be due to a far more serious injury, a stress fracture in the bone. People affected by these are not eligible for shin splint treatments.

What are the post-treatment guidelines?

There are no side effects to the treatments for shin splints.

How long does it take to recover?

Once treatment is complete and the pain is resolved, it is advised to start working out slowly and build up performance over a period of time. Stretching is always advised before any high intensity leg exercise. Proper shoes need to be worn, and it is advisable to replace them every few months. Suddenly changing the type of running track from plain to hilly is not advised. Preventive exercises that gently stretch the calf muscles and the Achilles tendon need to be repeated at least three to four times a day.

What is the price of the treatment in India?

Treatment brings the pain of shin splints down usually within three to six weeks.

Are the results of the treatment permanent?

Treatment for shin splints is very cheap, with elastic bandages starting from Rs.50.

What are the alternatives to the treatment?

Shin splints do not recur if regular care is taken and adequate preventive measures are adopted, including regular stretching, wearing proper gear, etc. A slight chance of recurrence always remains as shin splints are caused by overexertion of muscles and tendons, which is a very common possibility in sports.

Safety: Treatment Effectiveness: High Timeliness: Low Relative Risk: Low Side Effects: Low Time For Recovery: Low Price Range:

Rs. 50 - Rs. 2000

Popular Health Tips

Shin Splints - How To Treat It?

Fellowship In Joint Replacement, MS - Orthopaedics, MBBS
Orthopedist, Delhi
Shin Splints - How To Treat It?

Shin splints' is a condition, which is characterized by pain in the shin bone, the bone that is present in front of the leg. Shin splints tend to occur quite frequently in runners and dancers as their activities tend to stress the shin bone.

Causes: When excess force is applied to the shinbone, it may result in swelling of the muscles, causing pain and inflammation. It may also occur from stress reactions to fractures in the bone. Cracks tend to develop due to constant application of force in the bones. If the area is not well rested then these cracks will not heal and ultimately lead to a complete fracture.

Some other causes of shin splints are:

  1. Muscle imbalance in the glutes or the thighs
  2. Anatomical deformity such as flat foot
  3. Not using proper form during training
  4. Lack of flexibility
  5. If you wear improper shoes during workouts, then it may lead to shin problems
  6. Running downhill may lead to excessive stress on the shin leading to shin splints

Symptoms:
The symptoms of shin splints are: 

  1. You may experience swelling in the lower leg
  2. A dull pain in the front portion of the leg
  3. Tenderness around the shin area
  4. Numbness around the shin area
  5. Inflammation in the shin area
  6. You may experience severe pain while walking

Treatment: The basic treatment for shin splints is the RICE (rest, ice, compression and elevation) protocol. It means allowing the leg to rest, applying ice packs and wearing compression bandages. It is recommended to take rest and not exert the leg beyond a certain point to limit the damage. The complications that may result from shin splints are compartment syndrome, where there is buildup of pressure in the muscle. In some cases, where the muscle tears off from the bone, a surgery may be required to treat this condition. In case you have a concern or query you can always consult an expert & get answers to your questions!

1148 people found this helpful

How To Treat Shin Splints?

MBBS, MS - Orthopaedics
Orthopedist, Nashik
How To Treat Shin Splints?

Shin splints' is a condition, which is characterized by pain in the shin bone, the bone that is present in front of the leg. Shin splints tend to occur quite frequently in runners and dancers as their activities tend to stress the shin bone.

Causes: When excess force is applied to the shinbone, it may result in swelling of the muscles, causing pain and inflammation. It may also occur from stress reactions to fractures in the bone. Cracks tend to develop due to constant application of force in the bones. If the area is not well rested then these cracks will not heal and ultimately lead to a complete fracture.

Some other causes of shin splints are:

  1. Muscle imbalance in the glutes or the thighs
  2. Anatomical deformity such as flat foot
  3. Not using proper form during training
  4. Lack of flexibility
  5. If you wear improper shoes during workouts, then it may lead to shin problems
  6. Running downhill may lead to excessive stress on the shin leading to shin splints

Symptoms:
The symptoms of shin splints are: 

  1. You may experience swelling in the lower leg
  2. A dull pain in the front portion of the leg
  3. Tenderness around the shin area
  4. Numbness around the shin area
  5. Inflammation in the shin area
  6. You may experience severe pain while walking

Treatment: The basic treatment for shin splints is the RICE (rest, ice, compression and elevation) protocol. It means allowing the leg to rest, applying ice packs and wearing compression bandages. It is recommended to take rest and not exert the leg beyond a certain point to limit the damage. The complications that may result from shin splints are compartment syndrome, where there is buildup of pressure in the muscle. In some cases, where the muscle tears off from the bone, a surgery may be required to treat this condition.

Shin Splints

MS - Orthopaedics, M Ch. Ortho
Orthopedist, Hyderabad
Shin Splints

Shin splints, the catch-all term for lower leg pain that occurs below the knee either on the front outside part of the leg (anterior shin splints) or the inside of the leg (medial shin splints), are the bane of many athletes, runners, tennis players, even dancers. They often plague beginning runners who do not build their mileage gradually enough or seasoned runners who abruptly change their workout regimen, suddenly adding too much mileage, for example, or switching from running on flat surfaces to hills.
 
The nature of shin splints, also known as medial tibial stress syndrome (mtss), most often can be captured in four words: too much, too soon.
 
Treating shin pain from shin splints with ice pack
 
Identifying symptoms of shin splints

  • Shin pain doesn’t always mean you have shin splints. It might be a sign of some other problem. The following are two conditions that are sometimes mistakenly diagnosed as shin splints.
  • Pain on the anterior (outside) part of the lower leg may be compartment syndrome—a swelling of muscles within a closed compartment—which creates pressure. To diagnose this condition, special techniques are used to measure the amount of pressure. Sometimes surgical “decompression” is required. The symptoms of compartment syndrome include leg pain, unusual nerve sensations, and eventually muscle weakness.
  • Pain in the lower leg could also be a stress fracture (an incomplete crack in the bone), which is a far more serious injury than shin splints. A bone scan is the definitive tool for diagnosing a stress fracture. However, there are clues you can look for that will signal whether or not you should get a bone scan.
  • The pain of shin splints is also more generalized than that of a stress fracture. Press your fingertips along your shin, and if you can find a definite spot of sharp pain, it’s a sign of a stress fracture. Additionally, stress fractures often feel better in the morning because the bone has rested all night; they often feel worse in the morning because the soft tissue tightens overnight. Shin splints are also at their most painful when you forcibly try to lift your foot up at the ankle and flex your foot. 

Common causes of shin splints

  • There can be a number of factors at work, such as overpronation (a frequent cause of medial shin splints), inadequate stretching, worn shoes, or excessive stress placed on one leg or one hip from running on cambered roads or always running in the same direction on a track. Typically, one leg is involved and it is almost always the runner’s dominant one. If you’re right-handed, you’re usually right-footed as well, and that’s the leg that’s going to hurt. 
  • The most common site for shin splints is the medial area (the inside of the shin). Anterior shin splints (toward the outside of the leg) usually result from an imbalance between the calf muscles and the muscles in the front of your leg, and often afflict beginners who either have not yet adjusted to the stresses of running or are not stretching enough. 
  • But what exactly is a shin splint? there’s no end-all consensus among sports scientists, and theories have included small tears in the muscle that’s pulled off the bone, an inflammation of the periosteum [a thin sheath of tissue that wraps around the tibia, or shin bone], an inflammation of the muscle, or some combination of these. Fortunately, medical experts agree on how to treat them.

 
Treatment of shin splints

  • Experts agree that when shin splints strike you should stop running completely or decrease your training depending on the extent and duration of pain. Then, as a first step, ice your shin to reduce inflammation. Here are some other treatments you can try:
  • Gently stretch your achilles if you have medial shin splints, and your calves if you have anterior shin splints. Also, try this stretch for your shins: kneel on a carpeted floor, legs and feet together and toes pointed directly back. Then slowly sit back onto your calves and heels, pushing your ankles into the floor until you feel tension in the muscles of your shin. Hold for 10 to 12 seconds, relax and repeat.
  • In a sitting position, trace the alphabet on the floor with your toes. Do this with each leg. Or alternate walking on your heels for 30 seconds with 30 seconds of regular walking. Repeat four times. These exercises are good for both recovery and prevention. Try to do them three times a day.
  • If you continue running, wrap your leg before you go out. Use either tape or an ace bandage, starting just above the ankle and continuing to just below the knee. Keep wrapping your leg until the pain goes away, which usually takes three to six weeks. “what you’re doing is binding the tendons up against the shaft of the shin to prevent stress,” laps says.
  • Consider cross-training for a while to let your shin heal. Swim, run in the pool or ride a bike.
  • When you return to running, increase your mileage slowly, no more than 10 percent weekly.
  • Make sure you wear the correct running shoes for your foot type specifically, overpronators should wear motion-control shoes. Severe overpronators may need orthotics.
  • Have two pairs of shoes and alternate wearing them to vary the stresses on your legs.
  • Avoid hills and excessively hard surfaces until shin pain goes away completely, then re-introduce them gradually to prevent a recurrence.
  • If you frequently run on roads with an obvious camber, run out and back on the same side of the road. Likewise, when running on a track, switch directions.
  • If you are prone to developing shin splints, stretch your calves and achilles regularly as a preventive measure.

Shin Splints - Causes And Symptoms!

MBBS, MS - Orthopaedics
Orthopedist, Chennai
Shin Splints - Causes And Symptoms!

Shin splints is a condition, which is characterized by pain in the shin bone, the bone that is present in front of the leg. Shin splints tend to occur quite frequently in runners and dancers as their activities tend to stress the shin bone.

Causes: When excess force is applied to the shinbone, it may result in swelling of the muscles, causing pain and inflammation. It may also occur from stress reactions to fractures in the bone. Cracks tend to develop due to constant application of force in the bones. If the area is not well rested then these cracks will not heal and ultimately lead to a complete fracture.

Some other causes of shin splints are:

  1. Muscle imbalance in the glutes or the thighs
  2. Anatomical deformity such as flat foot
  3. Not using proper form during training
  4. Lack of flexibility
  5. If you wear improper shoes during workouts, then it may lead to shin problems
  6. Running downhill may lead to excessive stress on the shin leading to shin splints

Symptoms:
The symptoms of shin splints are: 

  1. You may experience swelling in the lower leg
  2. A dull pain in the front portion of the leg
  3. Tenderness around the shin area
  4. Numbness around the shin area
  5. Inflammation in the shin area
  6. You may experience severe pain while walking

Treatment: The basic treatment for shin splints is the RICE (rest, ice, compression and elevation) protocol. It means allowing the leg to rest, applying ice packs and wearing compression bandages. It is recommended to take rest and not exert the leg beyond a certain point to limit the damage. The complications that may result from shin splints are compartment syndrome, where there is buildup of pressure in the muscle. In some cases, where the muscle tears off from the bone, a surgery may be required to treat this condition. If you wish to discuss any specific problem, you can consult an orthopedist.

4464 people found this helpful

6 Symptoms Of Shin Splints!

Diploma In Orthopaedics (D. Ortho), DNB (Orthopedics), Diploma SICOT, Fellowship in Spine Surgery, Fellowship in Endoscopic Spine Surgery
Orthopedist, Vadodara
6 Symptoms Of Shin Splints!

Shin splints' is a condition, which is characterized by pain in the shin bone, the bone that is present in front of the leg. Shin splints tend to occur quite frequently in runners and dancers as their activities tend to stress the shin bone.

Causes: When excess force is applied to the shinbone, it may result in swelling of the muscles, causing pain and inflammation. It may also occur from stress reactions to fractures in the bone. Cracks tend to develop due to constant application of force in the bones. If the area is not well rested then these cracks will not heal and ultimately lead to a complete fracture.

Some other causes of shin splints are:

  1. Muscle imbalance in the glutes or the thighs
  2. Anatomical deformity such as flat foot
  3. Not using proper form during training
  4. Lack of flexibility
  5. If you wear improper shoes during workouts, then it may lead to shin problems
  6. Running downhill may lead to excessive stress on the shin leading to shin splints

Symptoms:

The symptoms of shin splints are: 

  1. You may experience swelling in the lower leg
  2. A dull pain in the front portion of the leg
  3. Tenderness around the shin area
  4. Numbness around the shin area
  5. Inflammation in the shin area
  6. You may experience severe pain while walking

Treatment: The basic treatment for shin splints is the RICE (rest, ice, compression and elevation) protocol. It means allowing the leg to rest, applying ice packs and wearing compression bandages. It is recommended to take rest and not exert the leg beyond a certain point to limit the damage. The complications that may result from shin splints are compartment syndrome, where there is buildup of pressure in the muscle. In some cases, where the muscle tears off from the bone, a surgery may be required to treat this condition. If you wish to discuss about any specific problem, you can consult an orthopedist.

2692 people found this helpful

Popular Questions & Answers

I am suffering from severe pain in shin bone whenever I relax my legs especially when I am working while sitting on chair. Its happening since 3 months. I tried medicines, gels and rest for shin splints but its not helping. What should I do?

BPTh/BPT, MPTh/MPT - Cardiovascular & Pulmonary Physiotherapy, MBA - Hospital Management
Physiotherapist, Jaipur
Icing on affected area stretching of muscles of affected limb strengthening of affected muscle limb No running on hard or hilly terrain or on treadmill on incline avoid it in physiotherapy needling therapy will be of help.

I feel pain in Tibia (both 'Tibial tuberosity and 'the mid-surface of Tibia') after running for a mile. Soon I am going to attend the Police recruitment drive. Please help me for that.

T.M.M.F, pain management, T.M.M.F.,
Physiotherapist, Madurai
It's called shin injury, A course of ultrasound therapy in physiotherapy clinic will be good, also apply ice for 20mts twice day.

I am a long distance runner age 31 years suffering from lower shin pain which is not healed even after taking 40 days rest. I am not sure if this is diagnosed correctly.

BPT
Physiotherapist, Chennai
Hi sir, You consult physiotherapist for assessment of your pain then proceed with the treatment. US for 10 days will reduce the pain.

Greetings. I am preparing for Telangana SI exam in that competition running competition is there while I am practicing running I am getting SHIN PAIN even I can't running. Please suggest me please.

Doctor of Osteopath, MSPT (Master of Physical Therapy), BPTh/BPT, MSc Osteopathy, Certification In Applied Manual Therapy, Certification From Bell Rogerouth & Harris / Upper and Lower Quadrant Dysfunction, Certified Dry Needling Practitioner, Certified Wheel Chair Trainer
Physiotherapist, Lucknow
Hi, Correct your running techniques Do icing Take good shoes Take foam roller to roll you shin it gives great relief.
1 person found this helpful

Hi Sir, I am 19 year old. Sir muje running karte time shin pain hota please kuch suggest.

Master of Physiotherapy, Bachelor in Physiotherapy
Physiotherapist, Guwahati
Hi wear a proper sports shoe while running. If there's more pain still you need to get evaluated for faulty mechanics during running. If you are a beginner need to strengthen your leg muscles. And slowly need to start running at pace prescribed for you. For more details consult as online. Regards.

Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?
Play video
P.R.I.C.E.: How Is It The First Aid For Sports Injuries?
Hi,

I am Dr Rajiv Mehta, Physiotherapist, practicing since 1999. I have been working in sports physiotherapy, Orthopaedic physiotherapy, neuro physiotherapy and Paratik physiotherapy.

Today I am going to talk about sports injuries, now many of the sports are coming up in India like cricket, football, marathons, gyming, badminton due to all of increase in this sports, injuries in related to this sports also increased. I am talking about few of the common injuries like Supraspinatus, it is a shoulder injury very common in badminton, bowling, cricket, another one epicondylitis that is also known as tennis elbow very common in tennis and cricket. Ankle sprain, very common injury in football also in marathons. Shin pain very much common in marathons, people who run in marathons get pain in their leg. Then knee injury, very common in football, cricket, marathons also. So what happens when this injury occurs, either sports person leave their sports or change their sports but believe me there is no need of leaving sports. One thing is sure that these injuries cannot be treated at home by any of the home remedie, nor rest only can treat this injuries. So visit a sports physiotherapist who will not only rehabilitate your current injury but also will prevent the further damage to that injury, one of the magical treatment for this sports injury that I am going to tell you that you should always do whenever there is any injury that is price P.R.I.C.E. P stands for Positioning, whenever there is any injury to any part first of all position it, stable it with any splint with any cast whatsoever is available, then R, R is for rest, keep that part in complete rest do not try to move that part and see whether the injury is at what extent, keep that to the professionals only. I is for Ice, immediately apply ice this ice prevent swelling of that area and reduces the injury by about 80%. C, C stands for compression apply a compressive bandage, crepe bandage over the injured area. Then E, E is for elevation, elevate the part above the heart so that swelling doesn't stay there the educate moves towards the heart. If you apply this P.R.I.C.E phenomenon in any of the injury, surely you will be back to your sports as soon as possible and trust your sports physiotherapist visit him as soon as possible, so that you can enjoy your sports, you can enjoy your prash. Regarding sports injury, I am treating many of the Olympians, many of the film stars, many celebrities and it's my promise that you won't have to leave sports neither you have to be on the rest for much of the time.

If you have any sports injury, visit to velocity fitness clinic its a velocity promise that you will gain your velocity as soon as possible.

Thanks, I am Dr Rajeev Mehta sports physiotherapist.
Play video
Exercise for Knee Health
I am Dr Rakesh Nair. I am an exclusive knee replacement surgeon. Today I am basically going to talk about how to prevent damage to the knees by doing the right type of exercises. So, the topic today is going to be Osteoarthritis and Osteoporosis. How are they interconnected? How are both important in terms of treatment?

Let us start initially with Osteoarthritis. What do I mean by Osteoarthritis?

Osteoarthritis means a worn out joint. The same knee which has souls start wearing out as you get older. Therefore, it is called a Primary. So, whether you have a problem at some age or not, this pain is going to happen to you, whether it happens at 25, 35, 40, 45 years. It might also happen at the age of 75 years. Most of my patients are going for surgery between the age group of 75-85 years. So here I am going to show you the right forms of exercises where your knee can last for the lifetime. So, we are looking at an average of 8 spans of 80-85.

So, will your knee last long?

The chances are very less because the present data says that the 80% of the general population has artificial knees because we are out living our knees. We are living much more than our knees can last.

What is Osteoarthritis? means what exactly happens to the joint?

The knees are made up of bones which are a thigh bone which is on the upper side and it is covered with the fine layer of the cartilage which is hardly 1 cm. The same thing is with the bone which is the Shin bone which is the lower part, again which is covered with the cartilage. Between these layers, we have a lubricant fluid connecting both the legs on the side we have strong ligaments which hold the joint together.

What exactly happen in Osteoarthritis?

In Osteoarthritis, the same cartilage which you see starts wearing out. There are small pieces which start wearing out. The joint which straight started getting bent which either like a bow like a deformity or a knock knee deformity depending on how strong or how weak your muscles are. When a straight knee finally become bent then we have to look for some surgical options.

What are the symptoms of pain in the knee?

The first and the foremost symptoms are when a patient feels pain while climbing and getting down from stairs. So this is the first sign of Arthritis when you get to know that your knee is wearing out. Then they complain of pain, swelling. In the advanced stages, we will see the patients with bent knees, either bent inwards or outwards.

Today, I am going to tell you that can we prevent this damage?

For this, I am going to stress on exercise protocols for strengthening. Now, you need to understand that there is a difference between cardiac training and muscle strengthening. Most patients believe in walking as an exercise. But I would say that walking is the main form of exercise if not balanced properly with strengthening is going to cause wear and tear on the knees.

First, you need to strengthen the muscles which are there in the front and the back of the knees. So we are talking about strengthening the cardio steps and about strengthening the hamstrings. I would be giving you the practical demonstration of how we can do the same.

These are the normal exercises which I ask 70 years old individuals to do.

Initially, the patient is lying down and push the knees downwards. Neeche dabaav daalo or thoda dheela karo. Push down and relax and do it till the count of 50. So, this is the basic first exercise you should do when you start any other exercise.
The second exercise is leg race. This should also be from 5-50 counts. When you can comfortably do 50 counts at a time then we start the same in sitting posture.
Lie down with the face down and start bending the alternate knees upwards and then release. This is what you would do for a hamstring strength
So these are the exercises which you can do from the age of 20 years to 80 years. Depending on the muscle strength, you can gradually increase the intensity of an exercise and take it to the next level.

If you are able to strengthen your knees simultaneously as you increase your cardio activity, that would be the best form without any damage to your knees. Another thing is that if you can balance your cardio in terms of saying that if you could do cycling, swimming, walking or running and balance all 25% of your work out when you are working out in the gym. So when you are going to the gym, the first thing should be doing is not going to the tread mill, you should start with the cycling as it is non-weight bearing exercise. Do it for 10 minutes, gradually as you warmed up you can do cross stepper and lastly, you can go to the tread mill. That is the commonest mistake when we talk about cardio. Tread mill should not be the primary exercise when you go to the gym.

Maximum work can get by the trainers in the gym because most of the times you end up doing squats and crunches. Basically, your lower body is not that strong to take the whole grant of the weight. So, I would suggest that if you are 35, 40, 45 years and if you are little heavy in the upper body then please do not start with free hand squats.

First, do the machines. On machines, you can do leg extensions, hamstrings and press rings. And when you start feeling that your lower body is capable of taking weight then start doing squats and lunges. And if you are going to avoid it, it will not make much difference, you can increase your muscle strength in terms of your leg extension and hamstrings.

Running can cause irreversible damage to the knees after the age of 40-45. The 25-year-old individual can run because at the young age, the cartilage has the tendency for the recovery. But after the age of 35 years, there is degeneration. If you want your knees to stay healthy between the age of 35-80, then you need to take care good care of it.

Let me give you some tips on running.

It is important that you wear good running shoes while running and walk on a good walking track. Avoid walking on the roads. Please try to walk on the grass or a mud track. Because walking on the road may cause nerve stress.

Before you start indulging into exercise, I would suggest you to have blood tests of Calcium, Vit- D3 and Vit- B12. You will be surprised, when you are deficient in either of these and you are going to take the exercise to the next level, then you will face some damage. Only if the reports of these blood tests are normal then only take your exercise to the next level. Otherwise, there will always the chance of injury.

I always ask females to do basic bone density along with the blood tests which I told you previously. Maximum damage to the female body is done during menopause. But if your basic density of Vit- D3, Vit- B12 and calcium is normal then you will suffer from least damage even after the menopause.

All the above mention tips will definitely help you.

For further information, you can contact me through Lybrate.

Play video
Knee Replacement
Benefits of Bilateral Total Knee Replacement

I am Dr. Rakesh Nair. I am an exclusive knee replacement surgeon practicing at Zen Hospital in Chembur. I am also attached to the Fortis Group of Hospitals at Vashi and Mahim and Holy Family Hospital at Bandra. Today, I am going to talk about Bilateral One Stage Total Knee Replacement. To understand the basic term which I have used here when I say Bilateral One Staged, I say both knees and one sitting. They are done together once the patient is wheeled in. They are not done in a gap of a few days. That s what I mean by both knees and one sitting.


In the surgery, all we remove is hardly 7-8 mm of bone from the thigh bone and around 7-8 mm from the shin bone, that is the lower part and all we do is just change the cap. It s like changing the cap of a tooth, so your bone and your muscle are your own. We are not chopping off the whole knee and replacing it. So, that is the reason why I am using the terminology Knee Resurfacing, we are changing only the cap.
Once the cap is changed, we are able to mobilize the patient, the same evening if required. And, with the advanced anesthesia techniques that we have, I am able to make the patient walk the same evening. So, there are some videos here also which would tell you the same where the patient has been operated in the morning by around 12 o clock once he or she is wheeled out the operation theatre. In another four hours by 4 o clock evening, the patient is walking with full weight on the leg without much pain because of the pain techniques that we in terms of the pain management.

Now, why would I say that we should be doing both knees in one sitting? So, what are the advantages of doing both knees in one sitting? If you see the further videos which I would also show you, most of the patients who come to me have severe deformities. They, like, have severe bow legs, legs which are severely bent, either towards the inside or either towards the outside. So, doing one knee and then doing another knee is not going to help at all because the patient is not going to be able to walk. So, when I do both knees in one sitting it restricts the surgical procedure so it is like saying I do everything under one anesthesia. The patient gets short of medication. The medicines also which go into the body is once you are wheeled into the operation theatre. The most important part is that the patient can be mobilized very easily because immediately both the legs are straight and the patient can walk with full weight bearing on both the legs. So, I can make the patient walk in the evening or the next day depending on how strong the bones and the muscles are. Another thing is, it reduces the hospitalization also, plus the hospital cost also goes down because we don t double use the medication nor the stay is doubled. The stay is same; it varies between 3-7 days depending on how strong the patient's knees are before surgery. So, I would definitely advocate doing both knees in one sitting.


What are the main advantages and what would you say in terms of why wouldn t we do a knee after a week or 10 days? There are studies which say that it is not the number of joints, so the number of knees you do in which causes the problem or the commonest cause which is an infection. The problem arises if you keep on wheeling the patient into the operation theatre. So, if somebody says that we do a knee today and then we do a knee after 4 or 5 days then cases of infection will increase because the patient is being wheeled into the operation theatre on two separate occasions. So, it is not that I have not done both the knees in one sitting, which is a better option because the chances of infection are less than doing one knee now and then doing the other knee after 4-5 days, where the patient gets the same medicines repeatedly plus he is bought into the operation theatre again and his stay also increases in the hospital.


We would be showing you some videos where the patient, how the patient is walking before surgery. If you see most of these patients, the legs are severely deformed. So, all of them I have been able to do a One Staged Bilateral Knee Resurfacing where I have done both the knees in one sitting. You see them how they are walking before surgery, you see them how are they are walking after surgery. And, if you compare the function, they are really able to walk very comfortably.


My patients even sit cross-legged after surgery but that is not. I will show you one of these videos which are showing the patient sit cross-legged after surgery. But that is not something which we promote. It is just to show that they get very good function and they would definitely be able to sit cross-legged but that is not something we tell the patient to do because that compromises on the life of the knee. So, there are a lot of records and results which say that, whether we do a Bilateral One Staged Knee Replacement or whether we a One Staged Knee Replacement, the complications in terms of infection, an embolism is always similar. In fact, it is much more in a unilateral knee than in a bilateral knee.


We use body exhaust play suits, again, during surgery. I will show you this video which is showing you the body exhaust play suits where we are working in a very sterile environment. We would not want to give any infection even from the OT personnel to the patient. So, these are body exhaust playsuits which prevent the impure air breath out of the operating team, it is not allowing it to go to the patient. In fact, it is sucked up by a rotating fan which is there on top of the body exhaust playsuits and the whole impure air is taken out from the patient s atmosphere. Even our conventional methods of mixing cement have been changed and we are using basically vacuum mixing for cement so there again is no impurities in the bowl in which we are mixing the bone cement to fix the implants to the bone.

We have all the options in terms of the knee replacement where we even have computer assisted Total Knee Replacement. We have Unilateral Knee Replacement where basically the unilateral knee replacement is used for younger patients who have deformities or pain in the insides of the knee where only a part of the knee has been damaged, the rest of the bone is all right, that s where we use the Unilateral Knee Replacement. The latest what we have is the Customized Jigs in Total Knee Replacement where we get the MRI done of the affected knee. On the basis of the MRI, ceramic Jigs are made and on the basis of the ceramic Jigs, the positioning of the implant can be as perfect as required. Obesity has always been, the patient has always come up to me saying, Doc, I am little on the heavier side, I am so heavy, is it a contraindication to my surgery? So, obesity as such is not a contraindication to surgery. Definitely chances of wound healing are a problem but, instead of a week to ten days, it will take another week to ten days for healing. Otherwise, it is not a contraindication to the surgery.


Now, a very important question which comes from the patient is, Doctor, how long will these knees last? So, I give a very simple answer to that is that, the more you take care of it, the longer it will last. So, the longevity of the knee all depends on how strong your muscles are before surgery, how strong your bones are after surgery or before surgery and depending on that we normally get a bone density done for the patient and we treat the patient either on a yearly injection for osteoporosis or daily injection which are meant to fill up the bone and that decides on how well the implant is going to hold on and how long the life of the knee is going to last.

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