A common misconception when it comes to pain of any kind is that massage therapy or surgery is the end all solution. The reason there is a pain in most cases is a muscular imbalance or inefficiency which causes Osteoarthritis. This can be corrected to avoid surgery altogether.
Knee replacements are a popular procedure to have done due to degenerative cartilage, the patella (knee cap). 95 percent of knee replacements done are due to Osteoarthritis (OA) of the knee and by age 65, 80% to 90% of people have OA. The procedure and condition can be avoided and treated with proper exercises for the Gluteus Medias and Vastus Medialis (VMO). For preventative exercises refer to the end of this post. The wear and tear leading to OA are caused from kneeling and walking causing degenerative cartilage surrounding the joints.
What happens is due to repeated use of the knee joint, the knee caves inwards relying on the Iliotibial band (IT band) to support the joint from collapsing entirely. The IT band inserts at the knee joint, and when the knee caves and then jerks back to neutral position, the patella grinds against the femur and tibia (bones connected at the knee joint) and scrapes pieces off with each step.
Osteophytes begin to grow inside the joints. Osteophytes are small, irregular, bony growths that are also called bone spurs. Bits of broken-off cartilage or bone are also found floating inside the joint. This causes even more pain, swelling, and immobility of the joint.
OA usually occurs after the age of 45, but it can occur earlier in life, and even be seen in the spines of teenagers. After menopause, women tend to get more severe and complicated problems. Weight-bearing joints such as hips, knees, and feet are more prone to OA.
There are four main causes of OA:
- increasing age: The cartilage wears down with time. By age 65, 80% to 90% of people have OA, as shown on X-ray, though a much smaller percentage have symptoms.
- family genes: Scientists believe that OA may be passed on through families, with the symptoms appearing in middle age.
- being overweight: Excess weight puts stress on weight-bearing joints such as hips and knees, and increases the risk of cartilage breakdown. This is the most important risk factor for OA affecting hips, and leg and foot joints.
- injury: Trauma to the joint, such as overuse, can damage the cartilage and lead to OA. This is often the cause of OA in younger people.
Repeated minor injuries due to constant kneeling, squatting, or other postures that place stress on the knee joint can cause cartilage to breakdown. Exercise can help reduce joint pain and stiffness.
For knee replacements, the majority of patients were classified as overweight and obese, class I (just over 28% in each group), followed by obese, class II (16.4%). The proportion of knee replacement patients in the normal weight group was very similar to that in the obese, class III group.
Something as simple as being a healthy weight will reduce the amount of pressure on your joints and can prevent OA and the need for knee replacements.
Key Exercises in Treating and Preventing Osteoarthritis
Crab Walk – Gluteus Medias
Wrap a resistance band around your ankles with your feet hip width apart. There should already be tension in the band. From here, lead with your heel and walk sideways standing upright. You should feel flexion in the sides of your bum (Gluteus Medias). This is the muscle in responsible for stabilising your leg at the hip preventing caving of the knee. It is also a great exercise for sculpting your bum.
Key Cue: walk leading with your heel.
Elevated Split Squats – Vastus Medialis (VMO)
This exercise if similar to a lunge. Step forward and bend with the leading leg forcing your knee outwards activating your VMO. The VMO is the tear drop looking muscle at your knee, one of the four muscle heads in your quadriceps. This muscle is responsible for pushing your knee outwards preventing caving of the knee joint. This combined with the Gluteus Medias will relieve the IT band and stop the grinding of your patella (knee cap).
Key Cue: Maintain your weight on the heel of your leading foot