Treating And Preventing Knee Arthritis

Published March 21, 2014 08:52AM

The Symptoms

Pain, swelling and stiffness in the knee and an inability to use the joint as much as desired.

What’s Going On In There?

Arthritis is simply the wearing out of a joint’s lining, leaving bone to grind on bone. It’s caused by a combination of factors, including old injuries, genetic predisposition, overuse and sometimes just bad luck.

Arthritis gets worse over time, but it’s possible  to continue at your current level of fitness. Find ways to train and maintain fitness while reducing the wear and tear on your knees.

Fix It

Build super legs. If you rest or scale back on your activity level, you lose muscle and the condition worsens. I suggest biking and swimming to build leg strength. Quad-, hip- and glute-strengthening exercises are musts. Multidirectional lunges as well as squats, squat jumps and squat thrusts once you’re able to do them are all good muscle builders.

Fix foot mechanics. Pronation (when the foot turns inward as it strikes) puts extra pressure on the knee joint. Arch supports and stability shoes can help relieve excess knee pounding. Also, try to shorten your stride and raise your foot strikes to 90 per minute.

Try supplements. There is not scientific data to prove the benefits, but many of my patients report that glucosamine and chondroitin help with arthritis pain.

Try an NSAID. An anti-inflammatory like ibuprofen or naproxen can help with pain and swelling.

Change the conditions. If possible, switch to a softer running surface. Blacktop is softer than concrete, dirt and grass are softer than blacktop, and the all-weather track is best of all.

When To Call A Doctor

If you suspect you have arthritis in your knee,  it’s a good idea to see a sports doctor, who can verify it easily with an X-ray (which is a better diagnostic tool for arthritic joints than an MRI). A full-on assessment of biomechanical factors such as strength, flexibility and foot mechanics, as well as of external factors such as shoe type, running surface, bike fit and training regimen, can be a huge help.

A doctor can also administer more aggressive treatments if warranted. For example, prescription anti-inflammatories and injectable forms of hyaluronic acid (a substance that occurs naturally in cartilage and helps cushion joints) can help alleviate symptoms.

Last, since arthritis is a degenerative condition, it’s a good idea to see a doctor early in its course to establish a baseline for your condition. Your doctor can use it to assess later changes as he or she continues your care.

Do You Need Surgery?
Generally, no. As you  get older, however, knee replacement surgery may be an option if your condition no longer responds to regular therapies.

Prevent It

I say it often: Strength controls pain. The stronger, more flexible and better conditioned your kinetic chain, the more support your knees will get from muscles, ligaments and tendons. Building your quad strength helps make your knees more stable and less susceptible to pain. The stretches and exercises here all help build powerful legs with minimal impact on the knees.

Prisoner Squat
Stand as tall as you can with your feet spread shoulder-width apart. Place your fingers on the back of your head. Pull your elbows and shoulders back, and stick out your chest. Lower your body as far as you can by pushing your hips back and bending your knees. Pause, then slowly push yourself back to the starting position.
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Dumbbell Lunge
Grab a pair of dumbbells and hold them at arm’s length next to your sides, your palms facing each other. Brace your core and step forward with your right leg and slowly lower your body until your front knee is bent at least 90 degrees. Pause, then push yourself to the starting position as quickly as you can. Complete the prescribed number of repetitions with your right leg, then do the same number with your left leg.

Low Side-To-Side Lunge
Stand with your feet set about twice shoulder-length apart, your feet facing straight ahead. Clasp your hands in front of your chest (or use dumbbells as illustrated). Shift your weight over to your right leg as you push your hips backward and lower your body by dropping your hips and bending your knees. Your lower right leg should remain nearly perpendicular to the floor. Your left foot should remain flat on the floor. Without raising yourself back up to a standing position, reverse the movement to the left. Alternate back and forth.

More medical advice from Dr. Jordan Metzl.

From The Athlete’s Book of Home Remedies by Dr. Jordan D. Metzl, M.D. with Mike Zimmerman. Copyright 2012 by Rodale, Inc. Published by arrangement with Rodale, Inc.