My Meniscectomy Cost a Lot

The pain in my left knee just wouldn't go away. I couldn't pinpoint the exact cause. Could have been some sort of fall, could have been pivoting my knee wrong, could have been some sort of sports injury. I wasn't exactly sure. I was sure that there was something wrong and it needed medical attention. I could walk around, but couldn't dream of running; I had a pretty noticeable limp, some swelling and plenty of pain that just wouldn't go away, even after weeks of rest.

I had insurance, but I had a pretty high deductible, so the first four thousand worth of medical expenses would be my responsibility. I didn't want to pay some doctor a few hundred bucks to tell me I need to ice it, keep it elevated and rested. Eventually, I got so sick of having to limp around that I decided it would be worth my peace of mind just to get it checked out.

The doctor looked at it and after playing around with it for a little bit said that he thought it was the meniscus. I didn't even know what that was, but I was relieved that it wasn't the ACL. He showed me what he thought it was, but said the only way to be sure is to get an MRI. I thought to myself: "ok, maybe there is something wrong, but if there isn't I am out a thousand bucks for this MRI!" I agreed to get the MRI because I didn't want to risk doing further damage to my knee.

The MRI was the most expensive 45 minutes of my life. It was a very simple and painless procedure. They gave me the slides right after I was done, which I foolishly tried to decipher myself. After a half hour of trying to figure out what I was even looking at, I gave up and decided to wait until going to the doctor again to get them professionally read.

The doctor took one look at them and confirmed that it was a torn meniscus. He said that the only way to fix it would be arthroscopic surgery. He assured me that it would never be able to heal on its own, and I would just end up with accelerated arthritis in my knee as I grew older. I scheduled my surgery and kissed the last of my deductible goodbye.

The surgery went perfectly. I was nervous going in, but the nurse helped ease my nerves. They knocked me out and the next thing I knew, the surgery was over. My knee was really swollen for the next couple days, but started to recover rapidly. I soon began physical therapy which helped make a full recovery.

After the whole process, I checked my insurance online to see all the claims. I was shocked to see how expensive everything was. Four thousand for the surgeon, eighteen thousand for the surgery center, nearly a thousand worth of doctor visits and physical therapy appointments, another thousand for drugs and the anesthesiologist. All in all, I realized that only paying four thousand for all those services was a pretty good deal on my end.

I had purchased the insurance (I am self employed) thinking that it would only really come in handy in the event of some sort of horrible accident, cancer, or other very unfortunate event. I didn't realize that it would come in so helpful for something as simple as knee surgery. The moral of the story is that health insurance is something that everyone needs, because even if you can't afford to have it, you can never afford not to have it.

Back Of Knee Pain - What In The World Is My Problem?

Having back of knee pain can be very confusing to say the least, I mean what the heck causes back of knee pain in the first place?

It almost leaves you wondering if there should be any pain back there in the first place. It's not like that's where you knee joint or knee cap are, there's really nothing back there so what gives?

Well, here's a list straight out of Grovers medical Sept 2007, where they give a pretty thorough count of possibilities.

Patellofemoral syndrome

Patellar Subluxation dislocation

Bakers cyst

Bursitis and tendonitis

Meniscal disorders

Arthritis

Ligament tears

Tendon rupture

Deep vein thrombosis

I know how you feel attempting to narrow this down to the cause because that's exactly where I was at about a year ago.

What I found was that having the same frustration that you have now I wanted to get the whole thing narrowed down to what exactly was my problem not just a whole list of a bunch of stuff I had never heard of before. Well ok, a couple of those I had heard of before but that was about it.

What I found was that unless it was an actual real injury like the Tendon rupture one then it was totally treatable for me at least with really sound nutritional advice. The second biggest thing I found was that drinking water was one of the huge keys to success.

I know what you're thinking, you drink tons of fluids every day. But if they are not just pure water they truly don't count. It has to be nothing but just pure plain ole water. What I found was data suggests that the average American is chronically dehydrated. So one answer is to make sure you get your daily water requirements.

And the truth of the matter is this helped me a ton to get a good percentage of the back of knee pain to ease up.

But that was not the main thing that really got rid of the pain and got my knee to start really healing again.

Why Does Arthritis Affect Women More Than Men?

Even though Arthritis does not only affect one sex or age group for some reason it tends to affect women more than men.

Below you will find out how Arthritis affects the day-to-day lives of many women across the globe:

• Women with this condition find that their sleep will be affected more than if they were suffering with any other chronic illness.

• Women who have Arthritis often do not have young children.

• Depression is quite common amongst Arthritis sufferers, especially when compared with other chronic conditions.

• Women are more likely to need help with their daily activities than men.

• Around two-thirds of all Arthritis sufferers are female, which works out at around 41 million Americans.

• 37% of females have this condition, compared with only 28% of men.

• Around the world there are 16 million women with Osteoarthritis. This figure is 3 times higher than the number of males with this condition. You will also find that this condition develops earlier in women too.

• 1.5 million or 75% of all Rheumatoid Arthritis patients are women.

• African-Americans are more susceptible too with the development of Lupus 3 times more likely than Caucasian females.

Why is Arthritis so prevalent in women?

At the present time there is no clear reason why this condition affects women more than men. There are however a few suggested reasons that may be worth exploring in more detail:

• Autoimmune diseases are more common in women.

• Women have a number of hormone changes throughout their lives, for example through puberty, pregnancy and the menopause.

• Often women are not as active as men, which raises the risk level of developing these types of conditions.

• Women store more fat than men, resulting in higher cholesterol levels that have been linked with the development of Arthritis.

What's the best way to manage this condition?

Even if you have this condition this does not mean that your life is over as there are ways to help manage and alleviate the symptoms.

By taking a little time to research a suitable treatment will help to relieve the pain and inflammation caused.

You do not need to rely solely on surgery or prescription medication either as certain foods can help, plus there are exercises and techniques shown to help.

Finally herbal supplements are a great option to give you the relief from pain and a chance at being more active in your life.

The benefit of an herbal supplement is that unlike prescription medication you wont have to discontinue its use after a short amount of time.

An effective supplement can reduce the inflammation and pain and will be a safer option to those prescription medicines that often cause side effects.

Little Known Facts About the Treatments For the Arthritis of the Knee

Arthritis affects 46 millions of Americans and, with baby boomers aging, the number of sufferers is expected to rise 67 million by the year 2030. Obviously, arthritis remains the nation's leading cause of disability in those over age 15. And until recently, researchers viewed arthritis mainly because of wear and tear on the joints that caused little by a gradual loss of cartilage, the smooth layer of connective tissue that enables our bones to absorb the shock of joint motion and to move easily and without pain.

However what is it that makes us lose cartilage? Accidents and injuries are one factor, but they are the cause of a relatively small proportion of all cases of osteoarthritis. One of the main reasons, in fact, is inflammation - its link with osteoarthritis- and to pain in general- was found only recently in scientific studies. Ironically, inflammation is a self-protective process that happens when you are getting hurt. Inflammation has many positive effects such as increasing blood supply to an injured area. But what we really don't know is that this protective reaction can backfire on us. Sometimes inflammation continues long after it is needed, leading to greater pain and further loss of cartilage in joints.

Injuries aren't the sole triggers of inflammation. In fact, poor diet and lack of exercise also play a part. But one of the keys to reducing the pain of the arthritis of the knee is stopping unwanted inflammation. While there is no treatment for arthritis at present, you can do a few things to slow its progression and alleviate the pain. The following noninvasive cures can provide relief to most arthritis sufferers.

1. Watch Your Diet. Eat foods that reduce inflammation, and get away from those that cause it. Red meat and high-fructose corn syrup both are packed with omega-6 fatty acids, which are likely to promote inflammation. Processed sugars and fatty foods also are prime culprits in America's epidemic of overweight and obesity, which are factors in arthritis. Extra weight places further stress on the spine, hip, and knee joints and exacerbates any inflammation there. To reduce inflammation, consume more foods that are rich in omega-3 fatty acids like deep-sea fish, flaxseed, brightly colored fruits, dark-green leafy vegetables, and olive oil. Remember that nutritionists now advise eating these same foods to improve overall health.

2. Take safe supplements. Recent study indicates that the use of ginger, glucosamine and chondroiton sulfate may be helpful for moderate to severe arthritis. In fact, ginger has been used in India for centuries as treatment for knee pain. Talk to your physician for specific suggestions.

3. Use Your Body. Some sufferers of arthritis are afraid that exercise can hurt them. However what they don't know is that simple exercises are needed for proper functioning of joint. To start with, stretch the affected joint and if you arthritis joint can manage it, walking just 20 to 30 minutes a day can avoid further deterioration.

4. Breathe Slowly and Properly. Proper breathing in a slow, controlled rhythm is the quickest joint pain relief. Any mild form of stretching with controlled breathing like yoga or tai chi also can alleviate arthritis pain.

5. Try Massage and Acupuncture. Because mainstream medicine has not provided enough treatment for arthritis short of drugs and surgery, a lot of arthritis sufferers have turned to natural remedies for arthritis such as massage and acupuncture. Generally, massage therapy has been shown to be beneficial for arthritis of the spine and hip, and acupuncture has yielded promising results for arthritis of the knee in clinical trials.

6. Other Arthritis Treatments. For those whose knee pain continues even after adopting these lifestyle changes, a spray such as Brazilian Heat may provide instant relief. This spray helped relieve knee pain by turning off the knee pain nerves.

Meanwhile, eating a sound anti-inflammatory diet, taking safe supplements for arthritis, and following a sensible exercise routine while keeping your body weight in check will help you avoid many of the side effects of arthritis.

The Great in Crate

When you were a kid did you like to play with boxes? Not shoe boxes or crummy fruit boxes, but big fridge boxes or stove boxes, washing machine or tumble dryer boxes. Boxes you could really climb in and knock around in, boxes that echoed if you went, "Ooohh, ooga ooga ooga." Good boxes in other words. You had to play very carefully though; you weren't allowed to break them. Because we had to hoard boxes in those days, just in case we had to move and we needed something to pack the china ware in.

These days collecting boxes is so passé. Now we rent crates. And if you have not heard of this little phenomenon then darling, where have you been? Everyone is doing it. It's the ultimate in moving chic.

Ok, so that might be a slight exaggeration, it might still be directed more at commercial businesses than at private property or home owners right now but it's only a matter of time before the trend reaches us. Business can't have all the fun, besides I'm sure that the crate companies would like to cash in on the relatively lucrative private market. A lot of people move home you know. That's a lot of cardboard out there that needs to be replaced.

The advantages of crates over cardboard boxes are enormous. First, crates are solid. They will not bend or break thus providing better security and safety to your treasured possessions. No more worrying about your beloved books being bent all out of shape, no more worrying about the side splitting or the bottom ripping and losing granny's priceless vases. Second, the crates seal, the rain and the damp cannot get in, so again your books are safe from curling and discolouring, your curtains, blankets and bedding are safe from mildew and funky smells. Third, because they are solid and sealed they are easily movable. Fourth, because they are rented you don't have to deal with them after the move. You don't have to find space for them for the next move or throw away those that are broken beyond repair. They just get taken away. And you don't have sticky masking tape left lying around for unsuspecting bare feet to stand on. Which is always a bonus.

There is of course another advantage; because the crates can be used over and over and over again, we can all take our cardboard boxes (once kiddies have played in them to their hearts content and maybe even broken them) and have them recycled. There is no reason why we can't be more environmentally conscious while our lives are made just that little bit easier. Our homes are therefore less cluttered, we feel better about ourselves in general and we set a good example for our children. Where is the bad in that?

Crates as you can see are the bees knees, the cat's pajamas, the dog's ... well you get the point. They're very useful that's all. The time of the cardboard box is up, a new era is born, one with structure and a seal-able lid. These are exciting times. Now we just hope that that crating industry hurries up and allows us private folks to take advantage of its high quality product. Or else mild mannered suburbia might just become not so mild mannered after all.

What Are the Alternatives to Knee Replacement Surgery?

If you are having problems with one or both of your knees, you may be at the point that you are ready to throw in the towel and go through the process getting an artificial knee. Hold that thought, there are alternatives to knee replacement surgery. This procedure should always be a last resort. You want to make sure you have put a good effort into exploring your other options before you go under the knife. Knee surgery can come along with a difficult and painful recovery period, so before you take this drastic measure investigate all the choices available.

When you visit the doctor to discuss your painful knee, the first suggestion you are likely to get is to lose weight. When you carry around excess weight, you place undue pressure on your joints. Over time, this pressure can wear down your knees. Just losing 10% of your body weight can bring enormous relief to your aching knees. Your doctor may also refer you to a nutritionist help you lose weight in a healthy and sustainable way.

If your pain is not related to weight, your doctor will look towards exercise as an alternative to knee replacement surgery. Exercise, in proper amounts, can do wonders for your body. You can strengthen the muscles around your sore joints to improve function and reduce pain. Exercising will increase your flexibility and improve the blood flow around your knees and other joints. When implementing a plan to improve the function of the knees, be sure you select low-impact activities. If your knees are in pain from high-impact workouts, your doctor will probably recommend you cut back on those activities to allow your knees to rest and heal.

You many need to add some type of pain medication to your diet and exercise plan to manage problematic knees. There are many different forms and levels of both over the counter and prescription medicines that can alleviate pain. Collaborate with your physician to come up with an appropriate plan for your situation. There are other surgical alternatives to knee replacement that might work, should you have exhausted the non-invasive treatments. These involve removing excess cartilage and realigning the bones in the knee joint. If you and your doctor do make the decision to have total knee replacement surgery, be sure to have a quality recovery program in place.

Following knee replacement surgery you will have a strict doctor ordered rehabilitation program. Unfortunately, this rehab program is only enough to give you some of you mobility and life back. They don't expect people with total knee replacements to have full flexibility like they once did, so they don't even try. With the right exercises and routines, though, you can have that life back, despite what the doctors tell you. Take the time to learn about rehabilitation from knee replacement surgery, and how you can ease your fear of living a sedentary life by taking action now.

Knee Surgery And Recovery - What To Expect

As you get older, you may get arthritis in your knees that damages the structures and may necessitate surgery. Or, you may be very active in sports and have injured ligaments or cartilage that may require surgery. Although it's still not a picnic, knee surgery is not the harrowing ordeal it used to be. Depending on the type of knee surgery you require, recovery times are much faster now and get you up on your feet and moving again with minimal pain. If you have to undergo knee surgery, there are some things you should know. First, let me explain to you about the 3 main types of knee surgery.

•Arthroscopy - done mainly to diagnose knee problems or to repair ligaments or remove fractured cartilage or bone. Incisions, sometimes several, are made around the knee, to create "portals" where an instrument called an arthroscope can be inserted to look into the inner knee. This is an outpatient procedure so you will be up and moving afterwards, however, complete recovery time is usually 6 to 8 weeks. You may need a cane or crutches to assist in walking. Limited activity, icing, and elevation of the leg is necessary in the post-op recovery period.

•Arthroplasty - done to reconstruct the knee from internal damage to the knee structures, usually cartilage. Metal or plastic components are used to replace the worn cartilage. This is an inpatient hospital procedure and you will be there about a week. You will have physical therapy every day to stand/place weight on the knee; learn how to walk with crutches, before going home. About 3 weeks is needed to completely place weight on the artificial joint. This procedure usually also requires the patient to have a course of physical therapy to re-train the motion of the knee with its new artificial components.

•Knee Replacement - this is the most extensive and time-intensive type of knee surgery as far as recovery and limitation of activity is concerned. Usually, the entire knee, or a large part of it, is replaced by artificial components. It may take as long as a year to completely recover full movement of the knee/leg. Ongoing physical therapy is done during that time as well. You will need assistance from family or friends to do certain things, as your activity level will be greatly decreased for a while.

Healing Your Knee - What You Can Do

You should always follow your doctor's advice regarding your postoperative activity, treatment and care of your knee post surgery. However, there are some important things that you can do for yourself to help the healing of your knee by rebuilding and strengthen existing muscles, cartilage and ligaments for support.

Nutrition:

•Protein - a diet rich in protein, enough to support your weight at 0.5 grams per pound of body weight, should be eaten every day. Beef, pork, fish, chicken, legumes are rich sources of protein and B vitamins for energy and red blood cell regeneration. Protein rebuilds muscles and also helps make collagen, the material that your connective tissues, i.e., ligaments and cartilage are made from.

•Vitamin C - in addition to protein, Vitamin C also helps create collagen, which "knits" ligaments and cartilage back together to strengthen them especially after they've been over-stretched or torn, repaired, or replaced from surgery.

•Fish/Krill Oil - provides crucial Omega 3's, which decrease inflammation (and pain!) and provide natural lubrication within the joint. Research has shown that arthritis sufferers move more easily and without pain after taking these oils.

•Collagen supplements - recent research by Harvard Medical College has shown that 100% pure collagen supplements bolster your own collagen production and help heal ligaments and cartilage faster. These come in capsules, but the powder form that can be mixed into water or juice, have been shown to work faster.

• Glucosamine, Chondroitin, MSM - this combination of collagen building agents also decreases inflammation and promotes healing of the joint tissues.

Behavioral:

•Quit Smoking - smoking increases the inflammation throughout your body that increases pain and stiffness. Smoking also delays healing and recovery time.

•Watch Your Weight - a large number of knee surgery/procedures result from too much body weight placed on the knee joints, the largest weight bearing joint in your body. If you are overweight, likely your doctor has already told you to take off some weight before you have your procedure, if possible. Afterwards, if you still have some weight to lose, it will help your knee significantly if you can get some more weight off. However, remember that your activity level will be decreased after surgery, so at least try to maintain your weight and not gain any more.

•Rest and elevate - don't try to do too much too soon as you will damage the delicate reconstruction within the knee. Wait until your doctor tells you it's okay to do certain things again. You will be given specific exercises to do during your recovery but rest and elevation (to alleviate swelling and pain) is important.

•Sleep - your body repairs itself during sleep, so be sure to get adequate sleep at least 6-8 uninterrupted hours per night after your procedure.

Your doctor will give you a more detailed set of do and don't instructions with your procedure, and you should follow those to the letter so your knee surgery recovery will be as speedy as possible. Becoming proactive towards your procedure with proper nutrition and lifestyle adjustments will ensure that you heal properly for the best outcome possible!

Sharp Lower Back Pain Hurts

Here are the four reasons for lower back pain, although they could be the reasons for other kinds of pain as well. These pains could be sharp, dull or throbbing, all stem from the same basic causes.

#1. Causing More Damage When You're Already In Pain

Using pain meds, stretching or putting pressure on your joints unnecessarily will increase pain throughout your back. Your lumbar spine is designed for stability, not mobility. Trying to stretch, take pills or move into awkward positions will increase mobility but not stability, and it's a lack of stability that is causing you pain.

#2. Poor Movement Patterns in Daily Life and Exercise

Do you sit in a chair all day? Do you hunch over when sitting? Are you slouched in your car while driving to and from work every day? Fix these things by placing your feet squarely in front of your body and raising your head to the top of your neck. Be sure to adjust your chair, steering wheel and computer monitor to allow for idea upright seating conditions.

When you reach down, do you bend your back or your knees? You're supposed to bend your knees! Squats are actually a great way to improve your movement patterns, so be sure to work on proper squats every single day, it's all about practice and re-training those back/knee muscles.

#3. Underlying Muscular Imbalances and Postural Dysfunctions

Do you stand or sit with all your weight to one side? If so, knock it off. You are seriously messing up the alignment of your body, similar to that of the axles in a car.

#4. Deep Core Stabilizer Muscles that DON'T WORK

Sometimes all these other causes will lead to a more serious problem, the shutdown and atrophy of core muscle groups in the back. If this happens then you must work on fixing the other three causes before this one can be addressed. It's a viscous cycle, and it's about time you broke yourself out of it and fixed your back.

Eight Basic Badminton Techniques

If you want to improve your game, you should practice these 8 basic techniques. Even if you just play badminton for fun, you can always learn something new to better your performance.

1. Badminton Grip

The right grip is your basic foundation for badminton. For more power and accuracy, make sure you are holding the racket correctly. There are 2 main types of grips: forehand and backhand.

Use the forehand grip when your shots are in the front of your body, and you hold your hand on the handle as if you where shaking hands. Keep the racket face perpendicular to the floor.

When the shot is behind your body, you should use the backhand racket grip. Hold the handle just like you did for the forehand, but then turn the racket counter-clockwise so your thumb is to the left.

2. Badminton Footwork

Your opponent will try to keep the shuttle away from you, so be prepared to move around the court quickly and accurate with good footwork. You'll need moves like skipping, shuffling, gliding, lunging and even bouncing. It's up to you how to use them during your game. Always keep your knees slightly bent and ready to move at all times. Generally stay in the mid-court area so you can reach all corners of the court quickly.

3. Serving

You can even gain points with the right serve. There are 4 basic kinds of badminton serve: high serve, low serve, flick serve, and the drive serve. You can choose the right serve after watching your opponent. Serving to the back of the court with a high serve is a good idea if you are playing against someone who likes to stay close to the net, for example.

4. Clears

The badminton clear is the most common stroke, and it can be played from either forehand or backhand, as well as overhead or underarm. Regardless of exactly how you use the clear, the objective is to send the shuttle to the back of the court, forcing your opponent back away from the net to open up the forecourt.

5. Drop Shots

The drop shot is the opposite of the above mentioned clear shot, as it is intended to drop right behind the net and force your opponent closer into the forecourt. This can open up space in the backcourt for your next play. This move can be played either forehand or backhand, and usually has a lot of wrist movement to it.

6. The Smash

The badminton smash is a powerful move that you should strive to master. It's a downward shot that comes down steeply into your opponents fore or mid court area. For a faster smash, you can jump and make the shot as you some down. Your opponent will have little time to react, almost guaranteeing you the point. Don't overuse the smash because it will tire you out. You usually use a forehand grip when doing a smash.

7. The Drive

If the ball is too low for a smash, you can use a drive instead. The drive shot moves horizontally, rather than arching upward. The shuttle would just skim the top of the net, moving either diagonally across the court or straight from your position. You're trying to get the shuttle behind your opponent, making it difficult for them to return with a good shot.

8. Badminton Net Play

Net play shots are usually done with just a wrist movement, and lack the power of most other techniques. The intent is to gently knock the shuttle over the net, usually when your opponent can't reach the net in time to counter. Any light shot near the net is hard to return, especially if you get the shuttle tumbling.

Martial Arts Marketing Success

There are over 45 forms of mixed martial arts in the world. With these variations, there are millions of different practitioners worldwide. Dojos are built and maintained to cater to this number of martial artists. However, the need to eliminate costs and generate more profits seems to be much more of a challenge compared to teaching the arts.

One of the main areas where profit seems scarce is the Karate business. Karate means the art of kicking or punching. Based on the meaning, it is likely to knock any opponent out but in Karate business its strength does not seem to take effect.

Everyday, more karate dojos lose business because of the stiff competition surrounding it. These dojos may have the best locations in their area. They may have the best teachers and facilities, yet their operations have gone into a standstill. Why? I believe the reason is poor business strategy.

Developing strategic methods does not necessarily mean conducting extensive researches, no; we do not have time for that. It simply means understanding your market and using your advantages as your edge. Just like in the art of Karate, you have to learn how to use your bare hands and knees as weapons. Create a plan and stick to it.

A karate business plan does not need to be all that grand. It only has to include four main parts: A. Objectives, B. Mission, C. Keys to Success, and D. How to Use these Keys. The objectives should include your goals. It may a combination of tangible and intangible. Under the mission portion, it should have what you envision your Karate business would look like. It's like seeing it from dream, only that you know it's not. The keys to success are those factors that you find unique to your Karate business. It could be that the location is convenient for all your students. It could be the cleanliness of the dojo and the quality of the equipments that you have. Most importantly, it could be the kind of instructors that you hire. And lastly, using the key elements that you have discovered; what are the steps that you should take in order to realize your mission and achieve your goal? Formulate your own Karate business plan using this formula and watch your profits grow.

It is vital that you include in your karate business plan the impression you wish a student would have as soon as he/she steps into your dojo. Statistics say that one of the primary reasons why a martial arts student would quit is because of the first impression he had. Remember, it's all about giving the correct mindset.

With a very good plan, martial arts success would be at hand. Martial Arts success has two faces. One is for the shihan or he who owns the dojo. Success for him would mean the satisfaction of seeing new faces as well as the profit he would get. Not to mention keeping illness at bay through regular exercise. Martial Arts success would also benefit the student. Not only will he learn the different levels of discipline, he will also add another hour to his life free from stress. Studies show that mixed martial arts is a form of exercise and meditation that leads to reduced tension, anxiety, depression, and anger.

So, start developing your own Karate business plan and welcome to the world of success.

Arthritis Relief From Joint Implants Coated With Hydroxyapatite and Titanium

Hydroxyapatite (HA) and titanium are now more than ever used as coatings for joint replacement implants and dental implants. HA and titanium promote bone ingrowth between the joint implant and the patient's bone itself. This ingrowth allows for a sturdier implant that precipitates less pain and recovery time when compared to traditional implants that contain cement.

What follows is a list of the most common types of implants for which HA and titanium are used as implant coatings and the benefits that these coatings specifically provide for each implant.

Finger:
Joint replacement is recognized as a treatment option for large joints which have been severely damaged by arthritis. Most people are unaware that when small joints such as those found in fingers become painful, deformed and/or limited, relief can come by replacing the joints with titanium and hydroxyapatite coated implants. Since full function is not restored, finger implant surgery is not considered the first choice of treatment, but for those who do make the choice, the reduction of pain due to arthritis is often significant. The surgery is most valuable for patients who will regain function and who will benefit greatly from achievable pain relief.

Ankle:
Total ankle replacement is an option for patients with severe arthritis. Similar to hip and knee replacement surgeries, total ankle replacement involves removing the arthritic ankle joint and replacing it with an implant. Total ankle replacement was developed in the 1970's with limited success. The older implants often loosened or malfunctioned and frequently needed to be removed. Today, manufacturers have developed a porous titanium implant coating that has made ankle replacement surgery a more viable option. Typically, the implant consists of two titanium end plates with a refined polyethylene center. When the end plates are coated with titanium or hydroxyapatite, the coating allows the implant to mimic the motion of a natural ankle. Prior to total ankle replacement surgery, the only surgical option for patients with disabling arthritis was fusion, which completely restricts the patient's ankle motion.

Hip
Total hip joint replacement is an orthopaedic success story, enabling hundreds of thousands of people to live fuller, more active lives. Using metal alloys, high-grade plastics, and polymeric materials, orthopaedic surgeons can replace painful, dysfunctional joints with highly functional, long-lasting prostheses. Hydroxyapatite and titanium coatings allow for cement-less implants and promote bone ingrowth between implant and human bone. Today, the top performing designs all have porous titanium and hydroxyapatite surfaces that make for stronger implants and shorter recovery times.

Dental:
Dental implants are available uncoated, with a titanium plasma sprayed (TPS) coating and with a hydroxyapatite coating. The choice of coating is a matter of personal preference as all coatings are successfully used by clinicians around the world. Although, hydroxyapatite (HA) coatings can help jump start the integration process in dental implants, reducing recovery time. As a result, dental implants coated with hydroxyapatite are becoming an increasingly popular choice when placing an implant.

L-Vertebrae: Degenerative Disk Disease (DDD) is one of the most common causes of lower back pain in adults. Many patients discover relief from pain caused by DDD by pursuing nonsurgical methods such as therapy, anti-inflammatory medications and weight loss. For patients who don't experience adequate pain relief through nonsurgical treatments, lumbar fusion has long been a common surgical treatment for alleviating lower back pain. While lumbar fusion can be an effective treatment, it severely restricts motion and it does not always provide pain relief. Porous titanium coatings have allowed many medical device manufacturers to develop new, FDA approved artificial disk replacement options. Artificial disks can reduce lower back pain while also allowing the patient to retain spinal motion. Disks coated in titanium become firmly fixed in bone just weeks after the operation and typically allow for reduced pain and greater range of motion.

Elbow: Until recently, patients in need of implant surgery to relieve the pain that comes along with elbow arthritis received elbow prostheses that require cement for bone fixation. In fact, despite the increased use of hydroxyapatite and titanium as implant coatings, cement implants are still fairly common. Hydroxyapatite coatings achieve greater bone ingrowth than do cement implants. Increased bone ingrowth makes for a more durable implant that allows for increased range of motion and less pain.

Shoulder: Arthritis of the shoulder joint causes damage to bone and cartilage. If left untreated, the damage can cause a great deal of pain. Shoulder implant coatings are currently made of a variety of materials, including titanium, cobalt chrome, ceramics and pyrocarbons. Pyrocarbon is a very lightweight material that is preferable to traditional steel coatings which are heavy and bulky. Implants coated with titanium are lightweight and have a similar consistency to that of bone. Shoulder implants coated with advanced materials exhibit exceptional bone ingrowth qualities which gives the implant superb strength and the patient increased range of motion.

Knee: Recent advancements in titanium coating characteristics have allowed medical manufacturers to develop knee implants that exhibit superior bone ingrowth to traditional implants. It is the porosity of titanium that allows for bone ingrowth and thus makes it ideal for knee replacement implants. Improved bone ingrowth reduces recovery time and increases range of motion in knee replacement patients.

Hydroxyapatite and titanium implant coatings have made joint implant surgery a more viable, less painful option for many people suffering from joint pain.

Arthritis: Knee Pain and Joint Pain Most Common Symptoms

Do you Suffer from Aching Bones and Stiff Joints?

Arthritis is a condition in which the joints of the body become inflamed. Knee pain, joint pain and knotted or inflamed joints are common symptoms of arthritis which range from mild to extreme. People who suffer from arthritis may find their movement becomes limited by aching bones and stiff and sore joints. Arthritis is most commonly found in the hands, mostly affecting the fingers and wrists, but also occurs in the knee joints.

The word itself "arthritis" literally means inflammation of the joints from the Greek word 'arthron' meaning "joint" and the Latin word "itis," meaning "inflammation".

What to expect from Arthritis

While some of the most common complaints from arthritis sufferers are painful knees and joints, other joints to be affected by arthritis, the hips, finger joints, thumb joints and lower spine. Shoulders, elbows, wrists, ankles, and toe joints are less commonly affected.

Arthritis Care UK estimates that there are close to 10 million people in the U.K. alone that suffer from one form or another of arthritis. This makes it one of the most widely spread conditions in the UK. Seeing as arthritis affects so many people, let's take a closer look at what exactly it is.

Symptoms of arthritis vary in strength and severity; they can often start off mild and become stronger as the condition develops. Knee pain and joint pain may start to develop especially before or during weather fluctuations. Pain may develop in the joints of the wrists, knuckles, fingers, ankles and toes. Shoulders may become stiff first thing in the morning and also give rise to pain. Movement may become limited in the hips and other affected areas.

Knee Pain and Joint Pain - Possible Symptoms of Rheumatoid Arthritis

In rheumatoid arthritis, knee joints can become inflamed and swollen, resulting in pain, joint stiffness and in extreme cases, reduced movement or even loss of joint function. Rheumatoid arthritis affects the elbows, knees, shoulders and hip joints. All of these joints contain a special lubricating fluid called synovial fluid. The fluid of the joints comes under attack from the body's own immune system. Painful and inflamed joints are often symptoms of rheumatoid arthritis that may lead to discomfort and can often making movement painful.

Rheumatoid arthritis symptoms tend to develop gradually, over a period of several weeks and tend to be more common in women than men and usually starts between the ages of 40-60. The word 'rheumatoid' comes from the Gk. rheuma meaning "stream, current, a flowing," as this condition affects the fluid in joints.

Bones become Worn Away in Oseotoarthritis

One of the most common forms of arthritis is osteoarthritis and is caused by a wearing away of the joints, most specifically, the cartilage at the end of the knee and hip joints. Other joints such as the fingers, thumbs and lower spine may also be affected. These are predominantly the weight-bearing joints. The word 'osteon' comes from the Greek language and means 'bone'.

What actually happens to the cartilage when someone has osteoarthritis is that it can become rough and brittle, it literally gets worn down. Sometimes the underlying bone tries to compensate for the additional load on the cartilage and bony growths can occur at the outer edges, making the joint appear knotted and thick. Over time, the affected joints can become stiff and inflamed, leading to pain and often immobility.

There are natural health products that may be of benefit in alleviating the suffering and symptoms of arthritis.

Choosing a Doctor for Knee Surgery

Choosing a doctor for knee surgery is a serious issue to contemplate. Knee surgery is a complex and invasive form of surgery and many people need to be well informed and understand the risks of surgery and the possible use of their knee after knee surgery has taken place. If you are contemplating knee surgery, here are some tips on choosing a doctor for knee surgery.

Choosing a doctor for knee surgery may be a lengthy process. There are many factors that should go into choosing a doctor for knee surgery. Is the doctor experienced with the specific type of surgery that you require, do you feel the doctor has the qualifications to complete your surgery successfully and without complications. Is the doctor's office accessible for surgery as well as after surgery visits. Does the doctor have the latest tools and technology to perform the necessary procedure. As you can see it can be difficult choosing a doctor for knee surgery.

Many people choose a doctor for knee surgery through word of mouth or through a referral from their doctor. Most people usually see a few specialists that can help determine how severe the knee ailments are and what kind of procedures are necessary. Many people usually build up a relationship and respect for a specific doctor and feel comfortable with them conducting the procedure.

There are also referral agencies that can help you choose a doctor for knee surgery. Referral agencies have a large database of doctors and their qualifications and recommend a doctor or surgeon in a specific area usually free of charge. So if you have knee troubles, look at the above tips for choosing a doctor for knee surgery.

What to Look for In a Post Operative Knee Brace

Knee pain, whether chronic or acute, is one of the most common complaints affecting the skeletal structure that doctors see and treat with regularity in an active society. The knee is taxed to bend and rotate and often manages to accommodate such movements when it shouldn't leading to strains, sprains and other injuries.

Among the conditions that can lead to surgery are:

• Ligament Injuries - most often the result of athletic activity affecting any of the four separate ligaments responsible for stabilizing the knee joint. They are the anterior cruciate ligament (ACL), the medial collateral ligament (MCL), the posterior cruciate ligament (PCL) and the lateral collateral ligament (LCL). Injury can occur from twisting the knee with the foot planted, hyper-extension, sudden stopping in the midst of running, shifting weight from one leg to the other, jumping, landing in a flexed position or direct impact to the knee.


• Dislocation of the Knee Cap - occurring after a sudden or unexpected changing of direction on a planted leg position or else from direct impact.


• Cartilage Injuries - having a wide range of causes from genetics, to meniscal or patella tendon injuries, to Osteochondral Defects, to arthritis, to instability from weaknesses, the result of repeated micro-traumas or a single impact.


• Condylar Fractures - affecting the lower end of the femur corrected with a groin-to-toe plaster for un-displaced fractures or surgery for displaced fractures.


• Tibial Plateau Fractures - involving the most critical area in the knee that accommodates load-bearing, the upper end of the tibia bone.


• High Tibial Osteotomy (HTO) - knee surgery to repair osteoarthritis.

The ability to perform myriad movements on a joint as complex as the knee presents the possibility of incapacity. The most frequent complaints of pain and injury come from those participating in such sports as basketball, football and skiing. Recognizing the potential for injury and the subsequent need for recovery that will support the joint during repair, there are a series of post-operative knee braces (link) from which to choose to help in this process.

Selecting a Post-Operative Knee Brace

Rehabilitation and recovery can occur very soon after surgery in most case, with the need to focus on mobility while strengthening the knee. This means being able to have a stabilized range of motion as the damaged knee and surrounding muscles are worked. Immobilizing the knee is necessary to prevent further injury while still allowing for a range of movement, depending upon the degree of injury. In some cases, complete immobilization is necessary to promote healing.

The post-op knee braces available today have features that allow for adjusting compression and range of flexibility through the use of rigid hinges and straps that can be fitted for comfort and adjusted for the best therapy while in use. They have been designed to allow for control of bending and straightening the knee joint along with the flexion and extension that normally occurs through movement. This can be achieved with the use of locking mechanisms that enable a patient to lock the brace out in full extension so as to prevent any flexing of the knee joint, or by degree, depending upon what has been prescribed by the surgeon.

Manufactured in either telescoping or pre-determined lengths for an individual's specific height, these braces are able to accommodate cold therapy wraps or dressings to aid in speedier recovery. Some of the braces have a limited 6 month warranty, in the case of Donjoy post-op braces, while others have a 30 day return policy. Among the manufacturers, there are brands made by Breg, New Option Sports, Ossur, Orthotic Rehab, Donjoy, Hely Weber, Deroyal, Neuroflex, Comfy, Thermoskin and RCAI. These brands represent only the highest quality post-operative knee braces available on the market today.

Information Regarding Arthroscopic Surgical Procedures - A Knee Surgery Brace Can Help!

What is Arthroscopy?

Arthroscopy is a minimally invasive surgical procedure in which a physician uses an arthroscope to evaluate or to treat meniscus injuries, for the reconstruction of the anterior cruciate ligament (ACL) and to treat cartilage microfracturing.

The arthroscope (one of the surgical tools used in the surgery) is inserted into the knee joint through a small incision that your physician will make. This incision is approximately 4 mm (1/8 inch) in length. Another small incision is made so that the surgical instrument being used can work upon the affected area. As a result of using surgical instruments that are smaller than traditional instruments, the procedure can be monitored. For example, a small fiberoptic camera (the endoscope) into the 4mm incision in order to monitor the joint, and the surgery taking place.

Less Invasive

As a result of being less invasive, this procedure can reduce recovery time and can increase the success rate of the procedure. The success rate can rise because there is less trauma done to the joint and its connective tissues. Since it is a less invasive procedure there is also less scarring. In order to make "surgical space" the knee joint will be distended by the use of irrigation fluid. This fluid can sometimes leak into the surrounding soft tissue and cause edema (swelling).

The Benefits of Arthroscopy

One of the benefits of arthroscopy is that most patients can return home, walking with a pair of crutches the same day, or within 24 hours. Many times people will ask how long it will take to heal, and this depends on the reasons why surgery was needed in the first place. Was it an ACL reconstruction, or a meniscus tear? These two different procedures will vary in recovery time. - A person's physical condition will also be a factor to consider in regards to recovery time. It is important to listen to your physician, but is not uncommon for athletes in good physical condition to return to normal athletic activities within a few weeks of the procedure. (See your physician for details).

Common Cause of Knee Pain - Osteoarthritis

Many of the conditions that cause knee pain are more common in younger people, but there is one painful condition of the knee that is more frequent in older patients, especially those who are over 40. This condition is known as osteoarthritis, and it is actually the most common form of arthritis, with millions of people all over the world suffering from it in varying degrees, in their knees as well as other joints in their bodies. Although it is more common in adults over 40, knee osteoarthritis can affect pretty much anyone at any age.

What Causes Knee Osteoarthritis?

There is a smooth articular cartilage that coats the bones that make up the knee joints, the thigh bone, the shin bone and the kneecap. When a patient develops osteoarthritis, this coating begins to get brittle and loses elasticity, and it is much easier for patients to sustain injuries, which will in turn cause even more damage to the cartilage. The person with osteoarthritis will end up with irritations caused by the bones no longer rubbing smoothly across the cartilage during movement, and some patients even end up with bone spurs. There are often mineral deposits in the cartilage of those with osteoarthritis, and the knee fluids thin and do not protect the knee as they should.

Symptoms of Knee Osteoarthritis

Often, symptoms of knee osteoarthritis go unnoticed for quite some time, because it is a gradual condition. One of the first symptoms of the condition is stiffness in the knee. Patients will also notice that their range of motion becomes more and more limited and that they experience pain, especially when going up or down stairs. Weakness, and swelling are also common symptoms. Because there are many different symptoms, in order to correctly diagnose knee osteoarthritis, there will be certain tests performed, including x-rays and MRIs. The patient's medical history will also be studied. Some factors that increase the risk of knee osteoarthritis include obesity, aging, injury and repetitive activities that involve impact to the joints.

Treatment of Knee Osteoarthritis

At one time, it was thought that those with knee osteoarthritis should limit their activity, so as not to put any added stress on the knee, and to keep the irritation from building up. Today, we know differently. It is actually beneficial to maintain regular movement for knee pain relief, because a lack of it will cause the joints to stiffen, making movement more and more difficult and painful. It is important that those with knee osteoarthritis remain active, and there a numerous exercises that your physician or physiotherapist can recommend to help this condition.

Other methods used to treat osteoarthritis include heat and cold. Heat is used to help reduce pain, while the cold treatments are used to ease swelling. Acupuncture has also been known to be a successful treatment, and knee braces are often worn by those with knee osteoarthritis. Weight loss is often recommended, and some patients benefit from over-the-counter anti-inflammatory medications and topical creams.

Once osteoarthritis has been correctly diagnosed, it can easily be treated, and the patient can live a relatively pain-free life, doing their normal activities. If you think you have osteoarthritis, in the knee or any other joint, see your physician, and find out what you can do to treat it now.

Arthritis For Old Age

When a person grows old, the body eventually gets weaker, since it has been alive and functioning for the past, let's say, seventy years. The body is strong enough to stand the test of time, at least for a hundred years or so. Of course, it depends on the person if he/ she maintains their health and body to last them through their golden years. But not all people endure being old. A lot of cases concerning health conditions are showing through old age. Since the body gets weaker, it is more prone to illnesses and diseases that may harm or hurt the person more, hence, they have become more vulnerable to such conditions.

A common type of arthritis that affects people over the age of 60, is osteoarthritis. Since symptoms of arthritis are mainly regarded as joint inflammation, or the feeling of pain or stiffness, this type of arthritis also has the same conditions, but is occurring mostly when of old age. Aches and swelling with weakened motion in the joints, particularly hands, hips, knees or spine are the common symptoms of arthritis, specifically osteoarthritis. According to the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), osteoarthritis is described as the deterioration of cartilage and its underlying bone within a joint; also bony overgrowth. Basically, this illness is breaking down a person's cartilage. Since the cartilage is the tissue that is wrapped around the ends of the joint, having this joint disease will make the bones rub together, causing joint damage over time.

This condition can be very painful if not treated immediately. Due to this illness being parallel to old age, it is very crucial to know the patient's condition as often times as needed. But old age is not necessarily the cause for such disease. Being overweight can be a factor in getting osteoarthritis. It can alter your movements in a number of ways. It will limit your movements up to the point where you cannot reach for that certain object because your fats are way heavier than you think. By not moving that well, or without proper exercise, this may cause to reduction of motion in your joints. Another factor in considering osteoarthritis is by simply injuring a joint. A person who has injured his joint can also lead to this disease, if not medicated promptly or properly.

In dealing with osteoarthritis, it is important to know different kinds of arthritis pain relief. Since most of the people with this illnesses are old, it is crucial for them to be able to function more properly and without pain. Arthritis pain relief comes in the form of simple painkillers, topical pain relief or pain killer creams, pain relief gadgets, exercise, weight control, and surgery. The most suggested method for arthritis pain relief is therapy. There are certain types of therapy that are much considered in dealing with osteoarthritis. Therapies such as massage, pet, warm water, music and hypnotherapy are among them. Moreover, relaxation and meditation are just an overview of possible arthritis pain relief.

With this in mind, it is substantial to know this certain type of arthritis, its causes, and how to relieve the person of it. To our grandparents, or those who are overweight, be sure to ask advice and help from your physician in order to lessen, if not stop, this disease from getting worse.

Knee Replacement Surgery - Get Back on Your Knees!

Knee replacement surgery is an expensive affair in the USA and UK. It can cost anywhere near $50,000 in US. Hence, this surgery is not an affordable option for patients with no insurance or who have been heavily hit by the recession blues. But there's hope for these patients who can now go in for a complete knee replacement surgery that costs just around $8,500 in countries like India, Malaysia, Thailand and Singapore. This is possible because of the high exchange rate of UK and US currencies in relation to the currencies in these countries.

Low cost doesn't mean any compromises on the quality of treatment or the qualification of doctors. In fact, hospitals in these countries use top-of-the-line medical technology and most of the doctors have trained in US and UK. So, you can undergo quality knee replacement surgery at very affordable costs. There are various types of knee replacement surgeries performed on patients.

- The Total Knee Replacement Surgery replaces severely damaged cartilage tissue with a metal or plastic prosthesis.
- Unicompartmental (Partial) Knee Replacement is when only the damaged compartment of the joint is replaced. People with arthritis usually are good candidates for this surgery.
- Bilateral Knee Replacement is surgery performed on both knees as in the case of severe arthritis patients.
- Minimally Invasive Surgery use smaller incisions and therefore less soft-tissue dissections. This type of surgery affords faster recovery.
- Computer-Assisted Surgery (CAS) gives a better internal view and helps in the precise alignment of the artificial joint in the bone and may increase the long-term effectiveness of knee replacements.

After surgery, patients may remain in the hospital for two to six days depending on the procedure involved. Patients receive physical therapy to help them adjust to the prosthesis. Walking aids such as crutches and walkers are needed for about three to six weeks following surgery.

God Remains Faithful Even When We Pull Away From His Love

Even before you were born, God has already prepared a place for you on earth. You already have a spot in His heart even when you're still in your mother's womb. You were brought to this world with the angels celebrating your arrival. The heavens are filled with joy because another child of God is born. You were raised and God has prepared a good future for you.

But then there were times when temptations would knock on your door and problems will sweep you off your feet. These factors pulls you away from God, and you will be left wandering in the desert of unhappiness and fear. You become the slave of the world until you come to the point of giving up your life because of too much pressure.

Many times we've lost our way, lived according to the world, and given up our souls to the call of desires and yet God patiently waits for our return. He sent His son Jesus to rescue the lost. Such a sacrifice that He watched His son died just so He can save the souls of His people. He cries for every souls that are lost and celebrates for every child who comes back to Him.

Whenever you feel like nobody cares for you and you are being swallowed by pressures in life, start looking up and just whisper God's name, he surely will hear you. Most of the time, we prioritize our jobs, careers, and our desire for earthly things. We focus on things that will merely give us more pressure. The lord said in His word that who ever calls unto Him will be blessed. Why worry for your everyday needs when you can pray and it shall be provided?

Many successful people still feel empty and unhappy despite all their achievements. Many rich people die of stress when in fact they have nothing to worry in life. And finally, a lot of people work hard everyday and yet find out at the end of the day that their efforts are still not good enough. They all get tired and start asking themselves where and how to find rest. The Lord said, come to me and I will give you rest. Whoever wants to fill something which is missing in their hearts, you've got God to to the job for you.

People get married and become miserable. The wife starts nagging to her jobless husband. The husband then finds a way to get out of the home and finds another woman. The marriage is already at the point of breaking. As a woman, do you have to bear the pain of losing the harmony and peace inside your home? Turn to God, ask for forgiveness and be humble. He promised to heal broken relationships and restore a shattered home.

You may be facing a cliff while strong winds are blowing from behind you, you cant look down nor turn your back, but you can look up. Say a prayer, its never too late for a miracle. You may be lost in the wilderness with nothing but darkness, dont be afraid, God is with you, just close your eyes and get on your knees, He surely will send a light for you. The Lord never abandons us, He always has our back, all we have to do is call. No matter how far you are, He hears. No matter how hard the walls around you, He can break it. And no matter how painful the situation is, He can heal it. Now get on your knees, and say His name, Jesus.

Osteoarthritis - Definition, Signs, and Symptoms

Osteoarthritis is a group of diseases and mechanical abnormalities that involve degradation of the joints. Sometimes, the degradation can include articular cartilage as well as the subchondral bone that is next to the joint. This condition is the most common form of arthritis and it is also referred to as degenerative arthritis or degenerative joint disease. This disease normally affects the hands, the feet and the spine. It also affects the large bearing joints such as the knees and the hips.

Clinical symptoms of this condition include pain, sharp ache or a burning sensation in the affected muscles and tendons. Other symptoms are stiffness, inflammation and a creaking or a crackling noise when you move or touch the affected joint. You may also experience muscle spasm as well as contractions in the tendons.

Osteoarthritis can lead to loss of cartilage; a protein matrix that lubricates and cushions the joints. When the bone surfaces are less protected as a result of loss of cartilage, the subchondral bone may be exposed and damaged. The re-growths may lead to a proliferation of ivory-like dense reactive bone in the central areas of the cartilage loss. This process is referred to as eburnation.

Although this condition is as a result of trauma, heredity has also been linked as another cause. This disease often affects several members of the same family. Recent studies show high prevalence of the disease among siblings especially identical twins. Sixty percent of osteoarthritis is said to be as a result of genetic factors. Available treatments for this condition include manual therapy, exercise and medications.

Arthritis Treatment: Knee Osteoarthritis - What Are the Alternatives to Knee Replacement?

Arthritis is a term derived from the Greek: "arthron" meaning joint and "itis" meaning inflammation. It is used to refer to more than 100 different diseases.

The most common form of arthritis is osteoarthritis (OA) which affects more than 20 million Americans. Osteoarthritis is a condition that impacts hyaline articular cartilage, the tough gristle that caps the ends of long bones.

Hyaline cartilage is a complex material consisting of a combination of proteoglycans (complexes of proteins and sugars) and chondrocytes. Chondrocytes are located within the matrix... picture a gelatin mold with grapes. The gelatin is the matrix and the grapes are the chondrocytes. Chondrocytes are cartilage cells that manufacture matrix under normal healthy circumstances. They are responsible for nourishing the matrix as well.

However, when OA develops, a distinct change in the joint environment occurs. Chondrocytes begin to elaborate destructive enzymes causing cracks in the cartilage. These are called "fissures" and "fibrillations."

One of the most common areas affected by osteoarthritis is the knee. This is not a surprise since OA preferentially attacks weight-bearing joints.

The treatment of OA of the knee is primarily symptomatic. Weight loss, exercise, physical therapy, assistive devices (such as canes, braces, and walkers), analgesics (pain-relieving medicines), non-steroidal anti-inflammatory drugs (NSAIDS) which also reduce inflammation and pain, as well as thermal modalities such as heat and ice can all be employed.

However, once those resources are exhausted and the patient has undergone injections with glucocorticoids ("cortisone") and viscosupplements (hyaluronic acid..." rooster comb shots"), there is a large void that is present because until recently the only remaining option was knee replacement surgery.

Despite the improvement in technology, knee replacement surgery is still surgery with all the attendant risks of a major invasive procedure in a hospital setting. And the specter of having to have a revision procedure (a replacement of the replacement) done maybe three times in one's lifetime is an unhappy picture.

Recent work using autologous stem cells, sometimes referred to as mesenchymal stem cells looks very promising. (Wei N, Beard S, Delauter S, Bitner C, Gillis R, Rau L, Miller C, Clark T. Guided Mesenchymal Stem Cell Layering Technique for Treatment of Osteoarthritis of the Knee. J Applied Res. 2011; 11: 44-48)

While not effective for everyone, there is abundant evidence in animal models as well as anecdotal data in humans that certain procedures that incorporate mesenchymal stem cells using a framework of fat and stimulated by autologous growth factors may indeed slow down the rate of cartilage loss and may even improve cartilage thickness. This procedure is also undergoing an evolution of sorts just as all other medical procedures do. If the early work is validated, then this approach will certainly bridge the gap between current symptomatic options and surgery.

And just like recent data showing that orthopedic procedures are declining in patients with rheumatoid arthritis, maybe someday the same will be true for, patients with OA of the knee.

Knee Pain - Causes and Treatment

The knee joint is one of the important and most complicated joints. It tolerates the weight of the body and allows us to walk, run, sit, stand and facilitate to name a few. Since this joint that performs so many functions can be bent, straightened, and rotated, it may be put under high risk of injury resulting in knee pain. Knee problems can arise as a consequence of a variety of injuries. These injuries can be categorized as overuse injury and acute injury.

Causes

• Arthritis. There are several types of arthritis that can distress the knee joints.

• Torn ligaments are a type of injury usually suffered by athletes due to sporting activities causing discomfort and instability in knee movement.

• Cases of torn cartilages are generally seen in both youth and elderly people and occasionally obese people, too, happening due to overuse.

• Patellar tendonitis is one of the common causes of knee pain, thus affecting the patellar tendon, which is a large tendon that is situated at the frontage of the knee.

• Chondromalacia patella is caused due to softening of the cartilage and is described as a pain that spreads out from the base of the kneecap. This problem is frequent in individuals in the age group of fifteen to thirty five.

• Dislocation of kneecap is a major injury caused by dislocation and can lead to other type of chronic knee soreness.

• Baker's cyst is one of the reasons that may cause knee pain. Resulting from a meniscus tear; this sort of knee ache is normally accompanied by swelling.

• Bursitis distresses the joint over the knee cap and is an ordinary knee complaint that is caused due to activities that involves a lot of bending and kneeling down while working like construction workers, carpenters and gardeners to name a few.

Treatment

All the problems have cures and hence there are many effective treatments available to address your knee pain. These are as follows-

• Anti-inflammatory medicines- Nonsteroidal anti-inflammatory medications (NSAIDS) are frequently recommended by orthopedics for curing knee pain. This is effective for knee pain that occurs as a result of tendonitis, arthritis, and bursitis.

• Physical therapy- There are very effective forms of treatment for the common knee injuries and can be performed in consultation with a physio therapist. The physical therapy can assist in augmenting strength, reclaiming mobility and facilitating return daily activity with ease.

• Cortisone injections- These are normally used to inject cortisone into the knee joint to lessen or reduce inflammation. One should keep in mind that Cortisone is not a knee pain reducing medication; it's only a potent anti-inflammatory medication.

• Ice and heat application- Ice packs and heat applications are generally used as a first response for knee injury. Alternating between hot and cold packs can be of assistance to reduce inflammation and pain in the knee.

• Stretching- Basic stretching exercises that focus on muscles and tendons around the knee joint are of great help to reduce the knee pain.

Arthritis Treatment: Can Stem Cells Replace the Need for Surgery for Osteoarthritis?

Osteoarthritis is the most common form of arthritis. The Communicable Diseases Center in Atlanta estimates that OA affects more than 27 million Americans. Other estimates tend to run higher. Almost all agree that the incidence is going to climb as a result of the Baby Boomer "epidemic."

There are many symptomatic treatments for OA. These include analgesic medications, topical and oral non-steroidal anti-inflammatory drugs (NSAIDS), physical therapy, exercise, lifestyle modification, bracing, and injections of glucocorticoid or viscosupplements. However, once these fail, there is little else to offer than operative treatment. This is not acceptable.

Recently, there has been increasing interest in the use of mesenchymal stem cells (MSCs) to potentially slow down or even possibly regrow lost cartilage. Animal experiments have been promising and a few anecdotal reports in the literature along with short series have confirmed a possible benefit for humans as well.

Mesenchymal stem cells are sometimes referred to as mesenchymal "stromal" cells because their differentiation is along the lines of stroma or connective tissue.

Among the various tissues, mesenchymal stem cells can evolve into are skin, muscle, bone, cartilage, tendon and ligament, fat, and nerves.

Mesenchymal stem cells are relatively easy to obtain since they are abundant in both the bone marrow as well as adipose fat. MSCs have the ability to differentiate as well as replicate, given the proper environment. This last point is critical to understanding the biology of MSCs.

It is still not known what type of protection MSCs require when exposed to the hostile environment of a joint like the knee, where weight-bearing is such an important task.

It is important to know that a proper stem cell procedure done for OA of the knee involves more than just harvesting stem cells and injecting them into the joint. Selective injury administered to the area requiring repair is absolutely essential. Injury is the first step in healing and is required for stimulation of stem cell differentiation. The extent of injury required is still a subject of conjecture.

Combining ultrasound imaging as well as arthroscopy in order to visualize the area of disease and allow access to it can make the difference between a successful versus an unsuccessful procedure.

On a separate note, MSCs may find usefulness in OA since they do have immunomodulatory effects as well. It is now known that OA is an inflammatory disease that requires disease modification much the same way that RA does. This may be an important component that explains how MSCs work in OA.

What You Should Know About Joint Surgery And Recovery

In the US, as people successfully live longer and more active lives, the joints in our bodies literally wear out and need replacing. No matter if it is a shoulder, hip, knee or some other joint that needs replacing, a more common and successful surgical procedure is joint surgery. As technology has improved and techniques have been refined, recovery time has dropped significantly, however there are still some things you will want to know about recovering from surgery.

Because joint replacement surgery is very invasive no matter the type of joint being replaced, you will have to spend a few days in the hospital. This means you will need to expect to have a hospital stay which may last as much as a week or more depending on the surgery. If you are having hip replacement, expect your hospital stay to be longer than if you have an ankle or knee replaced. Fortunately, with the advances medical science has made with equipment and techniques, extended hospital stays are usually not required.

Once home, you will spend a few weeks going back and forth to physical therapy to carefully build up the muscles around the joint to bring back the strength. You will be required to do exercises at home as well, but physical therapy with a professional is where you will get most of your work done. Unless your job is physically demanding, you should be able to return to work after a couple of weeks. If it is, you may need to consider a change in career or you may need a longer recovery time. However, if you have knee joint replacement surgery instead of a total knee replacement, you may be able to return to even a physically demanding job in just a few short weeks.

You may not be able to do the things the same as you did before or you may experience a full recovery depending on the type of surgery you have. Even though the recovery and therapy process does involve a certain amount of pain, after the process is complete, the pain should diminish significantly and after a few months should be virtually gone. Unfortunately, joint surgery isn't an instant nor a magic process and effort will be required to bring yourself up to where you have as much mobility as possible. However, after recovery, you should be able to get a lot more quality out of your life than before.

Severe Knee Aches and Pains - Does the Pain Have You Begging For Mercy? - Support Can Help You

Do you have severe knee pain problems?

The knee is one of the most important joints in the human body. It supports your weight, and is used in just about every type of physical activity you do. Consequently, when you experience a severe knee ache, your whole life can seem out of sorts. Home remedies, such as ice, heat, over-the-counter medication or rest may help relieve the severe knee ache, but more than likely any such relief is only temporary. The pain comes back, and the more severe the knee ache, the more urgent your desire for relief. Still, you may think that treatment for your symptoms is bound to be expensive, time-consuming, or painful. Fortunately, the answer to your severe knee ache may be something as easy to use, affordable and readily available as a knee brace. - Take a second to read on because this may be the turning point for your knee pain problems.

Severe knee aches and pains can stem from any number of causes, such as over-exertion, degenerative diseases, and traumatic injury, just to name a few. You may have an idea of what is causing your pain (such as the after-effects of an injury you have sustained) or you may not have a clue as to the underlying cause. Typically, only a qualified physician can tell you exactly what is causing your severe knee ache, and this short article should not be considered as a substitute for seeking the advice of a medical professional. But the pain is the same, whether you know the cause or not. Still, whatever is causing your symptoms, generally, a knee braces can help relieve your severe knee ache. - Patient's we have had in the past call their brace a "pain pill".

While knee braces come in may different styles, they are basically all designed to do the same things:

1.) Help support your knee joint

2.) Help keep the knee in a proper position.

3.) Help to reduce your pain and promote healing.

With a properly fitting knee brace, you are less likely to make the condition worse by bending or twisting your knee in an awkward manner because of the severe ache.

In the end, your pain relief is in your hands. You can wait for it to go away by itself, but if it does not the pain is likely to get worse. Knee braces are great because you can start to use one in your very near future and they can be the option that is affordable and long lasting.

Anterior Cruciate Ligament (ACL) Injury In Dogs - Explaining the Joint and the Ligament

When a dog has been diagnosed with a torn anterior cruciate ligament (ACL) the attending veterinarian will probably suggest surgery to correct the problem.

Unfortunately, veterinarians sometimes use language that is difficult for the average dog owner to understand. This, along with the stress that the dog owner is under, makes it difficult to make appropriate decisions for the dog.

Here is what is involved in an ACL (anterior cruciate ligament) injury and its repair, explained in plain English:

In canine patients, the ACL is properly called a CCL, or cranial cruciate ligament. The term ACL refers to the same structure, but in humans. I'll be using the proper term, cranial cruciate ligament, or CCL, from here on out.

The dog's knee joint (the joint where the cranial cruciate ligament resides) is called the stifle joint. The stifle joint is composed of three major bones; the femur (thighbone in humans), the tibia (shin bone in humans), and the patella (knee cap in humans). The ends of these bones are surrounded by cartilage, the slippery stuff that allows for movement. They sit together in a fluid called joint fluid, and there is a seal around the joint called a joint capsule.

The CCL sits inside the joint, with another ligament called the caudal cruciate ligament. These ligaments cross each other, which is where the name cruciate (meaning cross) comes from. This is important later when explaining joint function.

Also in the joint are two shock absorbers called menisci (the plural of meniscus). When the stifle joint is viewed in an X-Ray, the femur and tibia appear to be separated by space - but the femur actually sits atop the meniscus - it's just that ligaments are not visible by X-Ray - so the CCL doesn't show up on an X-Ray.

The function of the stifle joint:

The stifle joint is a complex joint; but here's an analogy that might help: Think of the stifle as a hinge that can only swing two ways, forward and backward; not laterally. The center of the hinge is inside of the stifle joint. When it swings forward, it bears weight. When it swings backwards (in the swing phase of gait motion) it is non-weight bearing.

As you know, when you walk, only one foot is on the ground at any one time. The cranial and caudal cruciate ligaments are there to keep the femur in alignment with the tibia during motion. These two ligaments, which are in the shape of an X, maintain appropriate contact between the two bones.

The CCL attaches in the back of the femur and comes forward to attach to the front of the tibia. The caudal cruciate ligament attaches on the front of the femur, and goes backwards to attach to the back of the tibia. Where they cross each other is the "hinge" point.

Once you understand this, you can will have the basis to understand what happens when the cranial cruciate ligament ruptures.

Osteoarthritis of Knee Diagnosis and The Healing Process

Among the most frequent joint diseases is osteoarthritis of knee. It occurs when the cartilage suffers gradual wear and tear. According to doctors, the cartilage is a cushion layer situated between the knee bones. Also called the degenerative joint disease, osteoarthritis could as well affect other body joints. When the cartilage deteriorates, the knee joint feels stiff and sore. In the last steps of the disease, the pain and discomfort is unbearable. Consequently, the sick person could hardly walk steadily or even try to move his or her knee freely. Since the cushion between two bones no longer exists after degeneration, any movement will cause friction. This is because the bones will grind against each other. The result is intolerable soreness and discomfort.

The causes of osteoarthritis are numerous. However, not all the cases of the disease are necessarily similar, in terms of severity and frequency. The following is a brief outline of the known causes:

• Chances of developing osteoarthritis are high if you have had a serious knee injury in the past

• Being overweight is a good cause of many diseases, including this one. This is because heavy weight pressurizes the joints, as you walk. Consequently, the cartilage layer will slowly wear away

• Some cases of degeneration joint disease is gender specific

• Aging is generally the main cause of weaker joints, which eventually result to osteoarthritis

Several knee diseases show up closely related symptoms. Therefore, if you diagnose your problem, you are likely to be very incorrect. The most recommended action to take is to visit your doctor. He or she is in a position to examine your knee expertly. If you have this disease, you will generally have the following symptoms:

• Knee join soreness, stiffness and unbearable discomfort

• You will find walking as a punishment. If the knee joint cannot withstand your body weight, you cannot move properly.

• The cartilage degeneration continues to occur, as you try to figure what is happening to your knees

It is very important that you always take your health seriously. If you notice the above signs, do not take chances. Visit your doctor right away. This is fastest method of preventing more damage to the knee joints. When the physician is performing diagnosis, he or she will ask you to talk about your knee pain. In short, he or she will find out how worse the soreness gets, if, you workout and then rest. The doctor is much more likely to examine the problem with leg movement. Do not fear the check up exercise.

Your doctor might squeeze the joint slightly, but he or she may recommend an instant X-ray of the knee. The X-ray shows the exact cause of the soreness and discomfort. As some of you already know, osteoarthritis of knee disease is broad. To find out if a patient has other types of this disease, the doctor might take a blood sample. The treatment procedure could differ from patient to patient. Nevertheless, doctors recommend therapies to alleviate the knee joint pains. Generally, he or she will ask you to do the following:

• After a walk or any form of knee exercises, you should always take your time to rest

• For twenty to thirty minutes, you could place an ice cube on the painful parts of the knee. Do this everyday to minimize inflammation. It will ease the pain too.

• Take a specific over the counter cure. Never decide personally the medicine to pick between ibuprofen and acetaminophen. The doctor should guide you

• For stronger muscles and joints, you need to focus on special exercise. You need to work with a practitioner, who understands osteoarthritis of knee disease very well.

• In severe cases, physicians prescribe surgery.

How I Treated Arthritis in My Pony, Ben

My little pony Ben who was 13 h.h. that I had from a young child suffered from arthritis in his old age, Ben had a knee injury he had before I had him and I loved him to bits.

When the arthritis started to effected him he was around fifteen years of age, this is when he started to have slight joint puffiness , now this might sound strange to you but if you have a pony with this condition putting them into complete retirement could be the worst thing you could do because joints need strengthening muscles to protect them but with your vets assistance with a regular exercise program tailored to your horse or ponies needs and age, you can increases his joint-fluid circulation and get his nutrients up while getting wastes out, this will help keep his cartilage as healthy as possible. Whilst keeping his appetite up, his digestion system working properly and his attitude of well being going nicely.

Specific nutrients added to your horse or ponies nighttime feed can have a significant impact on his joint health, consult with your vet for a list of these and get him or her to help you put together a diet plan with supplements like I did as this can really help a lot.

Never change your horses diet without consulting with your vet first as this can be damaging.

I worked Ben's affected joint passively, all that this means is that I used a range-of-motion exercises to en-courage cartilage and soft-tissue healing in his inflamed joints that decreased his scar-tissue formation as this is what causes a loss of range of motion. I used a blend of aromatherapy oils and took the advice of a physiotherapist friend at the time on the best way to do this, so I was self trained but now you can get the information on the internet by using your search engine, but one of the main things to do is to gently massage, bend and straighten the affected joint or joints between 7 to 10 times.

This is the mixture I used watered down.

1) Black pepper: Commonly used for stimulating the circulation, muscular aches and pains.

2) Yarrow oil: Used to reduce joint inflammation.

3) Geranium oil: Used as a circulation tonic.

4) Juniper oil: Used as an anti-rheumatic.

5) Lavender oil: Brilliant even on its own for rheumatisms and for muscle's pain.

6) Lemon oil: Is well known for its stimulating antiseptic powers as well as being very good for arthritis.

Do you love your pony enough to have it living in your house? I did and it was the most marvelous and rewarding experience.

I used to take Ben for walks every day just like you would a dog on a lead. Ben loved to go down to the beach in the summer and would go into the sea with me, or should I say alongside me to swim, this I believe also helped him a lot, plus of course he loved doing this, he was after all one of the family. He especially liked his aroma therapy bath when we got home. I have very found memories of the way he would lift his upper lip and laugh at me when I washed him down, and run around after me like a spring chicken in the garden. Ben's last summer was such a happy one a real treasure in my minds eye.

Towards the end of Ben's life, and he lived to 32 years of age, he needed warmth in the winter because of his arthritis, so for the last winter of his life Ben slept on a huge mattress in front of our oil fired central heating radiator in our kitchen, now he could go in and out as he please into the garden, as he could open the door himself, and believe it or not he could also close it when he came back into the house. He never did a dirty in the house, and yes my kitchen door was a half stable one with an easy latch for Ben to use.

I do hope that this article helps another horse lover out there to make the most out of the later years they have with their horse or pony as I did with Ben.

Why You Need A Hinged Knee Brace

As the name suggests, this brace has a hinges in it. These hinges make the brace different from a general knee brace whose material is made from cloth. The general types are used to provide basic protection and support. A hinged knee brace provides advanced support and protection.

How a hinge knee brace is made

This brace has metal reinforcements that are connected from one end of the brace to another using hinges. Two or three hinges are most commonly used to give a stable brace. A hinge brace can either cover a thigh's lower section, upper region of the leg, or the whole knee cap region. Materials used in the brace are fabric, neoprene, various types of metal, and elastic.

This brace protects the knee from crashes and slips leading to injury. Depending on its model and make, a hinge brace can cost between $30 and $300. These braces are found in numerous colors from white, to classic black, to modern blue. With the braces strapped, you can engage in a preferred sport for longer periods of time without worrying of an injured knee. There are hinge knee braces that are tailor made for basketball of football players.

Common ligament injuries

ACL injury is a common ligament injury. It occurs when you twist without feet movement, change directions suddenly, or slow down quickly. This can lead to partial or complete tear of the ligament.

When the outside region of a knee joint is struck, it can lead to MCL injury. The knee may buckle causing the inside area to widen. When this ligament is over-stretched, it can lead to tearing or injury.

PCL is another ligament that can be injured. This may occur when there is direct impact on the front of the knee, for example, during football. When the knee is hyper-extended, it can also lead to PCL injury.

These injuries cause the knee to become unstable. Pivoting, twisting, or turning will become painful. There will be difficulty walking up or down the stairs. These injuries therefore need a brace support to facilitate healing of the ligaments. A hinge knee brace is ideal for such cases. This brace will keep your knee from twisting or bending. The brace protects your knees by controlling their range of movement. The hinges allow for adjustment on how far the leg should flex and extend.

The dynamic feature of this brace allows motion in spite of the hinges that give a rigid support to the knees. The purpose of the hinged knee brace is to control movement and give a stable support to a knee joint. The brace can also be used in case of a knee injury or surgery.

Play Doctor With an Online Surgery Game

If you have ever wondered what it would be like to operate on a person's heart or how a doctor may operate on a person's knee, you may not have to wonder for long. One of the many kinds of games you can now find online and play for free is a surgery game. This kind of a game comes in many variants and can be played either as a serious game that educates you on the intricacies and complexities of surgery or as a wacky game that makes you do crazy things with a person's body or organs.

There are a number of free games that focus on surgery online and finding them is pretty easy. You will find that there is a surgery game for the body part you are most interested in learning about or in experimenting on. There are games that make you operate on a person's heart, a person's brain, a knee, a hip and many more. Of course, those who aspire to become surgeons in the future can get their basic operation lessons at a early age and in a fun way with these games that both children and adults can play.

If you are into morbid games that show people operating on others with the use of tools that are not used in regular surgery, then you will be glad to know that there are a lot of those online too. There is a surgery game that gets you to use unconventional surgical tools to operate on your patients and these can include such weird items like a pizza cutter, a stapler, salad tongs, a kitchen knife and even a cigarette lighter. This weird yet fun game can prove to be very addictive and very funny at the same time as you try to work your way into the surgical business with the help of these tools.

Knee Maintenance and Care For Runners - Go Easy!

The human "second gear" is perhaps the most natural, simple, and effective form of exercise for our species. Walking, of course, is an excellent way to improve heart, respiratory, joint, muscular, and digestive health. Running simply pushes this benefit to a higher level. The whole body clicks into overdrive: it is the flight response used for centuries by our ancestors. Add some adrenaline to our run, and we leave our pursuers in a cloud of dust. These days, we mostly have a "personal best time" as our adversary. Yet we must also be careful; other adversaries exist that cannot be ignored.

One of the main complaints of both first-time runners and their seasoned counterparts is knee pain. Running puts considerable strain on the knee joint. If a runner is new to the sport, it is easy to over-train at the beginning. Take it slow, build your leg and joint strength. Establish a base of knee stability to prevent injury down the road. Experienced runners who are working on adding mileage for a new race distance should also take care: 10-kilometer conditioning and strength needs to be carefully modified if a 26-mile marathon is the goal. Knees will adapt to this new challenge if given the stability to do so. If two miles of moderate running cause pain at first, back off and rest. Give the knees time to stabilize.

Stability is essential to keep the knee working properly. Correct leg muscle development, obtained through gradual increase of mileage and intensity, will create stability. The quadriceps (on the front of the thighs) and hamstrings (on the back of the thighs) work in conjunction with each other, pulling on different areas of the knee at the same time. If these muscles are developed correctly, the knee joint will glide over and under itself without undue strain. Let's not forget the tiny, yet indispensable patella, as well. This engineering marvel glides over the front of the knee, adding stability and providing a liaison between thigh and lower leg bones. Thus the knee has been described by medical literature as being three articulations in one: draw a circle in the air with your toe, and you get the idea.

If more than a casual couple of miles per week are the runner's goal, it is mandatory that he or she invest in correct running shoes. People come in all shapes and sizes. Some people pronate, or roll the weight of their body to the inside edge of the foot. Others supinate, or roll the weight to the outside edge. Men and women even have different angles from hip to knee. This is why there are specific running shoes by gender. The best way to be fitted for running shoes is to visit a store that provides treadmill analysis. A shoe fitter will watch, or even video, the runner's heel strike to determine what kind of shoe is best to support the customer's body and running style. Yes, these shoes will probably be twice as expensive as the bargain-rack pair. However, to a runner, healthy, pain-free knees are well worth the price.

Novel Methods of Injury Rehabilitation: How to Heal Fast Starting From the Bottom Up

With time, we learn. Advancements are made daily, but sometimes the original concept is better. Injury rehabilitation is a great example of both progression and regression. In this article, I will show you when "out with the old, in with the new" is good for lower body rehab, and when it's best to "get rid of the new, and go back to the old!" Here we go...

Treat Ankle Injuries with METH

Let me start by telling you about my experience with METH.

The date: Tuesday July 19, 2011

The place: my backyard

It was a hot summer day, and I decided to finally trim the branches that were rubbing against my shed. I hopped on the fence behind the shed, did what I had to do, then I jumped down. The distance was a little further than I expected, and I ended up rolling my ankle over some river rock.

At first, no pain. A few hours later, lots of pain! There was no time for discomfort, though. I had a slew of training sessions ahead of me. But as the night progressed, so did the swelling and pain! By the time the last person left I could barely move, let alone walk. That's when I took action.

The standard procedure for an injury like this involves anti-inflammatories and pain-killers along with RICE: rest, ice, compression, and elevation.

What did I do?

Almost the exact opposite!

No rest and no compression - I used movement with traction instead. According to Dr. Tim McKnight (2010), rest will lead to atrophy and weakness and may disrupt balance and proper body positioning. Furthermore, compression can shut down blood flow to the area; whereas, traction will release the pressure and movement will encourage blood that is rich with healing factors, such as oxygen and white and red blood cells, to flow to the area. In addition, movement with traction reduces pain, enhances lymphatic removal of inflammation, improves flexibility, and restores normal joint alignment.

Absolutely no ice - I used some moist heat instead. Again, the key is blood flow. If you want something to heal, it requires blood! Do not slow down this process with ice. However, I did use varying degrees of elevation throughout the process. I learned this procedure from Dick Hartzell, co-author of the book Don't Ice that Ankle Sprain. (Keep in mind that this procedure is for grade 1 or 2 sprains only.)

I term this approach METH: movement, elevation, traction, and heat.

Did I take anti-inflammatories and pain-killers? Well, yes and no. I took proteolytic enzymes (natural anti-inflammatories), and I took them by the boatload on an empty stomach.

The end result: no pain and full function the next day, full leg workout 2 days later, and medicine ball circuit at a local soccer field 4 days later. This injury was rehabilitated in mere hours, not days or weeks. I bet you if I used the RICE approach, it would have taken much longer!

Bottom line: Forget RICE, do METH instead to heal injuries fast!

Volume Training for Knee Rehabilitation

Now we'll cover knee injuries, specifically post-surgery rehabilitation of knee injuries... but first let's touch on a topic that is very popular in strength training, volume training.

There are many excellent volume routines out there. One of the most popular systems involves the 10 sets of 10 reps method, like the German Volume Training (GVT) protocol that was introduced in the July 1996 issue of Muscle Media 2000. This type of routine is geared toward rapid and maximum hypertrophy - a lot of size in a short period of time!

Is it a new concept?

Not really. You will see this system scattered among the literature over the decades from various sources. For instance, in a paper originally published in the Russian journal Teoriya i Praktika Fizicheskoi Kultury, authors Vaitesehofsky & Kiselev (1989) discuss a protocol involving 10 sets of 10 pull-ups where the weight is reduced every second set (i.e., additional loading is used to start such as 9kg, then down to 6kg, then 3kg, and then body weight to finish) or the grip is altered in the latter sets to draw new, unfatigued fibers into work. Long-time Ironman contributor George Turner outlined a similar approach in his Real Bodybuilding audiotape series in the nineties.

What does this have to do with injury rehabilitation?

Well, think about it for a second. What are three things you need to reestablish after an injury, especially post surgery? If you said range of motion (ROM), muscle mass and strength, then you are correct. The quicker you can achieve these objectives, the quicker you can return to your activities of daily living and/or athletic endeavors. Intensity initially will be low because strength levels are low (pain and inflammation can inhibit strength), but in order to accomplish your objectives in short order, you must repeat a sufficient stimulus frequently. A volume training routine may fit the bill nicely if it is conducted properly.

You with me so far?

Okay, let's take a Pulp Fiction moment and go off on a tangent.

The Famous DeLorme Scheme

If I asked what the most popular set/rep scheme in strength training is, most people would respond with 3 sets of 10 reps. It seems to be the universal training prescription, but where does it come from?

The concept stems from a 1948 paper by Dr. Thomas DeLorme and Dr. Arthur Watkins where they recommend 3 sets of 10 reps using a progressively heavier weight in the following manner:

Set #1 - 50% of 10 repetition maximum
Set #2 - 75% of 10 repetition maximum
Set #3 - 100% of 10 repetition maximum

In this scheme, only the last set is performed to the limit. The first two sets can be considered as warm-ups. A few years later in their 1951 book Progressive Resistance Exercise, DeLorme & Watkins state: "By advocating three sets of exercise of 10 repetitions per set, the likelihood that other combinations might be just as effective is not overlooked." Still, the majority of trainees today automatically adopt the 3x10 scheme as if it were written in stone.

The Not-So-Famous DeLorme Scheme

Now, let's take a little journey back in time to 1945 when the same Dr. Thomas DeLorme unleashed a powerhouse of a paper titled "Restoration of muscle power by heavy-resistance exercises" published in the Journal of Bone and Joint Surgery. Back then, far more than 3 sets were recommended per exercise with great results. The clinical observations made on 300 cases showed a "splendid response in muscle hypertrophy and power, together with symptomatic relief", as DeLorme put it. Why change the system then? We'll explore that a little later, but first things first...

The 1945 DeLorme method consisted of 7-10 sets of 10 reps per set for a total of 70-100 repetitions each workout. The weight would start off light for the first set and then get progressively heavier until a 10RM load was achieved. The workouts were short (on average about half an hour), but they were repeated frequently during the week. In GVT, for instance, each body part is trained once in a 5-day period. With the 1945 DeLorme system, the injured body part is trained once a day for 5 days straight! Of course, the difference is due to the direct relationship between intensity and recovery - the greater the intensity, the more recovery is necessary, and vice versa.

If you adopt this approach, will you be sore initially?

Yup!

Will the soreness subside after a week or so?

Yup!

Will you be ecstatic with the improved hypertrophy, strength, mobility, and function after just a few weeks while others are complaining that they can barely move and are in an extreme amount of pain?

Yup!

Now, here is where it is important to read the entire paper and not just the abstract. DeLorme insists that a pulley system (common with most selectorized machines today) must not be used. Instead, use an iron boot, plate-loaded machine, or simply ankle weights to overload the terminal end of knee extension. This method will increase the overload on the vastus medialis oblique (VMO) muscle, a prime stabilizer of the knee (weakness of this muscle can impair function and cause pain of the knee.)

Of course, there are many ways to skin a cat. Terminal knee extension can be performed as a more "functional" closed kinetic chain (CKC) movement (i.e., standing with a band or cable attachment strapped behind the knee or by performing a low amplitude step-up) rather than the seated, open kinetic chain (OKC) option mentioned previously. However, DeLorme points out that weight-bearing exercises produce symptoms of pain, thickening, and fluid in knee joints that are controlled by weak, atrophied muscles. It may be best to implement CKC movements only after strength is matched in both limbs through the use of non-weight-bearing OKC movements.

Also, many patients are told to stop all activity until the pain goes away. I do not agree! I have talked about this issue many times in the past so I won't dwell on it much further; however, if you feel that you should rest the area, get some treatment here and there, and everything will return to normal, think again! You can do all the soft tissue work in the world to try to break down fibrotic tissue - the muscle will still be weak, atrophied, and hard! If you truly want to make progress, stop "pampering" the muscle and start exercising with progressive resistance. DeLorme makes that quite clear.

Back to the question: Why change from as many as 10 sets to only 3 sets?

This is what DeLorme & Watkins (1948) had to say: "In the initial publications concerning progressive resistance exercise, 70 to 100 repetitions were advocated, the repetitions being performed in 7 to 10 sets with 10 repetitions per set. Further experience has shown this figure to be too high and that in most cases a total of 20 to 30 repetitions is far more satisfactory. Fewer repetitions permit exercise with heavier muscle loads, thereby yielding greater and more rapid muscle hypertrophy."

That sounds reasonable, but before we go on let's establish two relationships:

1. There is an inverse relationship between intensity and volume (i.e., the higher the intensity, the lower the volume, and vice versa).


2. There is an inverse relationship between intensity and frequency (i.e., the higher the intensity, the lower the frequency, and vice versa).

If intensity starts to increase yet the frequency stays the same, something has to give! At a higher intensity, one all-out 10RM set can be performed 5 days a week. It's really only a total of 5 sets spread throughout the entire week. (Yes, I know that there are 3 sets performed each workout, but as mentioned earlier the first two sets are merely warm-ups.) Contrast 5 sets to as many as 50 sets (although not all of those 50 sets are taken to the limit), and you'll quickly realize why the 1948 "3x10" method was considered superior to the 1945 "10x10" method, but hold on a second. DeLorme still experienced quite a bit of success with that original method, and I do believe that it still has merit and can provide a "more satisfactory" result if it is implemented in a specific manner.

Here it goes: If intensity increases and volume stays the same, the variable that must decrease is frequency to allow for sufficient recovery. Using the 10x10 method may in fact be more superior if the frequency is altered as follows:

Stage #1: 5 days a week (Mon, Tues, Wed, Thurs, Fri)
Stage #2: 4 days a week (Mon, Tues, Thurs, Fri)
Stage #3: 3 days a week (Mon, Wed, Fri)
Stage #4: 2 days a week (Mon, Thurs)
Stage #5: 1 day in a 5-7 day period

Now, how long each stage will last will depend on the individual and their injury, but the key is to make progress each week and once that starts to stagnate, it's time for the next stage. Think of it as progressive resistance meets regressive frequency! By Stage #5, muscle strength, mass and ROM should be back to normal - this is the frequency used in most volume training routines.

Try this new twist to the original concept introduced by Dr. DeLorme over 60 years ago.

Here are some take-home points:

• Read an entire study not just the abstract, and as much as possible check the references.


• The 10 sets of 10 reps method is by no means a new method, nor is it meant strictly for bodybuilders. This form of volume training may be an excellent way to rehabilitate an injury.


• The primary objective during injury rehabilitation is to restore muscle strength, hypertrophy and range of motion. Endurance training can be counterproductive to these objectives and should only be implemented when strength of the limbs involved are approximately equal.


• During injury rehabilitation, pursue active (not passive) treatment with the use of progressive resistance exercises conducted at regular intervals with maximum effort.

Captain Thomas L. DeLorme, M.D., a renowned orthopedic surgeon at Massachusetts General Hospital, developed some novel methods to speed up the rehabilitation of injured soldiers during World War II. A true pioneer in the strength game, Dr. DeLorme passed away on June 14, 2003 at the age of 85, but his concept of progressive resistance exercise lives on today.

References available upon request.