Saturday, December 28, 2013

Knee Pain and Arthritis: You Don't Have to Suffer Anymore


I was like you: years ago I started having knee pain; it worsened with time to the point that:


  • I could no longer walk normally; I found myself limping often and I was no longer able to move my right knee as I used to: it seemed to have lost much of it earlier flexibility. I remember so vividly how I was in Vegas with my partner and, whilst having a fantastic time as we always did there, all I could think of was my knee pain; I was limping so severely that I looked as if I was walking with a massive cast all over my right leg. The pain was, needless to say, excruciating.

  • I could no longer sleep well because my knee pain was constant; lying in bed brought no relief and there was not one single position I could assume which would even remotely relieve me of some pain.

I tried with all sorts of painkillers but they never worked for me: the pain would never go away. Then, one day, as I was struggling to move around in my garden, I noticed that my right knee was now dramatically swollen: it looked and felt as if water had formed around it, under the skin. I was scared; it was the day when I envisaged that, sooner or later, I would have to function with the help of walking aids, at the very least and, in the worst case scenario, with a wheelchair.

I am a self-taught type of person and I always want to find out my options before I take a course of action. I also tend to favor natural or 'healthy' ways to achieve perfect health or recover from sickness. Thus, I began researching supplements and other natural ways to stop my disabling knee pain and arthritis.

There are many natural supplements which can help against knee pain and knee inflammation (including knee swelling): these include, above all, meadowsweet, which is supposed to help against pain and inflammation in any affected area of your body; at the same time, it's a powerful astringent (it tightens tissues) and has fever-reducing properties; finally, it also helps your body eliminate all excess fluid, which means it'll contribute to relieving your joint from the liquid formation all around it which may cause swelling (it certainly did in my case).

Other supplements include willow bark, butterbur, St John's wort and Jamaican dogwood.

I take omega 3 and Evening Primrose oil, as well as Vitamin D and calcium as a general preventative measure for the future; however, I also concentrate on ingesting a lot of inflammation-reducing foods and inflammation-reducing supplements and herbs.

Moreover, when I was at my worst (just after my horrible experience whilst I was in Las Vegas) I started homeopathic treatments to help my body 'help itself' and treat the 'cause' of what made it so vulnerable to knee degeneration.

Today I have regained complete mobility of my knee; I walk, I hike, I go to the gym, I walk up and down stairs, I sleep like a log and I do absolutely anything and everything I used to do when I was a teenager.

This could be you too.

Shoulder Resurfacing & Replacement - Avail Low Cost Surgery & 5 Star Service


Do you need to get your shoulder replaced or resurfaced. You can get this done for a low cost but at a five star service in India.

Shoulder arthritis is the second most common form of arthritis of the peripheral joints. Rheumatoid arthritis, post traumatic arthritis can all cause arthritic damage. Till now the treatment has been a total shoulder replacement. Shoulder resurfacing is now emerging as a superior alternative to replacement in India.

It is being provided for affordable costs in state of the art hospital facilities in India. International medical travel is bringing many western patients to India for shoulder resurfacing. Many international patients come to 5 star hospitals in India seeking value medical treatment like shoulder resurfacing.

Shoulder arthritis is less common than hip & knee arthritis in India. It mainly affects older individuals.

Causes of shoulder arthritis are:
• osteo-arthritis
• rheumatoid arthritis
• avascular necrosis
• rotator cuff tear arthropathy
• post traumatic arthritispost septic arthritis
• post tubercular arthritis

In shoulder arthritis like any other arthritis, only the top surface of the upper end of the arm bone (humerus) is affected. The socket is usually not damaged. There is no bone loss. The traditional operation for a shoulder arthritic problem is a shoulder replacement. However this involves sacrifice of bone. A shoulder resurfacing on the other hand preserves bone and can be performed in 95% of cases for the above mentioned conditions.

Shoulder replacement vs shoulder resurfacing

In a conventional shoulder replacement, the damaged parts of the joint comprising the shoulder joint are completely removed and replaced with a metal and plastic prosthesis. The metal portion is buried into the shaft of the arm bone (humerus). It has a stem and ball shaped end. The socket is made of polyethylene with a metal back and stem buried into the outer end of the shoulder blade.

In a shoulder resurfacing on the other hand, the top end of the arm bone is shaped to a hemispherical shape with cheese grating reamers. A central hole is drilled in the centre of the head of the humerus. The prosthesis made of Cobalt chrome, molybdenum and coated on the inside with hydroxyapatite is impacted in. Hydroxyapatite allows natural bony in growth over time and fixation.

The operation is done through a minimally invasive approach under either general or regional anesthesia.

The implant helps in preservation of natural bone and tissues of the patient.

It is seen as an ideal option for the younger, active patient who wants to lead a normal life. This cement less implant utilizes a patient's natural t issue growth. It can also be used in the older arthritic patient with good bone stock.

Shoulder resurfacing prosthesis

The Copeland shoulder prosthesis from Biomet is an example. This is the only surface replacement with the longest follow up. It was recently introduced in India.

At Indian hospitals, cost of surgery is low and is affordable by most international patients. Hospitals have state of the art infra structure and could be called as five star hospitals. The OR's have clean air which ensure a safe outcome after joint replacement. Rooms cater to all budgets ranging from suites general wards.

Shoulder resurfacing in Indian hospitals therefore has a chance of becoming a much sought after operation for international patients seeking treatment in India. You will get a high quality service at a very affordable cost.

Stand Up Paddle Boarding Part 1 - The Basics


Nearly every time I am out on my stand up paddle board I chat with some one on the shore or a boat or a bridge who comments "you make that look so easy!" My answer? "It is pretty easy!" And it's true. Stand up paddling is something that I think nearly everyone can do if they want to.

If you are new to the sport of stand up paddle boarding there are a few basic concepts that will help you to be better right from the start and decrease your chances of getting wet when you don't want to.

When getting on the board you want to start on your knees in a wide stance in about the center of your board. Usually the center is right where the handle on the board is so you can use that for guidance.

The most immediate and important concept with this sport is balance. When standing from your kneeling position you want to take note of where your knees are on the board, that is where your feet will go. You want a wide stance and your weight distributed evenly on "all four corners" of your feet. It helps to lift your toes once in awhile to help improve your balance and keep you from trying to grip the board with your toes and it helps keep your feet more relaxed.

Keep your knees bent and your body in an upright position not bent over or leaning forward from the waist. If you lean forward your center of gravity will be forward and you will have a far greater likelihood of losing your balance and falling.

It is nice to remember that if you encounter a large wave coming toward you that looks like it will knock you off your board, such as a wake from a boat going by, you can always drop to your knees and ride out the wave that way. It is very easy to stay on the board when you are down low and close to the water. If the wave is not too big you may want to try to stay upright and practice keeping your balance in this rougher water. It's not as hard as it might seem.

Remember that the forward momentum you get from paddling makes it far easier to keep your balance than when your board is stationary. So don't be afraid to move. Movement is your friend. The hardest way to balance is when your board is not moving.

If you don't have much experience paddling, please read part 2 of this article which has some basic instructions on how to paddle.

Lower Back Pain Relief - Are Shoes Important?


Proper footwear is a very important consideration when it comes to back pain relief. Not wearing the proper footwear can be a major contributing factor to ongoing lower back pain. If the correct footwear is being worn, it can help decrease pain by properly aligning the foot when it hits the ground and during takeoff. If the foot is aligned correctly when it hits the ground, the forces and weight are evenly distributed throughout the foot, ankle, knee and hip.

When the foot maintains the proper position, it enables the lower leg to perform its duties with increased efficiency. If the foot is not in the correct position, the joints above that area have to compensate for the decreased stability and poor positioning of the foot.

The following are a few descriptions of the most common walking positions and placement scenarios.

Supination - If a person tends to wear out the outside heal of their shoe, they walk in a manner that is referred to as supination. Supination forces the weight to be unevenly distributed along the arch of the foot and it can be a major cause of lower back pain. This is the most common type walking habit that leads to lower back pain.

When a person supinates their foot during the landing phase of walking, their weight is kept on the outside of the foot. This prohibits the weight to be naturally transferred through the longitudinal arch.

Without the use of the arch, the ability of the foot to spring to the next step is decreased and the joints above have to increase force to move the leg forward. While in this position the leg is now forced to swing forward with a circular motion versus a push off motion with the arch and big toes.

This "swing forward" motion causes the back to upwardly elevate the hips in order to clear the toes. In addition, repeated swinging of the leg causes the gluts to tighten and creates additional tension on the lower back. When this happens it causes the spinal system to be less efficient and more vulnerable to muscle imbalance and pain.

Pronation - another common walking style is called pronation. If a person tends to pronate, the inside part of their heel is worn out. This result is walking "knock-kneed". In addition, pronation causes a lack of stability in the knee area and makes a person shorten their stride and have less balance.

When the knees become too painful because of the poor landing position of the foot, the person will stop pushing their foot through the walk cycle and begin to swing the leg like in the last example.

This usually causes more knee and hip problems first, followed by lower back pain. The end result is increased lower back pain.

These problems can easily be adjusted by choosing the proper foot wear. Changing your shoes upon the sign of a wear pattern and working on good walking mechanics can make a real difference. Once you know how your foot tends to land, you can purchase shoes to help reduce your bad habits.

In another article, we will discuss additional important factors to consider while walking. Maintenance and strength of muscles involved in walking, flexibility and how to prevent compensatory patterns which in turn reduce lower back pain.

Knee Brace After Surgery


Are you thinking about having a knee surgery?

Your doctor may have mentioned that you will be needing a knee brace for after surgery. So what kind do you get?

1.) Introduction

Knee braces are used by people to help ensure that their knee is supported and to alleviate the pain that they are feeling. Knee braces are constructed using a variety of materials. They are designed in a way to either cover your knee cap or allow for an open patella. The kneecap is left open in most knee braces available in the market. Remember, you do not always need to cover your knee to help provide stability to it.

It is important to make sure that the knee brace you are wearing is well designed. In reality, a well designed knee support will make a huge difference in the life of a sufferer of injured knees. One of the many benefits that they offer is to help you avoid painful movements that could probably lead to aggravation of the injury you have sustained. This is really important if you think about it. Why push a hurt knee? Why threaten a healing injury?

Right after a surgery you may be wearing a large knee brace that keeps your knee locked out in extension. This can be helpful because everything is very delicate after a surgery and your doctor will not want anything to disturb the procedures results.

2.) As Time Passes After a Surgery

This time period is still considered to be after surgery is done, but you will most likely heal as the days and weeks go by. A knee brace for after surgery now can be seen with different eyes. These braces can still provide you with maximum support, but often times you are allowed to move your knee around more and thus your physician will request that you are allowed more free range of motion to get the blood going.

3.) Your Brace Specialist

When it comes down to it, you may need a couple different knee braces depending on how long after the surgery you are. You will need to talk to your brace specialist with any questions and they can help guide you toward the best options. Do not just go to someone on the internet that does not know what they are talking about. Of course everyone claims to be experts, but you should be able to ask them questions and get some qualified answers when it comes to purchaing one of these supports.

* This is health information. We are brace specialists who have seen the benefits of bracing over the years, but we have to suggest that you speak to your doctor regarding medical advice.

Growing Pains in Children


Growing pains in children can affect up to a quarter of all children at some stage. The condition can be distressing, but is self limiting and goes away on its own eventually. The real concern about the diagnosis is that the term is often used as a throw away term for any leg pain in children and there are a few potentially serious problems that can be dismissed as growing pains.

The true syndrome of growing pains is a bad cramp like pain in the upper calf muscles just behind the knee that usually wakes the child from sleep and lasts around 20 minutes. It is most common in the 4-5 years age group, but can occur up to 12 years of age. The pain does not affect activities the next day. The pains do not occur during the day and if they do, something else needs to be considered. The pain is also not deep in the bone or in the knee joint and if it is, something else needs to be considered. There is also no specific tender spot, so if there is something else needs to be considered.

If the symptoms do not match the classic criteria for growing pains (in the upper calf and at night), then the differential diagnosis needs to consider a juvenile type of arthritis in the knee joint; a pain referral from the hip; or a bone cancer if the pain is deep in the bone.

The cause of the problem is not known with a number of theories being proposed, including biochemical disturbances, hormonal imbalances and musculoskeletal fatigue. No evidence has been found yet to support any cause.

Parents and the child need to be reassured about the benign and self-limiting nature of this condition. When a child wakes with the pain, then simple rubbing or massage of the leg is usually all that is needed to get the child back to sleep. In severe cases, anti-inflammatory drugs at bed time can help. The condition is self limiting and will resolve on its own eventually.

Friday, December 27, 2013

7 Tips for Optimum Joint Health


Joint health is probably not the most important thing on your list of health priorities. But if you've ever had joint problems, such as arthritis, you know that taking your joints for granted is not recommended. A number of factors including poor nutrition, genetics, and aging can contribute to joint problems. Here are a few tips on how to prevent these conditions from occurring.

1) Pick the right shoes.

The "right" shoes are different for everyone. For example, women should avoid continuously wearing high heels because they pace a great deal of strain on the joints in the feet. High heels can also cause problems with the ankles and knees. Osteoarthritis is a common condition that occurs because of high heels.

2) Rest those wrists.

Today's technology advantages increase joint problems more than ever. Some individuals have jobs where they are required to work long hours on a keyboard. This can put extra stress on the hands and wrists. If your job is like this, be sure to stretch out your hands and wrists often.

3) Lost weight (if needed).

Being overweight or obese puts quite a bit of extra stress on the joints. Every extra pound can cause damage to the ligaments and joints around the knee. Find out from your doctor if you are considered overweight and determine a weight loss plan to improve your joint health.

4) Calcium, calcium, calcium.

We all know that calcium is needed for strong bones, but it will also benefit our joints. It's better to get the mineral from your diet instead of supplements, but if you find that you're not eating/drinking many dairy products during the day then you may want to consider one. Also, make sure you eat a healthy diet in general because vitamins and minerals will work alongside each other to keep your bones and joints healthy.

5) Get Your Omega 3s.

Omega-3 fatty acids are another important nutrient for building and maintaining bone and joint health. Foods rich in omega 3s include: cold water fish, flax seeds, and walnuts.

6) Exercise.

Adding physical activity to your routine will greatly improve the health of your joints. Something as simple as a daily walk will do the trick.

7) Joint Supplement.

Another consideration you may want to make to keep your joints functioning is by taking a supplement such as Zyflamend. This herbal supplement is formulated for inflammation response and promotes normal joint function.

Combining all of these recommendations together will prove to benefit your bones and joints. Say goodbye to pain and inflammation!

Natural Supplement For Knee Pain: Will It Give Ultimate Pain Relief?


We employ our knees in most of our body movements. With continuous bone to bone contact, the cartilage can wear out. For that reason knee joint pain is among the most frequent troubles amongst seniors these days. It is typically a part of getting old.

In order to reduce knee pain, health professionals frequently prescribe cortisone shots or an anti-inflammatory drug. The mentioned treatments give temporary relief only yet don't do anything to solve the condition and take it away once and for all. The problem is removed temporarily but the patient with left with the same condition. At times it becomes a whole lot worse when it recurs.

Now and again, pain reliever plus anti-inflammatory drugs accompany terrible unwanted effects. With regular use, cardiac problems can rise or develop. Others negative effects are bleeding, ulcer, perforation of the stomach or intestine. These conditions can be fatal putting seniors at a higher risk. So, it's not worth taking the risk. Do not rely on over-the-counter or prescribed pain killers. These prescription drugs only take away the pain but don't address the real cause of knee pain.

A good natural supplement can certainly give relief from pain and at the same time an even better condition. Cartilage building supplements support cartilage re-growth without side effects. It neither interacts with other supplements that the patient takes. Consequently, it offers the very best knee pain treatment found in the market these days.

The reason why medical doctors do not usually recommend natural supplements is that they receive little training in utilizing natural solutions to address illness. They have little or no clue regarding their nutrition. Also, huge pharmaceutical companies have little fascination with natural solutions simply because they can't be patented. They offer financing for studies on various other medications as well as offer prescription samples and other advantages for medical practitioners to ensure that the latter will suggest them. This has something regarding revenue.

Because of the negative side effects brought by prescription drugs, individuals have began searching for alternative solutions. Natural supplements for ailments and diseases are getting attention from these individuals these days. With the type of treatment of pain relievers as well as side effects of doctor prescribed medicines, re-growing knee cartilage by natural means would be the very best option for you.

I am not suggesting to disregard your doctor's advice. You just might wish to give consideration to trying a natural supplement for knee pain. Natural supplements for knee pain treatment commonly make use of glucosamine and chondroitin - ingredients that have been proven to help resolve joint problems.

Knee Brace With Side Stabilizer - The Two Types - Read This Or Risk Wasting Money!


Knee Braces With A Side Stabilizer

Does your knee cap ever deviate from its normal position?

Do you have pain when you move your knee from side to side?

Introduction: When you are looking for a knee brace, you need to do a little bit of homework first. There are so many different types that you do not want to waste your money, because you did not read this important article first. This free information can help clarify the two different types of "side stabilizing" knee braces, so you can make the right choice on a brace when the times comes.

Side Stabilizer Type #1

Many times people's knee caps can migrate laterally when they move. Sad but true. If you ever have problems with your knee cap moving out of place then you need to think about using a low profile, light weight brace for support. - It is a hassle to feel your knee cap jump out of place. But the mental aspect of watching this happen is also disturbing. - Maybe you know all to well!

Many knee cap stabilizing braces are elastic in nature, and then they will have an elastic strap that provides a dynamic forces going from the outside of your knee cap toward the inside of the knee. This will help to hold your knee cap in place.

Side Stabilizer Type #2

If you do not have knee cap problems then you will want to look into a knee brace that stabilizes the knee in a different fashion. Basically, what you are looking at is a knee brace with medial and lateral hinges. This type of support can help prevent excessive medial and lateral movements that cause pain and irritation to the knee joint area. It will help to control gross motions, not just the deviation of the knee cap.

They come in a lot of different sizes and a general rule of thumb when it comes to knee supports is the more deluxe or large the knee brace, the more serious the knee injury! If you have a serious knee injury, you do not want to go with an elastic type of support. You will want to rate your knee instability and pain on a mild, moderate, or severe scale. Next, you will want to ask your knee brace provider with any questions if you are confused about selection. (This is helpful health information, but you should speak to your doctor about medical advice.)

Rank of Best Penis Enlargement Pills


Where does Prosolution Pills rank among the best of penis enlargement pills?

There is no comparison, really. The best penis enhancement pills available on the Internet have just gotten better. In case you're wondering what could possibly be better about a product that was already number one on the market, then hear this: the new formula used for the pills is so potent that customers are no longer required to take three pills per day. Only ONE pill per day is now enough to bring you the same great results you have been used to.

The pills are endorsed by an MD, doctor Khalid Alzwahereh, a Medical Herbalist, G. Alexander, and a Doctor of Clinical Psychology, Michael Carter. This has further served to secure the trust of customers and to consolidate the top rand and position held by ProSolution Pills on the penis enhancement market.

Michael Carter is Doctor of Clinical Psychology who comes from Pittsburgh, Pennsylvania. After graduating high school, Dr. Carter obtained his Associate Arts degree in respiratory therapy from the Los Angeles Valley College and worked for several years as a Respiratory Therapist.

In order to learn more about world culture and knowledge, Dr. Carter joined the United States Navy as an air traffic controller. He served onboard the aircraft carrier USS Kitty Hawk for five years, which took Dr. Carter to 5 continents and many countries throughout the world. Dr. Carter left the Navy to pursue his business interests and educational goals.

He earned his Bachelor's Degree in behavioral science from National University and later received both his Master's Degree and his Doctorate Degree in clinical psychology from the California School of Professional Psychology, Los Angeles.

Dr. Carter also has years of extensive training in "Relationship Building Concepts & Philosophies," and couples therapy and is the founder of the Institute for Relationship.

Khalid M. Alzwahereh is an M.D. living in Los Angeles, California. His resume is truly impressive and testimony to his hard work. Dr. Alzwahereh has nine years of experience in orthopedic surgery as chief of an orthopedic department and three years experience coordinating and directing six clinical programs. He was a medical quality assurance instructor and a leading authority on supervised research programs.

Dr. Alzwahereh has extensive clinical expertise in Neurosurgery, Plastic Surgery, Cardiovascular Surgery, Urology, Tissue and Organ Transplant. He is currently working as a clinical instructor at the Bryman College, after having successfully completed his OSHA training.

Dr. Alzwahereh is certified to perform delicate full flexed total knee replacement surgery and to use the Ilizarove surgery methods. He is also a certified instructor for medical surgical techniques in orthopedics.

So, as to the question of the rank of best penis enlargement pills, one only needs to look no further than the doctors who endorse the product, as well as the many satisfied customers who rave about their results.

How Arthritis Cream Can Help You Feel Better


If you suffer from arthritis, chances are that you want to find targeted pain relief. Affected joints can throb and ache especially in weather that is cold or damp. Arthritis cream can be a great way to bring about temporary relief. Because arthritis cream uses medicinal ingredients to provide relief it is important to know about them so that you can avoid drug interactions or allergic reactions.

Arthritis cream is often divided into hot creams and cooling creams. This can be great since different types of arthritis need different care regimens and using the wrong product can make your condition worse.

If you suffer from rheumatoid arthritis, there can be heat and swelling in the joints. This is because the body's immune system is attacking the joints and there can be a lot of inflammation. It is this swelling and inflammation that can lead to pain and stiffness. Rheumatoid arthritis sufferers need to be careful of creams which cause the skin or tissues to heat up. This is because added heat can actually harm joints more.

Osteoarthritis does not cause the same heat and inflammation. This is because osteoarthritis is caused by a breakdown in cartilage. Osteoarthritis usually develops as a result of repeated joint use or advanced age although some athletes may develop arthritis in their joints at an earlier age. Joints may feel better as a result of using creams which heat the joints.

Cooling arthritis creams may use salicylate, a drug related to Aspirin to bring on relief from pain and stiffness. People allergic to aspirin should be careful since the drug can be absorbed through the skin.

Arthritis creams which heat the skin and the joints can be a great relief to people suffering from arthritis. They often used capsaicin, the ingredient which gives chillies their heat, to warm tissues and ease pain.

Heating and cooling creams can help in other ways as well. In order to apply the creams they must be rubbed into the skin. This is true whether it is a cream that is squeezed from a tube or put on with the use of a rolling applicator. When anything is massaged into tissues, there is a therapeutic effect. This is because massage will cause increased blood flow to an area which can help to make those body parts feel much better.

Arthritis sufferers who are on specific drug therapies should always make sure to talk to their doctor or a pharmacist before adding any medicines or products to their care regimen. This is because the skin can absorb medications and you want to make sure that there will not be any bad reactions between your cream and the other medications you are using. Finding a way to ease your pain and discomfort can be a valuable tool to managing your disease.

Your Knee Pain May Be Caused by Your Feet


Many people, particularly those who are athletic or very active, suffer from knee pain. Although there are many causes of knee pain, one of the most overlooked causes is foot imbalance.

Our feet take a lot of abuse, and as a result there are many opportunities for structural failure in the foot. One of the most common areas of foot failure is the medial arch.

The feet are incredibly complex and dynamic pieces of machinery. They are designed to move and adapt depending on how we use them and what we require of them. But over time there can be failures. The result is an imbalance in the foot that can result in many issues.

When there is foot imbalance it is common for our gate, the movement of our entire body while walking, to change slightly to compensate. This change in our gate can result in undue pressure at the knee. You have probably seen people with what is commonly called "knock knees" or that are "bow legged." These are conditions where the knees are either unnaturally turned in (knocking together) or are turned out (bowed).

Although these symptoms can be caused by other issues, many times the underlying cause is foot dysfunction. Knock knees and bow legged are extreme examples of what can happen when you suffer from foot imbalance, but many minor shifts in the knees can lead to severe pain.

A simple solution to this knee pain is orthopedic arch supports. One of the most common foot dysfunctions is over-pronation, where the foot "rolls" to the inside. This is usually caused by the arches in the foot functioning improperly. The result of over-pronation can often lead to knee pain.. Proper orthotic arch supports or cushioned shoe insoles can often bring balance back to the foot, solving the underlying problem leading to knee pain.

Thursday, December 26, 2013

Building Muscular Endurance Around Your Knee After Surgery


Building not only strength in our legs after surgery is important when the knee has been operated on but, muscular endurance as well has to be added into the exercise component for total rehabilitation success.

Strength building after a surgery will help the patient regain the ability to use the knee as its designed to during our activities of daily living. The knee will strengthen quickly after surgery of course depending on the patient and, their overall prior level of function. The muscular endurance however will take more time to recover and may be the last aspect of knee surgery rehabilitation to be completed.

Building muscular endurance surrounding the knee includes concentrating on the quadriceps and the calf muscle. Both play a major part in the proper functioning of the knee. Having one or the other muscle group not up to par as far as muscular endurance is concerned will affect either your ability to walk sufficient distances or, could cause knee buckling which will result in a fall.

Building endurance can be done with several easy exercises.

1. Walking. Yes as simple as this sounds many patients after surgery need to initiate a scheduled walking program as soon as they have been medically cleared to do so. Walking not only will assist in building muscular endurance around the knees but will assist in building overall strength in your entire body. Starting a walking program is easy starting with household distances then slowly expanding the distances to outdoors.

2. Stationary Biking. Stationary biking is a great exercise for building endurance. This so happens to be one of my favorites. This is the one I used after my knee replacement surgery and I found it to pay big dividends. Stationary Biking I feel is the best exercise out there after coming off knee surgery. When starting to bike as with all the exercises you have to pace yourself. Starting with five minutes a day for instance one time a day then slowly building to a minute or two each day should do the trick.

3. Treadmills. Though I do not use them myself they are great for individuals that may need some support walking in a controlled environment. As you get stronger you can slowly increase the incline as well and that will build the endurance you require to keep your knees functioning throughout the day.

Building the endurance is simply getting the muscles that are in question to continue contracting and supporting you consistently in a repetitive manner without tiring and causing fatigue that will shut down the muscles.

Generally muscular endurance and cardiovascular exercise are mentioned in the same breath for most of us however for older individuals that may be returning from a joint replacement or fractured hip after a fall, most forms of cardiovascular work other then walking may be out of the question.

Building both strength and endurance in the surrounding muscles that encase the knees will assist you in a safer more efficient way to carry on our day to day activities.

Discovering an Alternative Osteoarthritis Treatment That Will Work


Osteoarthritis treatment can be as complex as the condition itself. Frequently, the response of doctors is prescribe NSAID drugs to address the pain of osteoarthritis; however, it is quite important to note that this damage that osteoarthritis can do to joints can be so great that joint replacement surgery can become necessary. Addressing the pain and potential consequences of osteoarthritis are of paramount importance.

First it is necessary to highlight the fact that losing weight and eating a healthy diet can play an important role in addressing osteoarthritis in general. Losing weight means less stress on the joints, and that can translate into improving your osteoarthritis symptoms and associated pain.

We know that bad food choices can impact health, and this counts for osteoarthritis as well. Foods that cause inflammation, such as processed foods, fast foods and foods from the "nightshade" category of plants should be off limits. These include tomatoes and eggplants among others. In general, a diet rich in most fruits and vegetables will help improve health, add to weight loss and may decrease osteoarthritis inflammation as well.

Discovering alternative approaches for osteoarthritis treatment is one part experimentation and one part giving alternative approaches the necessary time to take effect. Anti-inflammatory drugs work well and they work quickly, but the long term effects of using such drugs should give one pause. Alternative and natural approaches might take longer, but there is far less concern attached with using these approaches.

The spice ginger has long been valued for its ability to reduce inflammation. Spices were amongst the most valued of possessions in the ancient world and for good reason. Spices and herbs were the medicine of the ancient world, and their health benefits were firmly established in the minds of our ancestors. Today, medical research has varied that many spices do indeed have powerful health benefits.

Ginger can be consumed in a surprising number of ways. Ginger tea is, of course, very common and stands as one of the single most consumed beverages in the world. Ginger root can easily be incorporated into a diverse number of meals, and it can also be used to make fresh tea.

In addition to teas and use in meals, ginger is well suited to pill form and is sold as a means of helping with inflammation. Quite often ginger is paired or suggested to be paired with the other great natural anti-inflammatory agent, turmeric. Together these two spices can achieve impressive results.

It should also be noted that ginger and turmeric are two of the most widely used spices and both are considered quite safe. Give these natural options time to work, and you will likely find that they do help provide at least some relief and assistance with your osteoarthritis treatment.

What's the Best Total Knee Replacement?


Total Knee Replacement (TKR) is an operation where the worn ends of the bones that make up the knee joint are resurfaced with metal and plastic implants.  Surgeons have many options to choose from.  Not only do several manufactures make different brands of knee replacements, but within each brand are different types.

For example, in a "PCL sacrificing" knee replacement, the PCL (posterior cruciate ligament) in the knee is removed and its function is replaced by the special geometry of the implant.  There are also a group of implants known as "mobile bearing" or rotating platform" where one of the components (the tibial insert) actually moves or rotates relative to the metal tibial implant affixed to the tibia (shin bone).

Given the myriad of implants available, it is natural to ask, "Which total knee replacement is best?"  Unfortunately, the answer to that question is not straightforward.  While each manufacture will tout the benefits of their particular design, long-term follow-up of most contemporary implants yields similar results.  In reality, it is probably more important for perspective patients to seek out a good, experienced surgeon, rather than a particular product.

This is because factors such as proper alignment of the implant components and restoration of appropriate soft tissue tension (things which the surgeon directly controls) are more likely to influence the outcome of a total knee replacement than the particular brand of implant.

At the end of the day, perspective knee replacement recipients should seek out a doctor they are comfortable with and one that has a lot of experience with a particular implant system.  Experience is important because the technique of total knee replacement is rather involved.   The surgeon must utilize a series of complex instruments to perform the operation.  Often, these instruments are "implant specific" so surgeons will usually become loyal to a single brand allowing them to develop familiarity and expertise with a particular system.

So the answer to the question "what knee replacement is best" may simply be the one which your experienced surgeon has chosen to utilize.

Top Total Knee Replacement Surgery Complications


Total knee replacement surgery is able to give the knee joint a new lease on life. It can be the ultimate solution to problems of pain and wear. The surgery is advised as a last resort and after the procedure is over, many will actually feel the results after a short time.

However, there are complications that may be experienced as well. The most common knee replacement complications are highlighted below and patients who go through the surgery should be well aware.

Swelling - This is one of the most common complications and may not happen at all in some patients. It may happen because of wear of implant material used in the knee joint. It will also happen as a result of overwork or strain to the joint. Infection of the knee joint can also cause the complications. Many times, the swelling will go away on its own. If it persists, consulting your orthopedic surgeon is in order. The surgeon will determine whether there is an infection or not by getting some joint fluid and testing it accordingly.

Loosening - This is said to be the most common of total knee replacement surgery complications. One of the major causes of this problem is faulty knee implants which are also responsible for a wide variety of knee complications. For example, some Zimmer and Depuy knee implants have been recalled. Many patients who received certain implants from these companies have experienced loosening and swelling problems. According to statistics 10% of all knee joint implants will loosen per annum.

Unstable knee - this complication has been found to occur in at least 1% of all cases. Weight gain will aggravate the problem as the knee joint simply becomes unstable. If left unchecked. This complication can lead to total knee failure apart from loosening.

Fractures - They may occur around the knee prosthesis. Fractures lead to pain around the joint and an X-ray will reveal the problem. 0.1% of all patients will suffer fractures. Braces are mainly used to correct this problem.

Vessel damage - This is another total knee replacement complication although very rare. Those who will be more prone to such damage are those who have undergone other knee surgeries.

Breakage of components - This happens when the joint implant is affected by pressure and weakness. It can break causing pain and devastation to victims. Polyethylene components especially tibial are prone to breakage. To remedy this total knee replacement complication, specialists will have to operate and replace the components.

Peroneal nerve damage - The signs that show damage of this nerve include tingling and numbness of the affected foot. In some cases, patients will find it hard to move or stretch their leg. This complication is treated using braces and applications of loose dressings. It is possible to overcome this problem without having to go through the knife again.

Scar pain - This is another total knee replacement surgery complication that happens mainly when patients touch the scar. The pain often goes away on its own without treatment.

Rigidity - It occurs when scar tissue form around the knee joint and limits movement. Through specialized movements, surgeons will try to move joint to the desired angle when patient is put to sleep to break the scar tissue formation. These are the most common total knee replacement surgery complications.

Joint Pain - Simple Home Remedies


Joint pains are very disadvantageous because they can interfere in the normal functioning of people. From an Ayurvedic point of view, joint pains occur when there are digestive problems in the body, which leads to the buildup of toxins in the spaces between the joints. Hence, when the joints are moved in the slightest, pain is felt in them.

Some people live with excruciating joint pains that don't go despite treatment. They look upon these pains as a part of growing up. However, with the right kind of medicine these pains can be totally eliminated.

Treatment with Simple Home Remedies

Remedy # 1

Take the juice of a ginger. Crush some vidanga (Embelia ribes, False Black Pepper) to a fine powder with some rock salt. Mix all of these and take them in quantities of three grams each time with honey. Lick on this thrice a day.

Remedy # 2

Massage the paining joints with the oil extracted from the seeds of the Bishop's weed. Warm the oil a little before massaging. A similar kind of relief is obtained by massaging with the oil of neem (Azadirachta indica, Indian Margosa).

Remedy # 3

In case of joint pains due to cold weather, add a fistful of Bishop's weed seeds and one teaspoon of salt in two cups of water and boil it. Keep a sieve on this, and then keep a cloth on the sieve. The cloth will get moistened with the warm fumes of the solution. Use this cloth to foment the painful joints. This will remove the pains.

Remedy # 4

Some joint pains are felt more acutely in the knees, fingers and shoulders when lifting some heavy weight. These are very persistent pains in most cases, and they do not dissipate despite treatments. In such pains, tomatoes are the best solutions due to their rich vitamin C content. Eat four to five raw tomatoes in a day, and eat one bowlful of thick tomato soup twice a day - in the morning and the evening. This provides great relief within a fortnight of continued use.

Remedy # 5

If there are sharp and sudden joint pains in any part of the body, then grind an amalaki (Emblica officinalis, Indian Gooseberry) in water that is a little warm. Then add a slightly crushed piece of cardamom in the water. Drink this concoction once a day. This will retain the zest and vigor of the body and also prevent all the inexplicable pains that arise suddenly in different parts of the body.

Remedy # 6

Take a petal of the yellow oleander flower, known as kaner in Hindi, and grind it to a paste in groundnut oil. Apply this paste regularly on the regions where the joint pains arise. Continuous use will totally eliminate the pains.

Remedy # 7

You can also grind some cloves of garlic and apply the paste on the affected joints. This will remove the pains in a short while. But the problem with this remedy is that the garlic paste needs to be washed off within a few minutes, or it will lead to boils on the skin.

Remedy # 8

Prepare a paste of mustard seeds with a little water. Apply this oily paste onto the affected joints. The pains will be eliminated in a short while.

Remedy # 9

This is a regimen that will take care of joint pains, but it takes some patience. Every morning after waking up, eat castor seeds in the following manner. On the first day of the routine, eat one peeled castor seed, on the second day two and so on keep increasing the number by one till the seventh day. From the eighth day onwards, begin reducing the number of castor seeds by one. Do this till the number comes down to one. The joint pains will vanish by then.

Remedy # 10

Cook some seeds of Bishop's weed in water. Let the water boil and the fumes come out. Bring your affected joints in contact with the fumes. This will make the joint pains disappear.

Remedy # 11

Put some bitter oil in a pan. Add some seeds of the Bishop's weed and some cloves of garlic. Use this oil to massage deep into the regions where you get frequent joint pains. This remedy has the potency to remove any kind of joint pains if done diligently.

Remedy # 12

Crush two cloves of garlic and add them to some sesame oil. Warm the oil and massage it deep into the paining joints. You will find immense benefits from this therapy.

Remedy # 13

If the pains are not that severe, then a simple steam fomentation with a cloth will also help. The cloth must be moistened with the vapors and then pressed deep into the affected areas. Fomentation must be done for at least twenty minutes a day, and preferably at dusk.

Remedy # 14

Prepare a brew of ginger juice in castor oil. Take no more than 10 milliliters of castor oil and a teaspoonful of the juice of ginger. Drink this twice a day - at dawn and at dusk - on an empty stomach.

Treatment with Special Ayurvedic Methods

Since joint pains are related to the accumulation of ama, the first step in their treatment is to remove all the toxins. This is done by making the patient fast for a day. After this, fomentation is applied on the swollen joints with dry heat. Castor oil is used extensively in Ayurveda to perform massage in case of joint pains. Herbs prescribed in various potencies are galangal, garlic, guggul and punarnava. Dashamoolarishta is the preparation most commonly prescribed, and treatment is generally carried on for three weeks.

The Little Wise Ones


Whenever I talk to kids about being artists they know exactly what I mean. They don't need to be told they're artists. They already know it. And they can provide evidence of the fact on the spur of any moment, with whatever tools may be at hand.

Last summer when as friend and I were doing a writing retreat at one of my aunt's cabins in the Adirondacks, we were interrupted one morning by a knock on the door. Two of my young cousins had come to visit, Jamie, 12 and Brittany, 10. I was working feverishly at the computer and Annie was on the porch revising some personal essays. I told the girls that we were very busy writing and they said they understood, they were writers, too.

Then they went on to explain, oh yes, both of them had written a variety of short stories and Jamie wrote poetry and Brittany was working on a play for her friends to star in. They knew all about the writing thing.

Well then, I said, won't you come in and write with us? They joined us happily. The four of us talked for awhile about what they would work on and they each decided to do a short story. The plan was to write for one hour, then take a lunch break and read the stories during lunch.

They chose their pads and pens carefully, then scanned the room for just the right spot. Jamie picked the overstuffed flowered chair with the wide wooden arms, plunked herself down and immediately started filling up the pages of the purple pad with her story, The Summer I'll Never Forget.

Brittany spread out belly down on the bed, knees bent and the soles of her pink sneakers facing the sky. Her number two pencil was a perfect match for her yellow pad. In big bold letters she printed out at the top of the page, THE HALLOWEEN NIGHTMARE, then paused for a bit while she nibbled at the eraser and waited for the first sentence to come out of hiding.

With Vivaldi stimulating our alpha waves, and loons warbling in the background, the four of us worked at a steady pace in a lovely combination of solitude and togetherness. No one was in anyone's way. No words broke the necessary silence, and each was lost in the world she was creating. Time flew by and an hour had passed in what felt like minutes.

I got up quietly and went to the kitchen to prepare our lunch, giving the writers a ten minute warning. Heads nodded, but no one's attention left their work and no hand paused on the legal pads. This was a writing frenzy if I had ever seen one.

When I had finished making the sandwiches and warming up the soup, I called them to the table. Moans of regret came from everywhere.

"Oh no, I'm right in the middle of the most important part."

"Can't we have just a few more minutes? Is that clock right? I can't believe a whole hour went by."

"Quiet, you guys, I'm working on an important paragraph!"

These were committed artists, so rapt in the joy of creative play that time to continue was all they craved. Food was too common a thing to pull them from the uncommon fun of making something up from nothing. We took a vote and decided to hold off lunch till the stories were finished.

When the last sentence was written, I dished up the soup as the writers made their way proudly to the dining room table. We held hands and said grace, giving thanks for the time to write, to be together, and to share our stories with each other. I asked who wanted to read first and Brittany said she did. While we sipped on soup and ate our egg and olive sandwiches, Brittany treated us to THE HALLOWEEN NIGHTMARE, an exciting tale of intrigue and mystery about an amazing thing that happened to a young girl one Halloween night. It was unexpectedly funny, full of colorful details, imaginative, and hauntingly true. We clapped for Brittany when she finished and each of us pointed out our favorite parts. She beamed with pride.

Then Jamie read her story of a summer adventure with two best friends, which was seven pages long and delicately textured with pre-pubescent conflict, tension and resolution. She, too, beamed when we applauded her writing and took time to discuss the details that made it work so well.

It was a touching event and one that I never anticipated when I heard the knock at the door. What I thought would be an interruption turned out to be an inspiration. These girls were right to call themselves writers and they didn't need any one else to confirm that. Their writing was good because they did it for the love of it, for the joy of visiting their imaginations, pulling out thoughts and trying them on like clothes out of grandma's closet.

These girls did not need a mentor calling forth their creativity as many of us do who have given up play as a daily practice. They have not forsaken that part of themselves where their deepest joy lives--that part which is of the heavens, which is in all of us, and which, while it is ours, belongs still to the universe.

When I have the honor of talking to school children about making art, we talk about this part of ourselves. The part that's invisible but very strong, like electricity or love. They understand about their own uniqueness and how no one sees things in exactly the same way they do, and that that's why their art is never the same as anyone else's. And why that is good.

Children know these things while the rest of us need reminding. We have forgotten the importance of play, forgotten how not to compete, forgotten that the thing in us which makes us unique is precisely the thing we are here to express. That thing which gives us the most joy, that we do to settle ourselves, in which we find comfort and a certain peacefulness--that is our art, the work which calls us and which we are called to do.

Kids nod their heads proudly when I speak of their uniqueness. They have a certain understanding about this. They are close to their creativity, best friends with their Muses, familiar with the power of imagination and playing in the imaginary.

In the matter of creating, they are, in fact, the wise ones.

Insight to Action

1. Set aside an hour to work on a creative project with a child. Assign each other the title of a short story to write, put on Vivaldi's Four Seasons (or whatever music the child chooses) and give yourselves a certain length of time to write the story. At the end of that time, allow a few minutes to wrap it up if it is not finished and then read your stories to each other. Have a conversation about the stories and comment on your favorite parts of each one.

2. This you can do alone or with kindred spirits of any age:

Get a sketch pad with large size paper (at least 11x14). Using crayons, watercolors, colored pencils, or chalks, create a map of your life in three segments, including where you came from, where you are and where you are headed.

3. Listen to the song "Children" on Sweet Honey and the Rock's Good News tape or the Flirtations CD. Following the song, take your notebook and write two pages without stopping on what images and feelings the song conjured up for you.

4. Set aside one day that will be orchestrated by a child. From morning till evening, the child will direct all activities, including travel (within a prescribed radius), meals, and entertainment. This may need to be planned in advance in order to budget for it. At the end of the day, talk about what happened, how it felt, what you liked. Thank each other for your company and go get a good night's sleep.

5. Write yourself a letter from yourself at the age of eight. Talk about what interests you, who your friends are and what they're like, what you hope to do when you get bigger, what your mom and dad are like. Get into the feeling of being eight and see how it feels.

Wednesday, December 25, 2013

Kitchen Equipment Storage


There is a vast range of equipment and appliances that we use in the kitchen, all of which are crucial to being able to get the most from our space and for being able to keep the area clean, tidy and safe. As such if you have a kitchen it is highly crucial to think about kitchen equipment storage and where you intend to keep all the items that you are going to use in order to make sure that your kitchen is as tidy, clean and safe as possible.

There are many different types of kitchen equipment storage. The most obvious is of course kitchen cabinets, draws and cupboards which will usually also provide the sideboards on which you are likely to chop food and peel vegetables etc. These then fit neatly into your kitchen and provide a vast range of storage possibilities for you to make the most of. Other kitchen cupboards meanwhile will be wall mounted so that you can store glasses and things over your sideboards. Again this gives you the ability to store your items without taking up any space in the kitchen and it means that you can use up more space in your room by accessing the extra dimension (storing your items higher up as well as along the walls).

Inside these cupboards and drawers however the kitchen equipment storage can vary and you will likely choose yours depending on various other aspects. For instance you might want a completely empty cupboard which will allow you to store things like plates piled up, but also small kitchen appliances such as blenders and unused kettles. However to get more out of your kitchen storage and to store more items without creating lots of tall towers, you can instead get cupboards with shelves. These will enable you to organise your crockery more and is also perfect for keeping tins and things.

For more advanced kitchen storage however you can also get your shelves on hinges, or even get those that rotate. Some clever storage devices will open out and 'unfold' to reveal multiple shelves as you open the cupboard door and this way you never have to bend over and reach into the cupboards on your knees. With those that rotate meanwhile, this very conveniently allows you to reach things that are kept at the back of your cupboard without having to route through and knock things over/reach right into the back. This is again perfect for tins as it means you can reach those tins around the back - getting rid of the age old problem where you end up searching for hours to get the jam. These kinds of more interactive shelves however tend to be reserved for those cupboards and storage units kept at the bottom of your draw rather than those kept higher up which would make them difficult to operate and to see into.

Drawers however are generally used only lower down, and those these are much of a muchness it is possible to choose basic variations in terms of whether you want deep drawers or shallow drawers, and whether you intend to use a tray for your cutlery.

Total Knee Replacement - Clicking After Surgery


Following knee replacement surgery, patients sometimes report hearing clicks or a clicking sound during certain activities or at a certain point or points during their gait cycle.  In most cases, this sound is believed to be benign and is not associated with pain or other adverse consequences.

So what causes this clicking?

To answer this question, it is helpful to understand a little bit about the nature of total knee replacement.  In knee replacement, the ends of the bones that make up the knee joint are "resurfaced" with metal and plastic components.  The surgeon uses specialized instrumentation and surgical technique to properly align the implants to the bones and the bones to one another.

This alignment is not straightforward because in the replaced knee joint, as in the normal knee, the bones are not "mechanically interconnected"; rather the joint is constrained by the remaining soft tissue (ligaments, muscles/tendons) and the conformity of the implant components.  During the knee replacement operation, the surgeon works to optimize range of motion and joint stability through proper alignment and sizing of the implant.

The resulting tension in the replaced joint can, therefore, vary slightly from patient to patient and can be different within the range of motion of a single patient.  That is, some patients may have "tighter" knees or "looser" knees or a single knee can be "tight" in flexion, but "loose" in extension and vice versa, but in general, some degree of laxity is desirable to allow for adequate motion.

Because there is almost always some laxity in a replaced knee, clicking can sometimes be heard as a result of contact between the metal and plastic components during activity.  Often it is heard during a transition from low or non-weight bearing to weight bearing.  For example, a patient may hear the click while walking as the leg comes out of swing phase and makes contact at heal strike.  For the most part, the clicking is usually not associated with any adverse conditions.

Knee Arthritis - Do You Know These Solutions?


Knee arthritis

Put simple arthritis is inflammation in the joints cause by the degradation of cartilage which results in bones grinding against each other. Since the knee is basically a joint surrounded by tissue and membranous fluids we can see why this would be an issue. Knee Arthritis is commonly found in individuals over the age of however age aside factors such as obesity and genetics (knee arthritis tends to run in families) can increase one's risk of getting arthritis. The two most common types of arthritis that affects the knee are rheumatoid arthritis and Osteoarthritis.

Rheumatoid arthritis

Rheumatoid arthritis is an inflammatory disorder that occurs when white blood cell starts to attack body tissue which results in the erosion of two opposing joint bones. This type of arthritis can lead to sever e deformity in bones if not treated early. I must state that there is no cure for this disease however early detection can help to improve quality of life. Symptoms shown by individuals with this disease are but not limited to, swelling and pain in the knee joint, stiffness of joint, fatigue, limited range of motion and tenderness along the joint. If you feel you exhibit several of these symptoms it would be best to speak with your physician as this is not a disease to be taken likely.

It is still not clear what causes rheumatoid arthritis.

Osteoarthritis

This type of arthritis results in the degradation of cartilage. The degeneration is not reversible and when this occurs joints are able to rub against each other causing tremendous pain and discomfort especially when in motion. The symptoms exhibited by an individual with osteoarthritis are similar to those shown by someone with rheumatoid arthritis.

Unlike with rheumatoid arthritis scientist do have some idea as to factors that can cause osteoarthritis. It is believed that diabetes, obesity and mechanical stress on joints are some of the contributory factors. Others include congenital disorder, Lyme disease, Marfan syndrome and weak quadriceps muscles all play a role in the development of osteoarthritis.

Treatment methods

Whilst the damage caused by arthritis is usually irreversible and the disease itself is incurable, there are various treatment methods that can reduce pain and inflammation thus greatly improving quality of life. Some effective treatment methods are as follows:

• Weight loss- reducing the mass which the knee has to support helps alleviate pain

• Lifestyle modification- one should no longer indulge in certain activities like playing football as this can worsen one's condition

• Medication - anti-inflammatory medications reduces swelling and pain relievers helps with the pain

• Physical therapy- strengthening supporting muscles like the quadriceps muscles helps to reduce tension on the knee and thus reducing pain

• Walking aids- clutches helps to relieve the tension place on the joint inflicted with arthritis

• Surgery - this is often a last resort and is usually followed by extensive physiotherapy. An orthopaedic surgeon can replace the entire knee joint or at least a portion of it.

Those are just some of the more effective methods of dealing with arthritic pain. I must emphasise though that early detection is key, so don't be afraid to contact your doctor if you have a genuine concern.

Causes and Treatment Options For Shooting Knee Pain - Secrets to Pain Reduction Revealed


A shooting knee pain can be the worst!

The discomfort can be caused by an injury to the cartilage, to the ligament or by an underlying condition such as arthritis. Many people who experience this kind of discmofort also feel their knee give out from under them on occasion. This can be very distressing and can end up causing you to fall down and sustain further injuries. In addition to questioning you about any accident or incident that you may have suffered recently, a doctor will also examine you and do an X-Ray or an MRI. Shooting knee pain can be acute or chronic and the treatment will depend on which of these two factors is causing the discomfort.

Acute Shooting Knee Pain

If you feel acute shooting pain that comes on suddenly, it is most likely the result of an accident or injury. This can be a sprain or even a tear of the cartilage or ligaments holding the joint together. Acute knee pain usually necessitates a trip to the doctor who will diagnose this pain based upon an examination. Some people find that they remember clearly when they got hurt in an accident that resulted in the discomfort, while others are not sure of what could have caused it.

Treatment for acute knee pain is based upon the level of the discomfort. One of the first things the doctor will want to do is to eliminate the pain itself. The doctor will most likely give you some type of pain relief while looking for the reason for the injury. If the acute knee discomfort is because of a sprain or other injury, the doctor will often times advise rest, elevation and wearing a knee brace, all of which will help alleviate the knee pain.

Chronic Shooting Knee Pain

A chronic shooting knee pain is one that recurs persistently. This ongoing problem can occur for a number of reasons and is usually caused by a tear in the ligament, or a form of arthritis. The doctor will want to do an X-Ray to determine the cause and will then recommend the appropriate treatment to keep the pain down.

Wearing a knee brace, taking over the counter pain pills that your doctor recommends, when the pain and using physical therapy exercises can help you manage chronic shooting knee discomfort and give you a modicum of mobility. (Speak with your physician prior to physical therapy exercises.)

Is Surgery Advisable?

Surgery to repair a knee ligament or cartilage should only be considered if all conservative treatment methods have been exhausted. This type of surgery can be somewhat risky and is not always successful. In some cases, the knee may end up becoming worse and you will not get any relief from the shooting knee pain. A doctor will often times look towards other methods such as medication, knee braces, and even therapy to cure the knee pain rather than use surgery that can cause someone to be off their feet for 6 months or more, become reliant on painkillers and go through months of rehab.

The Dumbbell Squat - Build Mass Without The Risks


As I'm sure you already know, squatting is often referred to as 'the king of exercises' for building mass. Many assume that this title is earned in reference to the squat's ability to build huge leg muscles. However, as well as being the #1 exercise for building the quads & glutes, squats also help stimulate growth in all the major muscle groups.

I could go on about the numerous reasons why every bodybuilder should include squats in their routine but hopefully you don't need convincing.

If you want to get big - squat- it's as simple as that.

However, for some, loading a heavy bar onto the shoulders and squatting till you feel dizzy can present a bit of a safety issue. For those that train at home or indeed without a training partner then squatting can be viewed as somewhat dangerous.

There's significant risk of running out of steam and struggling to rerack the bar.

For the lone trainer, heavy barbell squats are something that should only be attempted with a good quality power rack with safety bars. Too many times in the gym I've witnessed some poor guy struggling to get the bar back onto the rack after completing one rep too many.

Even with suitable equipment, if you fail to make the squat and drop the bar, there's still a risk it could go wrong and you end up inuring yourself. At the very least, you're gonna have to unload, lift the bar back onto the rack and reload. If that's ever happened to you then you'll know how much this can knock the steam out of the preceding squats sets.

A fantastic and much underrated alternative to the barbell squat is the dumbbell squat. It's often seen as the poor cousin to the barbell 'king' but for some, it can actually be the superior exercise.

For the newbie, home trainer or the experienced trainer without access to a spotter or suitable power rack, the dumbbell squat makes a superb alternative to the barbell squat.

With the dumbbell squat, you have pretty much all of the mass building aspects of the barbell squat minus the safety issues. The exercise begins and ends with the weights on the floor, a far safer alternative to the' top loaded' barbell squat.

With the dumbbell squat, if you find yourself struggling to make the final rep then it's far easier and safer to simply end the rep and return the weights to the floor.

Performing The Dumbbell Squat


  • Take a pair of medium weight dumbbells and align them in parallel, either side of you

  • Position your legs a little over shoulder width apart

  • Point feet directly forward or slightly out

  • Kneel down and take a grip of each dumbbell

  • Once you're happy with your grip, push up with your legs, keeping you back straight

  • Once completely upright, pause momentarily before lowering back to the start position

I've scoured the net to find you a video that best demonstrates the dumbbell squat and found the short demo below. I'm a little camera shy myself but perhaps one day I'll do my own video demonstration.

http://www.youtube.com/watch?v=bJqnATFga7Y

Tips


  • Ensure your back remains at a constant angle to your body during the squat. You want the power to come from your quads (and hip flexors) not your back.

  • When lowering, your knees shouldn't extend ahead any further than the end of your toes.

  • Make sure your feet point either directly ahead or slightly outwards but never inwards. In inward turn can place disproportional stress on your knees

  • Whatever foot angle you find most comfortable, it's imperative that you maintain the same angle for both feet. Different angles can place uneven load on one knee - not good.

  • Rather than try to lift the bar, focus on pushing your legs down into the ground. You'll find this actually makes the lift 'seem' easier. Plus, this approach also help you maintain proper form with a straight back by thinking about your legs pushing rather than your body lifting.

  • Given the similarity with the deadlift, you may feel a tendency to lean back slightly at the top of the movement as many people deadlifitng do. Please don't do this. Arching backwards places unnecessary stress on the lower back. Arching back is performed by power lifters in competition to satisfy the judges that a full standing position was reached. Unless you're a competitive power lifter, please don't lean back.

I hope this article has revealed to you the many safety advantages of the dumbbell squat over the traditional barbell squat, especially for lone trainers. Remember, when it comes to weight lifting, your ability to avoid injury is one of the biggest factors in determining your progress.

Understanding Knee Replacement Surgery For the Elderly


Knee surgery can be needed by anyone but it is more often perform in older people than younger people. There are many reasons for one to go for knee surgery, such as sport injuries, arthritis and pain associated with cartilage deterioration and the wearing out of bones.

When to Consider Knee Replacement Surgery

Knee surgery can be prevented sometimes and these methods should be explored first. Losing weight, medication, surgery or physical therapy can sometimes solve certain knee problems. If none of these worked, knee replacement might be your only option. The healthier you are, the less risks there is and recovery would be sooner. People with diabetes or high blood pressure can still go for a knee replacement surgery as long as their illness is under control.

What is Knee Replacement?

Knee replacement can be done partially or as total knee replacement. During the knee surgery, the damaged joints will be replaced with plastic or metal components, shaped to allow better motion in the knee. The operation will last around two hours for different types of knee replacement surgery. The minimal invasive procedures require shorter incisions and thus less scaring. The process is very technical and should only be performed by a highly skilled surgeon.

Recovery after Knee Replacement Surgery

Patients usually stay in the hospital for between 3 and 5 days after the surgery. During the stay, they will start their rehabilitation program immediately. A physical therapist will start working on the mobility with the patient, while the occupational therapist will assist the patient on preparing for usual daily activities such as dressing and washing.

All patients won't recover at the same rate as certain factors would have an influence. Strength, body weight and pain tolerance level of an individual all make a difference to the speed of the recovery.

If the doctor is not satisfied with the rate of recovery in the hospital, patients might still be able to return home after about 5 days and it can be arranged for a therapist to assist them with further sessions at home.

Some patients might need to get extra help at home during the first few weeks. This doesn't have to be done by a trained caregiver, but anyone that can assist with meals or helping the person to get dressed and occasionally go out.

To walk unassisted again will take up to six weeks in certain instances. After two to four weeks the patient might be able to use a cane or walker.

Tuesday, December 24, 2013

Senior Citizens Rheumatoid Arthritis, Osteoarthritis, and Arthritis - Causes and Treatments


"Arthritis" does not mean only that someone has stiff, aching joints. Many types of arthritis exist, each with its own symptoms and treatments. Most types are chronic, meaning that they can be a source of discomfort for an extended period of time. Arthritis can afflict joints almost anywhere in the body and may cause changes you can see and feel, including swelling, warmth, and redness in the joints. It can last for a short time but be very painful or continue for a long time with less pronounced results while still damaging the joints.

Arthritis is extremely common in the United States, especially among senior citizens. Still, there are many steps they and those providing care for the elderly can take to relieve the different types of arthritis. The most common types in this population are osteoarthritis, rheumatoid arthritis, and gout.

Osteoarthritis.

Osteoarthritis (OA) is the most common form of arthritis in senior citizens and begins when cartilage, the type of tissue that pads joints, begins to wear away. This can eventually cause all the cartilage between bones to wear away, forming painful rubbing of bones against each other. This type of arthritis is most common in the hands, neck, lower back, knees, and hips.

Symptoms of OA can range from stiffness and mild pain that accompanies exercise or bending to severe pain in the joints even in times of physical rest. OA can also cause stiffness during times in which you haven't used specific joints in a while, like when you're on a long car ride, but this stiffness usually goes away when you move your joints again. OA can eventually lead to problems moving joints and sometimes to developing a disability if the areas affected are the back, knees, or hips.

Aging is often the greatest risk factor for developing OA. Other factors depend on the area of the body afflicted-for instance, OA in the hands or hips may be caused by genetic factors; OA in the knees may be caused by being overweight; and injuries or overuse of joints in the knees, hips, and hands may lead to OA.

Rheumatoid arthritis.

Rheumatoid Arthritis (RA) differs from OA in that it's an autoimmune disease, meaning that your immune system attacks and damages the lining of a joint as if it were an injury or disease. RA leads to inflammation of the joints, which causes pain, stiffness and swelling, sometimes in multiple joints at once. It may be severe enough to prevent you from moving a certain joint. Senior citizens with RA may often experience fatigue or fever. You can develop RA at any age, and it's more common in women. 

RA can afflict almost any joint in the body and is often symmetrical, meaning that if you have RA in a specific joint on one side of your body, you probably experience RA in the same joint on the other side of your body. RA can damage not only joints, but also the heart, muscles, blood vessels, nervous system, and eyes.

Gout.

Senior citizens with gout experience the most severe pain relative to many other arthritis patients. An attack begins when uric acid crystals form in the connective tissue or joint spaces, leading to swelling, stiffness, redness, heat, and pain in the joint. Attacks often follow eating foods like shellfish, liver, dried beans, peas, anchovies, or gravy. Drinking alcohol, being overweight, and taking certain medications may worsen the symptoms. In senior citizens, using certain medications to lower blood pressure may also be a risk factor for a gout attack.

Gout is most common in the big toe, but it can occur in other joints such as the ankle, elbow, knee, wrist, hand, or other toes. Swelling may cause discoloration and tenderness due to skin stretching tightly around the joint. If you see a doctor during an attack, he or she may take a sample of fluid from the affected joint.

Other forms of arthritis.

Other forms include psoriatic arthritis  in patients who have psoriasis; ankylosing spondylitis, which mainly affects the spine; reactive arthritis, which occurs as a reaction to another illness in the body; and arthritis in the temporomandibular joint, the point at which the jaw attaches to the skull.

Arthritis Symptoms and Warning Signs.

Senior citizens and those providing their elder care should look out for the following symptoms as they may be indications of arthritis:


  • lasting joint pain

  • swelling in a joint

  • stiffness in a joint

  • tenderness or pain when touching a joint

  • difficulty in using or moving a joint normally

  • warmth and redness in a joint

Any of these symptoms lasting longer than two weeks should be addressed by a physician. If you experience a fever, feel physically ill, have a suddenly swollen joint, or have problems using a joint, a doctor should be contacted sooner. You will have to answer questions and go through a physical exam. Before suggesting treatment options, your doctor may want to run lab tests and take X-rays.

Arthritis Treatment.

Some common treatment options exist even though each type of arthritis is treatedsomewhat differently. Rest, exercise, eating a healthy diet, and becoming educated about the right way to use and protect the joints are key to minimizing the effects of arthritis. Proper shoes and a cane can minimize pain the feet, knees, and hips while walking, and some technology exists for helping open jars or bottles, turn doorknobs more easily, and otherwise improve quality of life in senior citizens with arthritis. 

Additionally, some medications can lower the pain and swelling. Acetaminophen (in Tylenol) and some NSAIDs are sold over-the-counter and can ease pain. Other NSAIDs must be prescribed. It is important for senior citizens and those providing their in home care to pay attention to the warnings on both prescribed and over-the-counter drugs and to ask a doctor about how to properly and best use over-the-counter medicine to treat arthritis. The FDA also has information about many medications.

Some treatment options are specialized for individual types of arthritis.

Osteoarthritis Treatment.

There are medicines to help senior citizens with pain associated with OA, and rest and exercise may ease movement in the joints. Managing weight is also important. If one experiences OA in the knees, a doctor can provide shots in the knee joint, which can help to move it without as much pain. Surgery may also be an option to repair or replace damaged joints in senior citizens.

Rheumatoid Arthritis Treatments.

Treatment can diminish the pain and swelling associated with RA and cause joint damage to slow down or stop. One will feel better overall, and it will be easier to move around. On top of pain and anti-inflammatory medications, a doctor might prescribe DMARDs, which are anti-rheumatic drugs that can slow damage from RA. Corticosteroids, including prednisone, can minimize swelling while waiting for DMARDs to kick in. Additionally, biogenic response modifiers block the damage inflicted by the immune system and help people with mild to moderate RA when other treatments have failed to work properly.

Gout Treatment.

If you've gone through a gout attack, talk to a doctor to discuss possible causes and future prevention of attacks. Work together with your doctor and other elder care providers to plan and execute a plan for prevention. Commonly, NSAIDs or corticosteroids are recommended for an acute attack. This treatment diminishes swelling, allowing you to feel better fairly shortly after treatment. Usually, the attack fully stops within a few days. If one has experienced multiple attacks, a doctor may be able to prescribe medication to prevent further attacks.

Exercise can help Arthritis.

In addition to taking the proper medication and allowing your joints to rest, exercise can help senior citizens to stay in shape, maintain strong muscles, and control symptoms of arthritis. Daily exercise like walking or swimming keeps joints moving while lessening pain and strengthening the muscles around joints. Before starting any new exercise program, it is important to discuss options with your physician. 

Three types of exercise are the best for senior citizens with arthritis:


  • Range-of-motion exercises reduce stiffness, improve flexibility, and keep joints moving. Activities like dancing fit into this category.

  • Strengthening exercises strengthen muscles, which improves support and protection to your joints. Weight training fits into this category.

  • Aerobic or endurance exercises improve health in the heart and arteries, prevent weight gain, improve how your body works overall, and may decrease swelling in some joints. Riding a bike fits into this category.


Other things to do to manage Arthritis.

On top of exercise and weight control, a number of other methods may help senior citizens ease the pain around joints. Applying heat or cold to joints, soaking in a warm tub, or swimming in a heated pool may help you feel better and move your joints more easily.

Surgery may be an option when damage has become disabling or when other treatment options have not adequately diminished pain. With surgery, joints can be repaired or replaced with artificial ones. Commonly, arthritic knees and hips are replaced.

Unproven remedies.

Many senior citizens with arthritis try treatments that have not been tested or proven to help. Some are harmful, like snake venom, while others are harmless yet unhelpful, like copper bracelets.

Here are a few ways to determine whether a treatment is unproven:


  • The remedy is said to work for all types of arthritis and other diseases

  • Scientific support is from only one research study

  • The label doesn't include directions or warnings of use


Areas for further research.

Studies suggest that acupuncture could ease OA pain in some senior citizens. Dietary supplements such as glucosamine and chondroitin are also under investigation and may reduce OA pain. More research is needed to determine whether these types of treatments actually work to reduce symptoms and damage to joints.

Talk to your doctor and others involved in your elder care.

Try not to make light of your symptoms by telling yourself that joint pain or stiffness is simply caused by aging normally. Your doctor and other elder care providers can discuss possible treatment options with you to safely minimize your pain and stiffness and prevent more serious joint damage.

What Is Outpatient Knee Replacement and Can It Help You?


Outpatient knee replacement is a method utilizing fairly recent advances in orthopedic knee arthroplasty (whether total or unicompartmental), that signals itself to be significant in the future of knee replacement procedures. Customarily, this was a variety of prosthetic operation that needed to be performed in a hospital setting. However, advances in techniques like minimally invasive surgery and anesthetics, originated by Dr. Robert Berger, have prominently shortened hospital times, and within the last ten years, have even made it feasible for an increasing number of patients to be discharged on that very day, and actually walk out of the clinic or hospital with no walker, cane, nor any crutch being required. With a steadily rising rate of knee surgery patients being scheduled for same day outpatient procedures today, the usual hospital wait for a total knee arthroplasty has been astonishingly dropped from two weeks just a few decades ago, to about a week by 1998, 4 or 5 days by 2003, and presently it is abnormal even for knee recipients using more traditional techniques to stay more than 3 days in the hospital.

An outpatient procedure of this variety needs everything to be done perfectly by the most qualified surgery team, which should include some knee specialists. Any omission, delay or other mistake on the team's behalf can cause an extended stay to be required for the patient. Not all facilities or doctors will be ready for same day surgery, as this depends on the modern technology together with the most experienced team. In April 2011, Dr. Kevin Stone, a California orthopedic surgeon, finished a knee replacement operation in faster than two hours hospital time, utilizing state of the art robot mechanisms.

The advantages of outpatient operating portend a major lowering in expenses to both patient and hospital, in addition to an accelerated recovery time allowing artificial knee recipients to start doing physical therapy the day after operating. The danger is regarded as minimal; Dr. Berger shows his research concluding a 94% rate of success in same day knee surgery. He has indicated that his minimally invasive method entails a solitary incision between the joint line and the knee cap, avoiding making dislocations or cuts on the quadriceps tendon and muscles.

Another crucial consideration is the presence of a complete team to help the patient in deriving benefit from the optimal therapeutic methods. The popularity of this improved method may signify that nearly all knee replacements will be capable of being finished in a matter of minutes or hours not so far in the future. Dr. Berger is moreover famed for his recent criticism of an artificial knee called the Zimmer knee, manufactured by his former firm, the Zimmer company, that he claimed has a greater danger of post-surgery knee failure; this has ended up in suits and recalls clustered around the Zimmer knee.

Likewise, outpatient hip arthroplasties have been done by Dr. Berger's team beginning in 2001, with the first such outpatient hip replacement in Virginia being done in July 2010 by Dr. Mark McFarland of the Newport News Orthopedic and Spine Center.

What Is Osteoarthritis of the Knee And What Is the Treatment?


Articular cartilage is the gristle that caps the ends of long bones. It consists primarily of a matrix of proteoglycans which are complex arrangements of proteins and glycogen molecules. The proteoglycans exist within a framework of tough collagen fibers. Within the proteoglycan matrix are cells called chondrocytes. These cells are the ones that are responsible for the synthesis of proteoglycans. In fact, the normal maintenance of cartilage integrity is highly dependent on the normal metabolic function of these chondrocytes.

Healthy cartilage can withstand the usual loads that accompany the activities of daily living. Cartilage, when loaded, acts as a shock absorber. It will partially deform but springs back to its normal shape under normal circumstances. It also provides a gliding surface which is enhanced by a small amount of synovial fluid, produced by the joint lining, that acts as a lubricant.

Osteoarthritis is a degenerative disease of articular cartilage. It arises as a result of the inability of cartilage to keep up with excessive breakdown. The first step is a disturbance in the matrix. This causes loss of cartilage resiliency. In addition, proteins that promote inflammation (called inflammatory cytokines) are produced by the joint lining. These cytokines activate destructive enzymes, called proteases. The proteases degrade the matrix and cause the chondrocyte to malfunction.

The inflammatory cytokines cause the production of other bad chemicals including nitric oxide and matrix metalloproteinases. These cause further cartilage breakdown.

Over time, cartilage wears away, underlying bone is exposed, and joint deformity occurs. Pain and disability are the end result.

The knee is a particular target of osteoarthritis.

With the aging demographic as well as the increasing incidence of obesity, knee osteoarthritis (KOA) is a significant public health problem. Significant disability can result and health care dollars are being spent at an astonishing rate for total knee replacement. The 2003 National Institutes of Health Consensus Statement on Total Knee Replacement estimated that the mean total cost of a knee replacement in the United States was $35,000. That figure is obviously higher now. And the dollar cost does not factor in the potential for complications.

More than half a million knee replacements occur annually and that figure will continue to rise.

Non-surgical treatments by and large are palliative. These include education, weight loss, analgesics, non-steroidal anti-inflammatory drugs (NSAIDS), braces, physical therapy, exercise, and injections of glucocorticoids and viscosupplements (lubricants).

Investigational therapies aimed at either increasing the production of matrix and/or collagen or reducing the amount of inflammatory cytokines are being scrutinized but so far, there is little cause for optimism.

More recently, the use of autologous stem cells, have been shown to have promise for KOA.

(Wei N, et al. Guided mesenchymal layering technique for treatment of osteoarthritis of the knee. J Applied Research. 2011; 11)

Knee Pain - The Causes and Symptoms


The knees are extremely prone to getting injured. This is mainly because they have extremely complex structures, and are made up of tendons, bone, cartilage and ligaments. They often experience quite a lot of rough treatment, just by our daily actions. They bear weight and often get injured when we fall over.

The following are the main symptoms and causes of knee pain:

Symptom: The knee is extremely sore, also swollen and painful when you move it.

Cause: This can often be due to the soft tissue below the knee cap having softened. Also, you could have a tear in your cartilage or ligaments.

Symptom: Pain when stretching your legs, or at the back of the knee.

Cause: You may have torn your hamstring.

Symptom: The knee always seems to be sore; it is hard to move and cannot carry much weight without becoming unstable.

Cause: You may have torn the cushioning cartilage at the end of the bones in the knee. It is called the meniscus.

Symptom: A constant but not extremely painful ache in the knees. Swelling also occurs.

Cause: You may have damaged your articular cartilage. This can be caused by an injury, or just everyday wear and tear.

Symptom: The knee being unstable, and giving way with any amount of weight being placed on it. If the knee makes a popping sound, swells or is sore when standing which may make it give way and prevent you from standing or very much movement.

Cause: It is possible that you have had an injury in your anterior cruciate ligament, otherwise known as ACL, or your posterior cruciate ligament, otherwise known as PCL. This is quite a common injury in dogs, and it is more common to injure your ACL.

Symptom: The knee shape has changed

Cause: You may have fractured the knee, or torn a ligament.

Symptom: The knee has swelled, is painful or is unstable when you put weight on it. Your mobility is reduced.

Cause: Over extension of the knee joint. It is a common injury if you do sports that involve jumping or turning, and the knee joint extends beyond being straightened like it usually is. It usually happens because of weakening bodily contact, or just awkward landings.

Symptom: Pain, stiffness or swelling throughout the knee joint in the long term. The pain increases throughout winter.

Cause: These are the symptoms of osteoarthritis.

Symptom: Swelling towards the back of the knees.

Cause: You may have Bakers Cyst.

Symptom: You are aged between twelve and eighteen, and the kneecap is sore to the touch.

Cause: It is possible that you have Osgood-Schlatter Disease. A lot of teenage males experience this, often when they have growth spurts.

Symptom: Sharp pain between the kneecap and the shinbone, especially during and after harder activities, such as jumping or running.

Cause: This is often a symptom of Tendinitis, which is an injury in the tendon that joins the kneecap and shinbone. It is caused by overdoing strenuous activities.

Symptom: The knee sometimes locks up, and is unable to move. Excessive pain felt throughout the knees, and a grinding feeling when you do move it.

Cause: You have probably torn a cartilage.

These are the most common knee injuries, and although none of them may seem life threatening, they are not to be ignored. If you find yourself suffering any of these symptoms, I would strongly recommend seeing your Doctor.

Alternative Surgery to Prevent Knee Arthritis


Osteoarthritis, the commonest form of arthritis affects the knee joint most often in India. Elderly afflicted by this chronic painful disease need joint replacements as a permanent solution to improve their quality of life and put an end to disabling pain. However it is increasingly common to see many young people also suffer from the earlier manifestations of the disease. In this group alternate solutions have to be recommended considering the age, increased demands like participation in sports and work. Joint replacements cannot obviously be a solution to young men and women.

Osteoarthritis is a age related wear of Articular cartilage which covers the end of the long bones in a joint. It is smooth, elastic, shining tissue. It is responsible for lubrication, shock absorption, and pain-free movements. Unlike other tissues of the body, it has limited capability of regeneration and repair as it has no blood supply and nerve supply. This limited repair capacity decreases with aging and leads to depletion in the arthritis knee. Pain and stiffness ensue, necessitating medication or surgery.

Osteoarthritis does not involve the whole of the joint to begin with. A localized area of cartilage damage called a lesion is the precursor and harbinger of the disease. If left untreated, lesions greater than 1. 5 cm will lead to arthritis after 15 years.

Some generalized and local conditions predispose to early cartilage damage. These are mechanical, chemical, and biological. Occupations, Obesity, mal-alignment or structural damage can predispose to cartilage damage.

Ligaments and menisci stabilize the knee. Menisci dissipate stresses, help in lubrication, increase joint conformity and confer additional stability. The ligaments inside the joint are called the cruciate ligaments. These are torn in many sports, or two wheeler accidents. An ACL injury is the commonest ligamentous injury. Unrepaired ACL's lead to further tearing of the menisci and both in association can lead to osteo-arthritis.

Meniscal tears can occur in isolation in sports or domestic accidents. After the importance of the menisci was realized and arthroscopic surgery came into vogue, attempts are made to resect and remove only the damaged portion of the menisci and preserve the rest. However, it is not always possible to do so as the damage is beyond repair and a total or subtotal Menisectomy is necessary. Such knees are also predisposed to develop secondary osteoarthritis (occurring in younger persons at an earlier age) cf Primary osteoarthritis which occurs in the elderly.

Some people have deformities around the knee. These may be situated in the thigh bone or leg bone. Normally in the standing position, there should be no gap between the inner side of the knee and ankle joint. If a gap exists between the knees, then the person has bow legs (Genu varum) and if a gap exists between the ankles, then the legs diverge at the ankle, causing knock knees (Genu valgum). Both these deformities can lead to one sided wear of the knee joint and arthritis in one half of the knee.

Surgical solutions are available to prevent or treat early arthritis. These alternatives avoid knee pain from arthritis.

These knee reconstructive procedures attempt to restore the anatomy of the joint and are mainly of a biological nature. They do not involve joint replacement. Examples are

1) Knee ligament reconstruction- ACL reconstruction is possible through tiny key-hole incisions (arthroscopic surgery). Graft is taken from the patient's own body (autograft) or from a brain dead person, (allograft). This tendon graft is threaded through bony tunnels in the leg and thigh bones and is fixed with screws, buttons or other devices.

2) Meniscal suture- This is a procedure in which attempt is made to suture a torn meniscus if situated in a suitable position. Concomitant ACL reconstruction is required if there is an injury to this ligament also. This is done through arthroscopic surgery.

3) Meniscal transplant- This procedure is to be introduced shortly. In this menisci are harvested from the knee joints of brain dead living donors or non heart beating donors. These are preserved and then grafted into the damaged knee.

4) Reparative cartilage procedure are available to salvage localised cartilage defects and prevent their progression to extensive involvement. These are microfracture wherein small holes are made in the raw area to generate a super clot and in growth of fibro cartilage. In mosaicplasty, cartilage plugs are harvested from non weight bearing portion of the knee and re-implanted into the lesions.

5) Corrective osteotomy- Mal-aligned joints can be corrected by an osteotomy (division of bone). After this surgery, stresses across a joint are distributed more evenly excess wear from one half of the joint is minmized. This again prevent rapid progression of osteoarthritis and can postpone the need for a replacement.

These surgical alternatives are available in Chennai to treat painful knees in young people and prevent progression to arthritis. By availing these alternate surgical procedures where one is indicated, one can preserve and continue with natural cartilage and postpone or avoid joint replacement by a decade or more.