Saturday, February 8, 2014

Anterior Knee Pain in Adolescents


Chronic pain occurring in the front and center of the knee can be common among active, healthy young female adolescents. While the condition can affect young boys, it is more prominent in girls. The cause for the pain in the anterior portion of the knee may not be known, but the complex anatomy of the knee joint makes it more sensitive and susceptible to activity, training, and overuse.

Pressure may have a tendency to pull the kneecap sideways due to overuse or activity, attributing to the pain just behind the kneecap. In adolescents a number of factors may be involved.

繚 Imbalance of thigh muscles (quadriceps and hamstrings) that support the knee joint

繚 Overdoing sports activities

繚 Poor flexibility

繚 Problems with alignment of the legs between the hips and the ankles

繚 Using improper sports training techniques or equipment

Symptoms in Adolescents

Most adolescents report that the pain in the anterior portion of the knee is gradual, but over time can occur at all hours of the day or night. If you suffer from this condition you may experience these common symptoms:

繚 Popping or crackling sounds in the knee when you climb stairs or stand up and walk after prolonged sitting.

繚 Pain at night.

繚 Pain during activities that repeatedly bend the knee (i.e., jumping, squatting, running, and other exercise, especially involving weight-lifting).

繚 Pain that causes your knees to give way (buckle), although this is uncommon

繚 Pain related to a change in activity level or intensity, playing surface, or equipment.

If the pain persists and limits regular daily activities, the thigh muscle may weaken due to lack of use. If the knee pain is lasting, it is important to see your doctor right away to diagnose the cause of the pain and administer treatment.

Treatment and Prevention of Knee Pain

If the pain is mild, but not severe enough to seek medical treatment, you may follow steps for conservative at-home care. Ice, rest, and simple exercises are often helpful for adolescents with pain just behind the kneecap. If the pain persists, a visit to the doctor may be required. Your doctor may offer non-steroidal anti-inflammatories to assist with the painful episodes.

If the pain goes away through conservative treatment at home, but you have concerns about it returning, you may be able to prevent recurrences by following these steps:

繚 Limit the total number of miles you run in training and competition.

繚 Stop or reduce any activity that used to hurt your knees.

繚 Wear shoes appropriate to your activities.

繚 Warm up with stretching exercises before physical activity.

Panhandling in the Information Age - Ask For Money Online!


So, most of us have seen them - the sad, grimy, down-on-their-luck types - perhaps holding a sign saying, "Will work for food," or "Homeless Vet." (One of my favorites - yes this was an ACTUAL sign and a web search will turn up pictures of it - is "Ninjas killed my family - need money for karate lessons.")

No matter how we feel about begging for money, it happens all around us. And as unbelievable as it may seem, people can actually make a very good living panhandling. A television news crew in Memphis recently reported on several local panhandlers who make $150 a day, just by asking for it. One beggar follows groups of tourists and hits up friendly-looking couples with nothing more than a smile... and averages $200 per night doing it!

In the information age, "virtual panhandling" is slowly becoming known as an option for anyone who needs money for any reason. Examples of cyber-begging, as it's come to be known, can be documented as far back as 1998. During the summer of 2002 it became widely known when a woman in Brooklyn, New York, started her web site asking people to save her from her credit card debt. She wanted to raise $20,000, and in a mere 20 weeks her website received over two million hits and her debt was paid off! 

Since then, there have been countless other examples of cyber-begging - successful and not. People are trying to raise money for everything from plastic surgery to divorce to house payments to vacations - and a significant number of them achieve at least a modest level of success! 

Now, I'm certainly not encouraging anyone to give up their day job and hit the street - physically or virtually! But if you have a financial need, and can present it online in a compelling manner, it may very well be worth it to you to ask for money online! You don't even need any experience creating your own web site. 

If you'd like to capitalize on already existing website traffic and search engine rankings, simply sign up on one (or more) of the available sites that have sprung up to help people ask for online donations. On most of them, you will pay a minimal monthly charge (with a few upcharge options for things like links that are bolded or shown in a different color, or preferred positioning for better visibility), and you are given your own page to tell your story and ask for money in whatever manner you choose. They will also provide you with a personal link straight to your page; this is very helpful if you wish to generate some extra publicity for your cause on an online forum, website classifieds, or even your local newspaper.

If you choose to go this route, you will want to carefully examine the site you choose to post on and the image it projects. Some sites definitely offer a more professional, caring, and welcoming design, while others offer a more cheesy/sleazy bent. While there is undeniably some room for "cheese" if you are trying to raise money for breast implants, you may want to project a more sympathetic appearance if you need money for medical school tuition.

If you're feeling a bit more adventurous and technically savvy, go ahead and set up your own personal cyber-begging site dedicated just to you! There are several places online that will allow you to set up and host your own site for little or no cost. In most of these cases, you can also choose to purchase your own domain name for your URL, or stick with the subdomain the host assigns to you. However, using this method, you need to be prepared to wait a bit longer for the donations to start rolling in. You will need to submit your new site to the search engines, optimize it for search keywords, and publicize it to drive people to visit it. That's definitely do-able, but will take a great deal more time and effort.

Either way you go, a PayPal account is a must. Using a PayPal account, you can receive donations from your new online friends anonymously - no one needs to send cash to your address, or a check to your name. PayPal makes it anonymous for the giver as well, freeing them from worries that you may contact them later to hit them up again! 

So, next time the money blues hit - whether you lose your job, want to finance your next vacation, or simply need a bit extra for that little pick-me-up - consider asking for money online. Who knows; the rewards could be, well, rewarding!

The Seeds of Arthritis Can Be Planted Early in Life


I used to play rugby in my younger days. Quite frankly, I was brilliant - fast, nimble, great foot-balling skills, and every other attribute that aging ex-players like to invent about themselves! Still to this day, I allow myself to dream sometimes that I could have played for England, if only I'd been noticed by one of the big clubs (and had 300% more talent)!

The funny thing is that I now actually feel incredibly lucky.

During my career in medicine, I saw so many aging ex-sports people (both professional and amateur) suffering with severe chronic pain and mobility problems which were often a direct result of injuries sustained playing sport.

Rugby, football, tennis and badminton were the biggest culprits in my experience, but ultimately it is rugby that has left patients with the most widespread problems throughout the body.

There are over 100 forms of arthritis, the most common being osteoarthritis and rheumatoid arthritis. Sports related arthritis is often referred to as secondary arthritis and occurs as a result of a traumatic injury, joint damage and years of repetitive pounding upon the joint. But normal work activity can often be blamed - jobs such as typing, construction and factory work, and working as a shop assistant - where joints can take a real hammering.

As in all forms of arthritis, this leads to wear and tear of the tissue around the joint. The loss of that natural cushion means that the bones will literally grind against each other causing chronic pain and severe reduction in mobility and suppleness. It's only now at the age of 65 that I've started to have my own struggle with arthritis, but I feel fortunate not to have suffered from it earlier. According to the law of averages, I could have suffered a lot more when I was younger, as I've had bad injuries with my knee and broken the same wrist twice - all down to rugby.

It's only in the last couple of months that I've started to feel stiffness and inflammation in the index and middle fingers on my right hand. I never broke them, but I did develop an agonizing habit of dislocating them - twice the index and three times the middle finger.

Fortunately, it's possible to relocate them immediately, but the cumulative effect of those injuries combined with other bruises and swellings over the years have finally taken their toll.

You can make your own luck

I'm convinced that the reason I've avoided arthritic problems for so long is all due to the way I've tried to look after myself, paying special attention to those joints that I felt were most likely to develop problems (wrist, knee and fingers).

I managed to stave off the onset of any problems, in particular, by taking natural supplements over the years. Not only have they helped to prevent the condition from starting but they are also proven to slow down further deterioration of a condition whilst bringing pain relief.

Ways to help yourself:

1. Watch your weight - the heavier you are, the more pressure you put on your limbs, especially the joints.

2. Light exercise, a gentle swim will reduce inflammation and aid mobility.

3. Heat therapy gloves (as recommended here before). Try to prevent the hands and wrist getting cold (see list of products opposite).

4. Seek advice from a physiotherapist and establish a daily routine of flexibility exercises.

5. Use pulse therapy - MicroDoctor is the most effective device available today (see list of products opposite).

6. Drink Queen of the Meadow (Meadow Sweet or Filiendula Ulmaria), a plant extract that alleviates pain and is a natural anti-inflammatory. Normally taken with tea.

7. Use Blackcurrant, take it naturally for best effect. It has been used to treat arthritis for centuries and is particularly good for the knees. Drink the juice and apply the remaining slush to the affected joint.

But now I need that something extra

I've dodged the bullet for a long time but finally my repetitive finger injuries have caught up with me. At one point during the summer it was so bad that Maria had to type the newsletter - the pain and stiffness were just too much.

I had another look at the arthritis products I mentioned here before and I was reminded that the two main ingredients of Artrosilium. Were Queen of the Meadow and Blackcurrant.

Knowing their proven worth, and understanding that a formulation with both would be even more potent, I sent away for six tubes which should take me up to Christmas.

After only three days, I could feel a significant difference. My fingers were more supple and relaxed, the pain had gone and the muscles around my fingers were moving comfortably once again. Overall, a fantastic result!

I've since started applying it daily to my knees and wrist, using it as a preventative measure. I know it's been only six weeks but all the joints - knees, wrist and fingers - feel completely normal, supple and pain free. If you would like to give your joints a chance of functioning normally and prevent any chronic pain from setting in, I couldn't recommend a better daily treatment than Artrosilium.

I'm continuing to take a regular dose of Queen of the Meadow in my tea and the odd application of Blackcurrant. You can never get too much of a good thing, especially when you know there are no side effects - unlike the worrying potential dangers of NSAIDS that I listed here last week!

Finally, I've received loads of letters asking me about the Q Link pendant experiment where I gave a number of you the chance to give me your views on its effectiveness.

I'm currently in the process of gathering the results and should be able to give them to you within the next couple of weeks - make sure you click on for that one!

After writing the newsletter, I often dream about some of the things I've written - I can't wait to go to bed tonight as I'm already planning to score the winning try for England against New Zealand - might even go to bed with my old boots on!

Anyway, that's all from me for now. Keep smiling and stay healthy!

Knee Ache When Sitting - You Don't Have to Stand For it Anymore - Special Report on Knee Supports


Can you relate to any of the following?

You don't enjoy going to the movies. You avoid long car rides. You dread sitting at your desk at work to finish an important assignment. Why? Is it that you're anti-social, or dislike travel, or hate your job? No! It's the knee ache when sitting. When you sit in one spot for too long, your knees start to ache and throb. The aches and pains can get worse the longer you sit until you can't stand it any longer. But the good news is, you don't have to stand for it anymore. The relief you've been looking for could be something as simple as a knee brace. Here's why...

A lot of people may think that knee pain occurs only with activity. However, knee aches and pains when sitting is a common problem. Knee aches when sitting is typically felt in the front of the knee, in the area of the kneecap (patella). Generally, this type of pain is caused by the compression of the knee cap (patella) and the cartilage underneath (meniscus) against the femoral groove (the indentation at the end of the femur-or thigh bone-where the knee cap sits). Normally, when the knee is bent, the pressure against the knee cap (caused by the pulling of the attached muscles and tendons), increases.

Over time, knee ache when sitting can be felt, especially if the knee cap is not sitting exactly as it should within the femoral groove. The ache may become worse the longer you sit. This type of pain (called patellofemoral pain syndrome), may occur in one knee or both. Still, while this condition is a common cause of knee pain problems while sitting, it may not be the exact cause of your particular pain, and it is always wise to have your condition evaluated by a qualified physician. In the meantime, while your symptoms might be partially relieved by taking a break from your sitting position, or by icing the knees while sitting, it would be preferable to prevent the knee ache while sitting from occurring altogether. A knee brace may help you do this.

A knee brace is designed to lend support to your knee joint. When used properly, a knee brace can help relieve the pressure on the knee cap as it is rests in the femoral groove while you are sitting. A knee brace may also help keep the knee cap properly aligned within the femoral groove, thus helping to relieve the ache caused by the compression when sitting.

Meniscus Tears - Information on Torn Knee Cartilage - Knee Braces For Improved Support


Meniscus Tears

Do you have a knee injury? - Do you have increased knee pain?

Introduction: Torn cartridge in the knee is also known as a meniscus tear. The meniscus is found in the between the shin bone (tibia) and your upper leg bone (femur). The meniscus helps to cushion the knee joint and allows movement of the bones without causing harm to the bones. When a tear occurs in the meniscus, this can cause a painful injury in the knee and often requires some form of medical treatment.

1.) Meniscus Tear Problems

Who is most likely to suffer from torn cartilage or a meniscus tear? The truth is that anyone can suffer from a knee injury in their life because the knee joint is one of the most used joints in the body. The knee joint has to be able to absorb the entire weight of the body, and if there is damage to the cartilage (or meniscus), the weight can become unbalanced in the knee and lead to further injuries. There are two main kinds of people who are more likely to suffer from a torn meniscus and those include athletes, or people who are active on a regular basis.

2.) How The Injury Happens

When people usually suffer from a torn meniscus, it can be caused from turning or twisting the knee suddenly and this can cause the cartilage in the knee to tear. People who are prone to degenerative diseases like arthritis usually develop meniscus tears over time as well. The meniscus gets worn down as we age, and if a person has a family history of arthritis or other degenerative bone and joint ailments, the chances increase of a meniscus tear occurring.

3.) Knee Braces For Support

When a person suspects that they have a meniscus tear and seek advice from a doctor. Sure you will be the first to know that someone is not right, but self diagnosis is never recommended. The doctor will usually start out with a series of questions for the patient to try to develop a cause of the injury and what the most likely reason for having the knee injury could be. Knee braces can be used very effectively to help promote healing with these kinds of injuries as well. The meaningful support can help you to reduce your knee pain, and improve your stability as well.

(*This is health information. Speak to your doctor about medical advice.)

How to Understand Rheumatoid Arthritis & Osteoarthritis - Chronic Pain and Treatment Strategies


The previous two articles in this series analyzed and discussed rheumatoid arthritis (RA) in some detail. The link between chronic pain and RA was analyzed and the progression of the RA chronic pain complex was revealed. Particular attention was paid to small joint pain, usually involving the neck, hands, and feet in the early stages of the disorder, then spreading as the disease takes hold and progresses. The progression of chronic, often acute pain affecting the larger joints, to include the upper, middle, and lower back, hip and knee pain, and even leg pain, usually expressed as sciatica, was discussed. As discussed in "Understanding Rheumatoid Arthritis - Dealing With Chronic Pain Associated With RA Part I & II," RA is a chronic and systemic disorder, widespread throughout the body, and without cure. In this article we will discuss the differences between rheumatoid arthritis (RA) and an often misdiagnosed, misunderstood "cousin," osteoarthritis (OA). We will discuss diagnostic features distinguishing the two disorders, the symptoms of RA versus OA, and some treatment variations and similarities. The very different outcomes, or prognoses, as well as certain strategies for confronting the two conditions head on will also be explored. Finally, strategies for alleviating, and in some cases eliminating, the chronic pain associated with rheumatoid arthritis and osteoarthritis will be offered. Chronic pain treatment strategies, to include treatment for neck pain, back pain, hip and knee pain, and sciatica, will be compared and analyzed.

As noted above, rheumatoid arthritis is a chronic, systemic disorder. Rheumatoid arthritis is an autoimmune disease occurring when the individual's immune system doesn't work properly or malfunctions. Rheumatoid arthritis causes chronic, often acute pain, stiffness and swelling, and progresses from small joint involvement, to large joint involvement, and ultimately to multiple organ consequences. Chronic pain associated with RA is usually the result of an inflammation of the synovial membrane, synovitis. The inflammation of the synovial membrane leads to friction, the friction leads to joint degeneration, which leads to more inflammation, which leads to more friction and joint degeneration. As the disease progresses, and begins to affect other organ systems, the result is usually total disability. The exact cause of rheumatoid arthritis has not been established. Many experts believe that RA may be the result of genetics, environment, and/or a number of other factors to include hormones and the body's reaction or response to stress. Onset of RA typically occurs in women between the ages of 30 and 50 years of age. However, rheumatoid arthritis has been known to strike the very young, men, and certain ethnic groups, to include a disproportionately high number of Native Americans. RA is also seen in higher numbers among smokers. Rheumatoid arthritis is generally not attributed to such things as aging, trauma and injury or obesity. Beginning with small joint pain and stiffness, the disorder culminates in deformity and chronic, often acute, back pain, hip and knee pain, and sciatica.

Osteoarthritis (OA) is generally considered an age-progressive phenomenon. Sometimes called the "wear and tear" disorder, OA may also be attributed to injury, trauma, stress, and/or obesity. Osteoarthritis typically expresses with joint pain, stiffness, and loss of function and did decrease in the range of motion. Unlike rheumatoid arthritis, osteoarthritis generally affects weight bearing joints, particularly the spine, the pelvis or hips, and the knees. Chronic back pain, particularly of the lower back, and leg pain (sciatica) are quite common. However, OA may also be present in the neck, the hands, particularly the finger joints, and even the big toe. Osteoarthritis generally worsens later in the day or after considerable activity. Alternately, rheumatoid arthritis is generally known for morning stiffness or stiffness occurring as the result of a lack of activity or after periods of prolonged inactivity.

Significantly, while as many as 1.5 million individuals in the United States have been diagnosed with rheumatoid arthritis, over 20 million people have been diagnosed with osteoarthritis. While diagnosis for osteoarthritis is usually established with the use of x-rays, in some cases CAT scans, rheumatoid arthritis usually takes a more comprehensive battery of diagnostic tests to properly diagnose. RA sufferers may require extensive blood tests, x-rays, CAT scans, and in some cases even an MRI to properly diagnose the disorder. The very different symptoms of the two disorders, one systemic and the other a "wear and tear" disorder, are evident in the laboratory and radiographically (x-rays).

Treatment strategies for RA and OA are often remarkably similar. Although RA requires pharmacological intervention, generally in the form of disease-modifying anti-rheumatic drugs or DMARDs, to reduce stiffness and chronic pain, as well to inhibit joint damage, this should not be the only treatment strategy employed. DMARDs often take weeks, even months to build up in the bloodstream and fully take effect, so NSAIDs are often used synergistically, and as a stop-gap until DMARDs are effective. Osteoarthritis, on the other hand, may also be treated by NSAIDs. However, ibuprofen and acetaminophen are routinely prescribed for pain associated with osteoarthritis.

In addition to medication, both rheumatoid arthritis and osteoarthritis are responsive to physical therapy and ice to reduce inflammation and swelling. Individuals suffering from RA or OA typically respond well to exercise. Exercise is particularly effective for RA sufferers in order to offset periods of inactivity and the stiffness associated with a sedentary lifestyle or simply the stiffness related to characteristic morning stiffness. Osteoarthritis, on the other hand, responds well to exercise for different reasons. Individuals affected by OA, a typically age-progressive, trauma, and stress related phenomenon, respond quite well to strengthening of the musculoskeletal system, particularly the core muscles responsible for posture and overall strength. As muscles atrophy, deterioration of the bones, particularly the vertebrae and weight-bearing joints, is quite common, leading to "wear and tear" and an exacerbation of the overall condition and subsequent degeneration. The degeneration leads to a constellation of chronic pain symptoms, to include neck pain, back pain, and sciatica.

Ultimately, while etiology or cause of rheumatoid arthritis and osteoarthritis are quite different, symptoms, such as swelling, inflammation, stiffness, and chronic pain are characteristic of both conditions. Individuals suffering from RA and OA are affected by a progressive disorder, both leading to total disability if not properly treated. Individuals diagnosed with osteoarthritis, because of the very nature of the disorder, have a much better chance of alleviating and even eliminating the long-term effects. RA is, by its very nature, more problematic. That being said, individuals suffering from rheumatoid arthritis may take control of the outcome, their prognosis, by engaging in an aggressive, holistic treatment strategy, one typically designed to treat the symptoms, since etiology is still unclear. In both instances, medication, ice for inflammation, swelling, and to reduce pain, and a medically approved, individualized program of stretching and exercise should be commenced as soon as possible. Chronic pain associated with both conditions should be taken as a warning to do something, rather than to do nothing. To do nothing will exacerbate either condition, leading to further degeneration and the progression of both disorders and their symptoms, to include chronic pain in the form of joint pain, neck pain, back pain, and/or sciatica.

Friday, February 7, 2014

Osteoarthritis Back Pain


Osteoarthritis back pain is one of the most commonly diagnosed sources of chronic dorsopathy, especially in the lumbar and cervical spinal regions. Arthritis comes in many varieties ranging from normal and asymptomatic to terrible and debilitating, but the osteo variety is particularly interesting to back pain scholars. Osteoarthritic change is virtually universal in the spine of every adult human and is one of the greatest back pain scapegoats in the medical industry. It is the goal of this article to provide an objective view of this condition and how it relates to the way chronic pain is treated in the healthcare sector.

Osteoarthritis describes a condition that affects many of the joints in the body. It most commonly occurs in the hands, hips, knees, elbows, shoulders and spine, although it can strike virtually anywhere. The signs of the condition include a wearing away of the protective mechanisms in the joint capsules, as well as the growth of bone spurs called osteophytes. As the protective cartilage is worn down between bones, friction occurs, causing bone spurring to begin where one bone touches another. Spurring can be seen on diagnostic x-ray, although MRI technology will provide a far more comprehensive view of the actual joint deterioration.

All this sounds really bad, but the reality clearly shows that osteoarthritis is universal, normal and expected to experience as we get older. Most arthritis truly begins to kick in around middle age, although genetic and lifestyle factors can make it commence later or far earlier. Abnormal wear and tear on the joints can make arthritis take hold at unusually early ages in some cases. Widespread research shows that arthritis can certainly be responsible for minor discomfort and some occasional pain. However, there is no evidence linking mild to moderate arthritic change to the types of chronic back pain most commonly associated with the condition. Despite these findings, osteoarthritis continues to be the second most common back pain scapegoat, bested only by intervertebral disc concerns, such as degeneration and herniation.

When a patient complains of back pain, doctors virtually always look for a structural source on which to blame the symptoms. This is an inherent practice of Cartesian medical philosophy. The advent of advanced diagnostic imaging technologies has made it simple to look into the joints and find evidence of arthritic changes which are subsequently blamed for enacting pain. In my experience, when arthritis is found in the spine, it is almost always cited as a primary causation or partial contributor to back pain, even though there is absolutely no reason to see it as a malignant factor.

In fact, doctors rarely inform diagnosed patients of the complete picture when it comes to osteoarthritis. Here are some lesser known facts that may surprise you if you have been diagnosed with spinal pain blamed on bone spurs, facet joint changes or vertebral degeneration common to arthritic processes:

* Arthritis is found in almost every adult. Most people do not have pain, despite varying degrees of arthritic evidence. The degree of arthritic change has little or no bearing on whether a person may complain of pain or not. Many patients with minor arthritic change have severe pain, while some people with extreme conditions have no pain whatsoever.

* Regardless of whether a condition actually causes pain or not, the typical treatments used for spinal arthritis will do nothing to resolve symptoms, if indeed they are caused by the condition treated. Physical therapy, chiropractic, pharmaceutical treatment, epidural injections and a host of others will not change spinal anatomy or do anything to resolve arthritic evidence.

* Often symptoms are obviously affecting soft tissues, such as muscles or ligaments, or involve neurological tissues. This is not consistent with arthritis, although the diagnosis usually stands firm if structural evidence is found.

I hope to have provided a different view on arthritis in the spine and possibly provided the groundwork for affected patients to do more research on their own diagnoses. As a final thought, the only treatment typically effective at ridding the body of arthritic alteration is spinal surgery. Although the supposed structural reasons sourcing the pain can certainly be eliminated using invasive interventions, the facts show that back surgery is the least effective and most risky of all treatments possible. If arthritis was truly to blame for all the pain, then an objective observer would expect the exact opposite to occur.

Osgood Schlatters Disease Treatments


There happens to be various methods to deal with Osgood Schlatters disease however, a few tend to be far more beneficial compared to others. One of the more typical treatment options is RICE (Rest, Ice, Compression, and Elevation) and taking some kind of pain reliever like Ibuprofen or Advil. In the event you go to a doctor they may explain to you some type of this specific treatment. They might also tell you to make sure you take around a weeks' time off from performing anything which places stress upon your knees and slowly begin to work out more. Carrying out this particular treatment method might do the job however, the discomfort will certainly not end up being eliminated, merely lessened. The only method for the pain to go away completely is for you to wait for the growth plate to stop growing.

A far more extreme measure can be for you to have surgery done and have the bone pieces of which didn't heal taken out. Surgery really should only be done on adults of which are completely developed mainly because it is taking away some of the growth plate during surgery which kids need to have in order to develop. Getting this form of treatment performed is only required when the pain is chronic and additional treatment methods don't do the job. According to one study anybody who had this specific surgery performed ended up with excellent results and were able to get back to regular exercising within just a short amount of time. The residual pain was also determined to be extremely minimal which in turn suggests the surgery is extremely effective.

The following treatment plan isn't actually a treatment but more of a solution to reduce the discomfort while performing physical exercises. A really helpful method is to purchase a jumper's knee band which and place the band right across your leg where the lump is. This places even and gentle compression on the lump which in turn puts less strain on the tibial tubercle. Doing this is going to help make it so the pain is manageable and you will be able to still exercising. An additional brace which oftentimes helps is a knee brace. This supports the entire knee and therefore placing significantly less strain on the knees. Both of these kinds of braces help with the pain when performing exercises however won't help the pain go away long term. Like I said previously the only solution to help make the pain disappear permanently is to wait until the growth plate is finished growing.

There are a large number of methods to cure Osgood Schlatters disease and you have to discover what one will work best for you. At this time there isn't anything that is going to magically cure you however there are options to assist with the pain. The options I went over above are the most effective and will yield the best results. If you have any other treatment methods, please comment below.

The Good and Bad of the Hip and Knee Replacement


When I speak with other orthopedic doctors, one thing is clear-hip and knee replacement surgeries are on the rise. As the baby boomer generation grows older, demand is growing for these increasingly common surgeries, according to a study presented at the American Academy of Orthopaedic Surgeons' 2006 annual meeting.

It's obvious that the baby boomers are not so willing to give up their active lifestyle and leisure pursuits, so hip and knee replacement is going to be more prevalent as time goes on! So the question for many over the age of 55 is:

Is Surgery For You?

When people suffer from severe osteoarthritis, hip or knee replacement is often the best option to stay active longer. In over 70% of patients, implants replace joints that are damaged or worn out due to osteoarthritis. But many also have the same surgery performed due to fractures, injury trauma or rheumatoid arthritis. Although the average age of patients is 71 years old, the trend seems to be leaning toward younger and younger patients.

Undergoing a hip or knee replacement is a major decision for you and your doctor, so it may help to know that 82% of 1,001 patients surveyed by Consumer Reports were "very satisfied" or "completely satisfied" with their results.

As I tell my patients, however, recovery doesn't happen overnight and may be painful. Of the people surveyed, the majority was able to cease taking pain medication after two months, but 12% were still taking it one year after surgery.

It is encouraging to know that 90% of patients could do everyday activities after one month. At the same time, it is important not to push your body too hard. In fact, one-third of hip patients and one-quarter of knee patients were unable to walk half a mile one year after their surgeries. While most people have success with replacement surgery, there is a small chance of infection, and complications, like weakened muscles and legs of unequal length, can occur.

Are There Less Drastic Alternatives?

It is true that a standard replacement gives most people the best possible results, but some alternatives are available:

Hip resurfacing - This procedure can help even severe arthritis sufferers by employing a smaller implant and removing less of the bone than standard replacement surgery.

Knee Osteotomy - Best for young, active patients, this surgery shifts pressure off of the weakest part of the joint. It is an option for people whose arthritis is located on only one side of the knee.

Partial knee replacement - This is a choice if you have limited osteoarthritis and involves resurfacing only one compartment of the knee.

Although hip or knee replacement-or the alternatives-is a big decision, it is important not to wait too long. If you have pain that makes it difficult to sleep and perform everyday tasks, and doesn't respond to pain medication, you should see an orthopedic surgeon who will help you decide what course of action to take.

The good news is that joint replacements are improving, so chance of success is high, and patients can enjoy many years of freedom from aches and pains. There is no reason why you shouldn't make your golden years as active and fulfilling as possible.

Oxinium Knee Replacement For Young Patients With Osteoarthritis


Total knee replacement is generally performed in older patients with osteoarthritis. For the first time in India, a new prosthesis for young patients with osteoarthritis will be introduced. This prosthesis made of a wonder material called Zirconium, a ceramic coated metal ensures longer survival of the prosthesis after implantation. The introduction of this prosthesis will hopefully encourage more number of young and middle aged Indians and Westerners to undergo knee replacement in India.

Advantages of Zirconium

1) The significant advantage of Zirconium knee implants is that it is considerably harder. On testing it lasts 85 times longer in tests that simulate the stresses inside the actual knee. Additional advantages are scratch resistance.

2) When it is wet, ceramic can glide smoothly along plastic, making for smoother motion than with metal-on-plastic. As a result, the Oxinium total knee replacement will not generate the quantity of plastic wear debris that cobalt chrome will, and the implants should last considerably longer. Zirconium is one of the six most biocompatible elements know to man. So, your immune system will more easily tolerate your new implant.

3) Lastly, patients who are allergic to nickel, the metal most often used in the current implants, cannot currently receive total knee replacements. The ceramic implant, however, can be implanted safely in patients with nickel allergies, since it uses a zirconium alloy with no nickel. Implants made of Oxinium have been implanted in larger number of patients in the UK Australia and the US with great success.

Who would benefit most from an Oxinium (zirconium) total knee replacement?

Three types of patient have been identified as the "best" candidates for an Oxinium total knee replacement.

"Younger" patients: Because Oxinium knee implants offer significantly less wear compared to cobalt chrome implants, they are expected to last considerably longer. In the past, orthopedic surgeons have advised patients less than 65 years of age to wait to have knee replacement surgery because the life span of the cobalt chrome knee implants is only 10-15 years. Now, surgeons have a viable option for a younger patient who previously would not be a candidate for a total knee replacement because the Oxinium knee implants should last much longer. Therefore, a patient under the age of 65 who has advanced arthritis of the knee no longer has to suffer for years until he reaches an appropriate age for total knee replacement surgery.

"Active" patients: Patients, who desire to return to an active lifestyle, including sports, dancing, gardening, or other strenuous activities, may also benefit from an Oxinium knee replacement. As a result of their high activity level, this patient population will put more "wear and tear" on their knee replacement, which can cause the implants to wear more quickly. An Oxinium knee is better able to tolerate this high activity level and last longer that the traditional cobalt chrome knee. Metal allergy patients: Because Oxinium is one of the most biocompatible materials known to man, it is the only choice for patients who exhibit metal allergies. Patients who have needed total knee replacement surgery, but could not tolerate the cobalt chrome implants due to their nickel content, can now have the surgery they need to return to an active lifestyle without the fear of an allergic reaction.

The first patient will be a middle aged Housewife with osteoarthritis. Whereas normal knee prostheses cost about 80,000 rupees, this new prosthesis may cost about 1. 25 lakhs, but it is comparable to the best in its category. The higher cost will be offset by the longer survivorship of the implant. A Total knee package is available for Indians and foreigners with normal and long life prostheses at affordable costs.

Runner's Knee Injuries & Treatments


Running is one of the most effective aerobic exercises around. It strengthens the heart, increases athletic endurance, decreases stress, whittles the waistline and even improves posture and balance. Like most athletic endeavors, however, running has the risk of injury. Since a runner's knees receive the bulk of the impact, it is no wonder that knee injury is among the most common running-related ailments. The three most common knee injuries observed in runners include:

Plica Syndrome
Plica syndrome is the inflammation of the tissue surrounding the knee joint. In some extreme instances, the lining can become so inflamed it creates a "shelf" that extends beyond the knee cap. Plica Syndrome can be very painful and treatment involves physical therapy and in some cases surgery.

Patellofemoral Syndrome
Also know as plain old "runner's knee," Patellofemoral Syndrome involves the erosion or softening of the cartilage around the kneecap and is usually the result of years of repetitive movement. While there is some debate over treatment and recommendations will vary depending on the injury's specifics, most medical experts agree that Patellofemoral Syndrome is best managed with mild to moderate pain relievers, isolated muscle work, preventative stretching, and a quality patella knee brace or sports knee brace.

Dislocating Kneecap
Dislocating kneecap is exactly what it sounds like... a propensity for the knee to dislocate during what would be normal innocuous movements on a healthy knee. This ailment is not only painful during the actual dislocation, but with time, it can lead to chronic pain and knee instability. Dislocating kneecap is best treated with physical therapy (typically strengthening exercises) and a patella stabilizer.

Note: This information is not intended to supplement or replace advice from a medical professional, or to diagnose or treat any condition.

Glucosamine For Knee Pain


Having knee pain is not fun and many people have this pain in their knees in vain. Many people are simply lacking enough of the fluid which is inside of your knee to prevent that painful feeling when you walk.

Well, I am going to give you the same advice that I was given long ago and it may just make your knee feel 100 times better in a matter of weeks.

Your knee has synovial fluid which acts as a slimy substance to reduce friction between the bones in your knee. When you don't have enough synovial fluid, your knee will start to hurt a lot. The good thing is that by taking glucosamine you can restore the lost synovial fluid to your knee. More fluid means more cushion and less friction which means less pain for you.

Your body does require some time to build this extra fluid in your knees but simply by taking some glucosamine for knee pain you will see a difference in as little as one month. At the second month you will feel like you had knee surgery and you have a completely new knee.

I got to the point where I couldn't extend me foot while I was sitting because the pain was so great in my knee, now I hardly ever even feel any pain in my knee when running up stairs or jumping. It is a great feeling to be able to run and jump again without worrying that my knee will give out.

Thursday, February 6, 2014

How Well Do Adult Stem Cells Work For Osteoarthritis of the Knee?


Current treatments for osteoarthritis of the knee (OAK) are inadequate. They provide symptom relief only and do not restore articular cartilage.

This is an excerpt from a presentation at the American College of Rheumatology meeting on an ultrasound-guided procedure using autologous mesenchymal stem cells, growth factors, and fat matrix (GMSCL).

The working hypothesis was: autologous stem cells from bone marrow can be stimulated to grow cartilage if provided with...

• A proper scaffold
• Autologous growth stimulating factors
• Limited weight-bearing

Our patient profile consisted of the following...

• 22 patients
• 36-64 years of age
• 16 men; 6 women
• BMI: 21-36.1
• Kellgren-Lawrence class:
o 6 grade 2
o 10 grade 3
o 6 grade 4

In preparation, patients were given the following instructions...

• No NSAIDS (oral and topical) for one month prior and one month post
• No fish oil for one month prior and one month post
• May continue prophylactic baby aspirin
• No intraarticular injections of any kind 1 month prior or during 1 year follow up.

Our procedure can be considered analogous to "Preparing a Garden"

• Sixty cc's marrow harvested posterior iliac crest (5 cc's stem cell concentrate~ 6 million stem cells)- "seeds"
• Sixty cc's peripheral blood for creation of platelet -rich plasma (5 cc's)- "fertilizer"
• Fifteen cc's fat from abdomen or flank- "soil"

Ultrasound guided fenestration was performed in all patients.

• Purpose: stimulate acute inflammatory response
• Joint capsule sites
- joint line
- adductor tubercle
- medial patellar facet

Regional treatment of fenestrated areas and joint was followed by direct ultrasound-guided instillation of...

• Stem cells
• Platelet-rich plasma
• Subcutaneous fat
• Calcium chloride/thrombin

Post-procedure, patients were given the following instructions...

• Non-weight-bearing for two weeks
• Limited weight-bearing with brace that unloads affected compartment for four to six weeks

A summary of our results is as follows...

Data Available

• 11 Patients at 6 months
• 10 Patients at 12 months

Treatment failures

• Four patients
• Defined as patients with no clinical improvement after three months

Two other "failures"

• One person died of an unrelated illness
• One person lived too far away to come back

Five patients haven't hit the six month mark

WOMAC

? 6 Months= -19.9

SD=17.92

SEM= 5.67

? 12 Months= -7.9

SD= 9.97

SEM= 3.15

Patient VAS Pain

? 6 Months=-33.7

SD= 16.71

SEM= 5.57

? 12 Months= -25.2

SD= 25.94

SEM= 8.20

Patient Global Assessment

? 6 Months= -33.0

SD= 24.13

SEM= 8.05

? 12 Months= -33.1

SD= 19.04

SEM= 6.35

Patient 50 Foot Walk Pain

? 6 Months= -26.3

SD= 15.54

SEM= 4.91

? 12 Months= -16.7

SD= 12.05

SEM= 4.01

Physician Global Assessment

? 6 Months= -51.2

SD= 21.60

SEM= 6.83

? 12 Months= -53.0

SD= 24.15

SEM= 8.54

Placebo effect? Probably not...

Example of Celebrex vs placebo in OA trials

Mean composite WOMAC score (pain, stiffness, physical function) = -5.7 (-7.5 to -3.9)

[Bensen WG, Fiechtner JJ, McMillen JI, Zhao WW, Yu SS, Woods EM, et al. Treatment of osteoarthritis with celecoxib, a cyclooxygenase-2 inhibitor: a randomized controlled trial.Mayo Clin Proc 1999;74: 1095-1105; Zhao SZ, McMillen JI, Markenson JA, Dedhiya SD, Zhao WW, Osterhaus JT, et al.Evaluation of the functional status aspects of health-related quality of life of patients with osteoarthritis treated with celecoxib. Pharmacotherapy 1999;19: 1269-1278].

Ultrasound measurement of patello-femoral cartilage thickness at 7 standardized points

• Knee flexed to 90 degrees
• Identical sites matched for accuracy
• Five measurements each point for reproducibility
• High and low dropped and the three middle averaged

Ultrasound measurement of patello-femoral cartilage thickness at 7 standardized points

• Mean improvement from baseline to 6 months (11 pts) - 0.4 mm
• Mean improvement from baseline to 12 months (10 pts) - 0.8 mm

Conclusion

While it is an uncontrolled study, GMSCL demonstrates some promise as a treatment for OAK. Further study is recommended

Degenerative Osteoarthritis


Osteoarthritis is a degenerative disease. The cartilage, which is a protein that cushions the joints, faces an eventual loss, causing this disease. There are more than 100 types of arthritic conditions but degenerative arthritis is by far the most common. The spine, feet, hands and other areas that bear the load of the body like the knees and the hips are most affected by this condition.

When the cause of arthritis is not known it is called primary arthritis, like erosive osteoarthritis, and after the cause is known it is called as secondary arthritis. The common example of which would be traumatic or post-traumatic arthritis.

Primary osteoarthritis is mostly caused due to aging. Secondary osteoarthritis on the other hand, maybe caused due to another disease or condition. Obesity, diabetes, gout, repeated surgery or trauma may cause this condition. The disease does not affect any organ of the body other than the affected joints. The main symptom of the disease is constant pain in the joint, especially during the later part of the day. Certain patients become greatly enfeebled due to pain, while in other cases there might be a greater case of degeneration of bones without as much pain.

X-ray is the most important method for the diagnosis of osteoarthritis. An x-ray is always followed by blood tests to find out if the condition is the consequence of any other disease. According to the x-ray reports, a decision regarding surgery is taken. Other effective means of diagnosis are arthrocentesis and arthroscopy. Arthrocentesis involves the extraction of fluid from the joint for analysis. It also helps relieve inflammation, pain and swelling. In arthroscopy, a viewing tube is inserted into the joint space by the doctors.

Avoiding exerting activities and reduction of weight are the only two ways that can slow down the process of cartilage degeneration, besides the use of medication and surgery.

Patellar Subluxation - An Open Patella Knee Brace Can Make All the Difference - Knee Pain Relief


Patella Subluxation

There are a number of problems that can strike the knee, but few are as painful as patellar subluxation. Read on for information regarding this painful knee issue and how to help treat it.

Anatomy Note

The trochlea is a groove on the thigh bone that is essential for knee movement. The kneecap slides up and down this groove, which allows your knee to bend properly. In some cases, the kneecap does not slide properly along this groove, which can lead to problems. In some cases, the knee leaves the groove altogether, which results in knee dislocation. In others it just slides improperly, which can cause pain or discomfort for the patient.

Patellar subluxation usually strikes adolescents or young children, however it can affect anyone. There are a number of reasons why someone may get patellar subluxation, including being born with a groove that is too shallow, a wide pelvis or abnormalities in ones gait.

A doctor will typically take X-rays of the knee to assess the damage. If the kneecap has left the groove altogether, the knee will have to be put back in place. If the knee is still within the groove, there are a number of other treatment options available.

Therapy

Physical therapy is commonly used to treat patellar subluxation. Strengthening the hip abductors and hip flexors is crucial to controlling the motion of the kneecap. This is accomplished using a range of pelvic stabilization exercises, which help to strengthen the muscles and support your knee.

Your Shoes

Take a look at your footwear. Improper shoes can promote an abnormal gait. Making sure that you have decent footwear can both help control your gait, and lessen the tension on your knee.

Using A Knee Brace

Using a knee brace can help provide knee support and to lessen the pain. There are knee braces that help control the knee cap, so it does not deviate from its course along the groove in the trochlea. These knee braces can be effective in decreasing knee pain as well.

Surgery

In some cases, the above treatment options may not work in the long term, and surgery may be required. In most cases surgery is not needed, but if your knee constantly gets dislocated or you are in severe pain a lot of the time, there may be no other option.

Patellar subluxation can cause other problems with the knee to occur. For instance, osteoarthritis can be caused by patellar subluxation, which is why consulting your physician is a wise decision if you are experiencing knee pain.

Bowlegs - Medical Treatment and Alternative Medicines


At birth, all babies are somewhat bow legged because, within the cramped space in the uterus, the legs are likely to fold over each other. This condition is referred to as genu varum in medical parlance. (In Latin, genu means knees and varum means inwardly curved.) In the simplest terms, legs are defined as bowed if, when the ankles touch each other, the unbent knees do not. In practically all cases, mildly bowed legs correct themselves, even if the condition persists until the child is three years old. When only one leg is bowed, however, the cause may be a turning in of the leg bone resulting from a birth injury or an inherited degenerative disease of the knee.

Diagnostic Studies And Procedures

A pediatrician normally checks a baby's legs during routine examinations. If the bowing is less than 20 degrees, chances are that the problem will correct itself. However, a bowing of more 20 degrees after the age of 18 months, or one that is progressing or causing pain when walking, should be investigated by a pediatric orthopedist. Mildly bowed legs that fail to straighten out spontaneously by the time the child is four years old also warrant an evaluation by an orthopedist. In arriving at a diagnosis, the doctor will ask about family medical history, nutrition, and any birth injuries. An X-ray may show bone deformities or injuries. If there is a family history of bowlegs and knock knees, a genetic disorder is likely. Other possibilities include Blount's disease, or tibial osteochondrosis, in which the shin bone curves inward because the growth plate ceases to function normally. This abnormality may develop in children who walk early, or who are very short or obese. It may appear also during the adolescent growth spurt. Bowlegs may indicate rickets, a disease caused by vitamin D deficiency due either to an inadequate amount in the diet, a lack of exposure to sunlight, or a genetic inability to absorb the vitamin. Without sufficient vitamin D, the body cannot utilize calcium, and the result is soft and deformed bones. Nutritional rickets is very rare in the United States, thanks to fortified milk and other basic foods that are enriched with vitamin D. Laboratory tests can detect the genetic form.

Medical Treatments

If the bowing is severe or worsening, braces and surgery are the first options to be considered. Correction should be undertaken as early as possible, first with braces, and if this treatment shows no positive results, with surgery to correct the faulty knee structure . Blount's disease usually requires surgery to rotate the shin bone to its proper position. Otherwise the condition may eventually result in disabling problems of the knee joints. Nutritional rickets is treated with large doses of vitamin D. The treatment of rickets that is caused by a genetic metabolic defect will vary depending on the nature of the disorder.

Alternative Therapies

Responsible practitioners of acupuncture, chiropractic, and most other alternative therapies would not undertake the basic treatment of bowlegs. Some alternative therapies, however, may improve the under lying causes.

Light Therapy

Exposure to sunlight or an ultraviolet lamp stimulates the skin's production of vitamin D. Be careful when exposing a baby to the sun, however, because of the danger of sunburn. A few minutes in the early morning or late afternoon two or three times a week is all that is usually needed.

Massage Therapies

Massage, using gentle manipulative exercises by a practitioner trained in pediatric care, may be helpful. Physical therapists on the staffs of orthopedic clinics are also knowledgeable about these techniques, and can show you how to exercise the child's legs yourself.

Nutrition Therapy

If a physician has determined that a dietary deficiency or a metabolic abnormality is the cause of bowlegs, she may suggest that a nutrition therapist be consulted to prescribe the appropriate amounts of such supplements as calcium and vitamin D. Careful monitoring is necessary when giving a young child supplements of these nutrients because they are stored in the body and excessive amounts can result in severe liver damage, metabolic abnormalities, and kidney disorders.

Self Treatment

When a baby appears to be bowlegged, parents should not encourage early walking, which can exacerbate the problem. They should also avoid bulky diapers, which can push the development of bowlegs, especially when a baby starts standing and attempting to walk. If your baby is overweight, consult a pediatrician about a change in diet.

Other Causes of Bowlegs

In rare cases, an inherited metabolic disorder called neurofibromatosis may produce leg bowing and other neuromuscular abnormalities. Sometimes bowing occurs as a result of a fracture in the growth plate, or metaphyses, the part of a long bone that abuts the cartilage and covers the end of the bone. This condition usually corrects itself as the bone heals.

Reasons to See a Knee Doctor Soon After You Notice Pain in the Area


For many people, a knee doctor is a necessity when they can no longer handle the pain. The discomfort can be in one or both knees, and it can range from mild to extreme. Whether you are suffering from pain that has been around for years, or have recently been injured, you should go to a specialist to get the care you need.

If you have a lingering injury in this part of your body, choosing the right knee doctor may allow you to finally get it treated. You should not have to live with constant discomfort. If it hurts to simply walk, you need to get treatment for the issue soon. Even if it only hurts when you are particularly active, such as while working out, you need help. It can be hard to stay healthy or get in shape when you have injuries in your legs, which means this issue can have a major negative impact on your life. Do not let your quality of life diminish because you have an issue that could be treated by a specialist.

If you recently got the injury, you should go to a knee doctor as soon as possible. Many people get these types of injuries in sports, keeping them from achieving their best. If you have impressive athletic abilities, do not let them go to waste just because your knees are out of commission. In many cases, surgery will be necessary. While this requires a recovery period, you at least have a date by which you can expect to start feeling well enough to play sports again. When you let injuries go untreated out of fear of what surgery will do, you face years of discomfort, and you may not even be able to play sports at all during that time. You certainly will not be at your best anyway.

Another reason to get the injury checked out is that it could spread to other parts of your body after a while. You may find that another area of your body has had to work harder to compensate for your knees, leaving you with additional problems. In fact, when you see a knee doctor, you may find out that you have a condition that starts in your knees and spreads to the rest of the body. Therefore, getting treatment early on can alert you about such conditions.

It clearly makes sense to at least get an initial consultation from a knee doctor near you. You will find out if you have to have surgery or if there is another treatment available. At that point, you can look forward to the pain finally going away in the near future.

Osteoarthritis Lead to More Knee Pain


The latest study on foot pain revealed that patient suffering from osteoarthritis of knee and other joint pain problems may feel greater foot pain. Patients with lower back pain and foot pain might suffer from increased foot pain.

Currently, knee osteoarthritis affects over 4.3 million adults in United States, specifically in age group of more than 60. Further it has been reported that presently 59 million people suffer from low back pain, due to which large number of people have difficulties in carrying out their daily activities. A test was conducted on 1,389 patients in age group of 45 to 79, who are suffering from knee osteoarthritis in at least one of the knee and also patients who have pains in lower back, shoulder, neck, hand, wrist, elbow, ankle or knee or other areas. An index called Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)?was used to measure the level of pains ranging from a scale of 0 to 20. Low score on the scale indicates low inflammation and higher score indicates high inflammation. Lower back pain was reported among 57.4 percent of patients. Low back inflammation had a score of 6.5 and those without pain in the lower back scored 5.2. Reports revealed that those persons with low back pains also reported increased pains the knee.

Researchers came to the conclusion that having pains in more than one area lead to greater amount of knee inflammation. Knee pain is a severe problem that tends to paralyze normal activities in human beings. So it is very essential that one should undergo knee treatment at the right time. Various health providers are now employing advanced technologies to heal pain as soon as possible, so that one can return to normal life. Knee pain is curable provided you undergo treatment or surgery at the right time.

Wednesday, February 5, 2014

Rheumatoid Arthritis: The Cure in Your Mind


We used to think that the cure to Rheumatoid Arthritis was either non-existent or totally relied on the use of heavy pharmaceuticals. Today the approach to removing symptoms of this arthritic disease or even sending it completely into 'remission' is very different.

Whilst many still rely on pharmaceuticals to treat certain symptoms of Rheumatoid Arthritis, such as inflammation, pain, swelling and stiffness, some are resorting more and more to the use of natural cures and this is bearing increasing success. The details of which natural supplements work best are on this further down this article.

Meanwhile, I want to explore what was suggested to me years ago, namely that the mind-boggling onset of Rheumatoid Arthritis (nobody in my family, immediate or distant, ever suffered from this disease) was in my case a psychological reaction to certain events taking place in my early teens (a nasty parents' divorce and an even nastier 'aftermath' in which my whole family ruptured and became highly dysfunctional). Don't get me wrong; it wasn't 'all in the mind': the symptoms were all there and the damage was real; I had X-Rays and other tests done at the early age of fourteen and they all showed I was suffering from Rheumatoid Arthritis.

At the time it was only in my hands, but I was already beginning to have difficulty playing the piano or even writing. When I left home and went to University (and therefore left the dysfunctional family situation I was living in), my symptoms (which had not been treated at all) suddenly disappeared. Doctors believed that I had been suffering from Juvenile Arthritis and that it was perfectly normal for the symptoms to recede years later. I therefore went on with my life thinking the disease was gone.

But, years later, when I started visiting members of my family for prolonged periods, I began to suffer from severe knee pain which, months later, almost prevented me from walking normally. The knee was swollen, inflamed, extremely painful day and night and no amount of painkillers worked at all. Then my right elbow started to feel very stiff and painful; I became desperate and was ready to try anything and everything. I went to a reputable homeopath, who was convinced that my Rheumatoid Arthritis was triggered by certain familial events which were affecting my mind; with homeopathic remedies aimed at treating repressed anger, psychological pain and resentment (as well as disappointment and abandonment), 3 months later my knee and elbow pain was gone and I was able to resume my very active lifestyle (I am an outdoors person, I love to hike, swim and cycle) in full. Not once did I take any painkiller or pharmaceutical. This means that, in my case at least, my homeopath was correct in diagnosing my Rheumatoid Arthritis as mind-based.

Knee Ache Causes - What's Really Going On? - Get the Support to Move On


How are your knees feeling?

Do you have pain now, or does it come and go?

The knee, one of the largest and most intricate joints in the body, is often taken for granted. People use their knees ever day in almost every activity they perform. Yet, they do not usually think much about their knees unless they start to hurt. When the aching starts, the knee suddenly becomes the focus of your attention, and finding and eliminating knee ache causes becomes a priority. - Can you relate?

So what are some of the most common knee ache causes? Of course, only a qualified physician can tell you for certain what is causing your knee ache.

What follows is a short list of some of the more frequent knee ache causes:

1.) Degenerative Arthritis: Otherwise known as Osteoarthritis, this condition results in a wearing away of the cartilage in the knee joint that prevents the painful rubbing of bone against bone upon movement. It usually occurs with age, and is a progressive condition. You can feel the symptoms on one side of your knee, or throughout the joint. This is one of the most common knee ache causes.

2.) Rheumatoid Arthritis: Unlike Osteoarthritis, this condition can occur at any age. It causes inflammation and stiffness within the knee joint, which in turn causes knee ache.

3.) Overuse of the Knee: One of the most typical knee ache causes is simple overuse. Athletes are prone to overuse, but so is the average active person, especially if they are performing an activity not part of their usual routine. Overuse causes the muscles and tendons to become overworked and strained, which in turn results in knee ache.

4.) Chondromalacia Patellae: This condition occurs when the cartilage under the kneecap (patella) becomes softened or worn, and the kneecap consequently fails to move smoothly over the joint as it meant to. It is one of the most well known of knee ache causes.

5.) Bursitis: This condition occurs when the bursae (small fluid filled sacks) that protect the knee joint at various points where the muscles and tendons move over the bone become inflamed. The inflammation can occur from overuse, injury or even infection, and cause pain problems.

6.) Synovitis: This condition, which is an inflammation of the lining of the joint, in not as common as the other knee pain causes, but carries the same symptoms of achiness.

Whatever the cause of your aches and pains, a knee brace, when used properly, can help reduce the friction and pressure on the knee joint, thus reducing pain stemming from any of the conditions noted above, plus the others not mentioned here. A knee support can also help keep the knee properly aligned which will in turn help reduce the stress on the knee joint, knee cap and cartilage underneath. Regardless of the cause of the knee ache, therefore, the use of a knee brace can help relieve your symptoms.

We hope that your pains disappears by itself, but if it does not, the problems can get worse. If you have knee pain, it is time to look it in the eye, and do something to get rid of it. Knee supports are low cost options to helping you deal with your knee issues. They are great because you can start using them right away to help rid yourself of your instability and pain issues. You deserve to get rid of your pain, don't you?

Diagnosing Knee Arthritis and Treatment


One out of every three adult Americans will suffer from arthritis. Arthritis is a disease that affects the body's bone joints. People who suffer from arthritis often experience many painful side effects, and there is no known cure. A very common type of arthritis is arthritis of the knee. This particular type of arthritis can make walking, bending the knee, and even sleep problematic. These mobility problems are common to sufferers of knee arthritis.

A common cause of knee arthritis is injury to the joint or extreme stress on the joint. For example, a sports injury or a bad fall may injure the knee joint. Extreme stress on the knee joint can also be the result of a injury to the area, or it can be the result of excess weight bearing down on the knee joints for many years. Whenever a joint has been injured or under stress, the likelihood of that joint developing arthritis increases. If there hasn't been an injury or stress on the knee joint, arthritis of the knee may be due to genetics and was inherited.

How do you know if you have arthritis in the knee? Symptoms can include swelling of the knee joint, a general tenderness in the area, aching in the joint, a popping noise when the joint is extended, or overall stiffness of the knees. Often, the symptoms are exacerbated by temperature changes, particularly coldness, or moisture changes in the air and precipitation. Many arthritis sufferers come to accurately predict the weather based upon their symptoms.

This correlation of arthritis symptoms and weather changes is based upon science. Joints that are afflicted by arthritis may develop an excess of nerve endings. These nerve endings are therefore much more sensitive to changes in the weather. This can also increase in the beginning of the day and when the joint is moved.

If you think you may have knee arthritis you should consult an appropriate doctor. A doctor will ask you questions about your medical history, what symptoms you are exhibiting, and can perform other tests to correctly diagnose the problem. An accurate diagnosis is vital to treating the problem. You may be suffering from another problem that is not linked to arthritis.

As stated earlier, there is no known cure for arthritis. There are however, therapies available to lessen the symptoms and provide some relief from pain. These run the gamete from doctor prescribed medicines and physical therapy, to over the counter medications and herbal remedies. Many sufferers find that a combination of pain management techniques and exercise can lessen the symptoms. In severe cases, surgery has also been used to treat knee arthritis. The appropriate treatment should be tailored for the patient and the severity of the arthritis.

The information compiled is not intended to be a substitute for any advice and information provided by a medical professional. It is for your information purpose only. If you believe you are suffering from knee arthritis or have questions about its treatment, consult your doctor immediately.

Choosing the Right Joint Supplement - Know Your Options


As a consumer, it can be hard to choose which medicinal and nutritional supplements are best for you.  Many, if not most, supplements do deliver on their promises; however, some are certainly better than others and knowing what to look for when choosing a supplement is extremely important.
 
For the purposes of this article, we will focus on one common ailment - joint pain and stiffness.  Joint pain, disability, and restricted mobility affect more than 40 million Americans.  As the U.S. population ages, it is expected that this number will more than double over the next decade.  These symptoms, once considered an unavoidable consequence of aging, are now being successfully treated by joint support products.  This is particularly true in the case of osteoarthritis. 
 
While some people are genetically predisposed to developing this most common form of arthritis, many people will develop degenerative osteoarthritis due to injury or overuse of joints.  The most commonly prescribed treatment for osteoarthritis pain is non-steroidal anti-inflammatory drugs ("NSAIDS"), which provide temporary relief from inflammation in the joints.  This common treatment generally works for a while, and many people will experience no complications from the drugs. For some, however, the side effects are significant.  Increased risk of stroke, heart attack, and digestive disorders are only a few of the serious risks associated with taking NSAIDS. 
 
Nutritional supplementation offers hope for osteoarthritis suffers, without the risk of the potentially deadly side effects of NSAIDs.  The acceptance of joint support products by consumers has been steadily increasing due to their proven effectiveness, as well as their ability to promote and maintain joint health with little or no side effects.  Millions of people have experienced some relief and pain remediation through regular supplementation with various dietary products. Glucosamine, chondroitin, and calcium have been popular choices for regular supplementation for joint problems and bone strength, but each has drawbacks with respect to effectiveness, bioavailability, and tolerability. The often overlooked mineral silica is an attractive alternative providing similar benefits but without many of the drawbacks associated with glucosamine, chondroitin, and calcium. 
 
Glucosamine:  In general, glucosamine is an amino sugar that has shown moderate ability to relieve the pain of osteoarthritis and restore partial movement to affected joints. However, taking glucosamine derived from sea creatures may cause allergic responses in individuals who are allergic to shellfish.  Individuals with diabetes may experience elevated blood sugar levels if they inject glucosamine which may even raise blood sugar for individuals who do not have diabetes.  Pregnant or breastfeeding women are also advised to avoid taking glucosamine because little is known about its effects on this patient population. 
 
During research studies, gastrointestinal complaints such as constipation, diarrhea, and nausea were attributed to taking glucosamine.  Some study participants who took glucosamine sulfate also reported drowsiness or headache. In addition, glucosamine may increase the risk of excessive bleeding when it is taken in conjunction with warfarin; other anticoagulants or anti-platelet drugs; aspirin; or herbal products that reduce the blood's ability to clot.  Finally, injecting it may increase blood sugar levels, thereby interfering with insulin and drugs or herbals that lower blood sugar.
 
Chondroitin: Chondroitin is a sulfate molecule that occurs naturally in the body and is believed to provide a different chemical from glucosamine that is important in the formation of cartilage; however, its effects are not understood as well as glucosamine's. Some people believe that it may help keep cartilage healthy by absorbing fluid into the connective tissue. However, studies have not shown conclusively that chondroitin helps repair or grow new cartilage or even helps prevent cartilage from further deterioration.
 
Many chondroitin supplements are made from cow cartilage.  If you are a vegetarian or otherwise object to the use of animal based products, look for a supplement made from algae instead.  There have been occasional reports of mild side effects which include nausea, upset stomach, diarrhea, constipation, indigestion, stomach pain, and heartburn. Chondroitin is similar in chemical composition to heparin, a drug used to thin the blood; accordingly, it is theoretically possible for chondroitin to increase the effects of blood thinners. 
 
Chondroitin is often combined with glucosamine in many popular supplement products such as Osteo Bi-Flex, Cosamin and Estroven. The Arthritis Foundation recommends exercising caution in taking glucosamine and chondroitin for the treatment of osteoarthritis. Moreover, due to the popularity of glucosamine-chondroitin supplements and the apparent lack of reliable information about their usefulness in treating osteoarthritis,the National Institutes of Health funded a study to test the effects of chondroitin and glucosamine on osteoarthritis of the knee.  This multicenter, placebo-controlled, double-blind, six month long trial found that glucosamine plus chondroitin had no statistically significant effect on symptoms of osteoarthritis in the overall group of osteoarthritis patients.
 
Calcium:  Calcium supplements are widely popular and come in several forms including calcium carbonate and calcium citrate.  The primary difference between these two types of calcium supplements is the amount of elemental (or actual) calcium they contain. Calcium carbonate contains almost twice as much as citrate, which generally makes the carbonate form less expensive.  Calcium citrate is often recommended for the elderly because it may be easier for their digestive systems to absorb.  A recent review of calcium and bone mass studies found that calcium citrate malate has high bioavailability in all age ranges including young girls as well as postmenopausal women. 
 
Side effects of calcium supplementation include nausea, vomiting, loss of appetite, constipation, stomach pain, thirst, dry mouth, and increased urination.  Although it is well accepted that calcium supplements reduce the risk for osteoporosis, there is concern that high calcium dosages may increase the risk for hardening of the arteries and kidney stones.  High calcium intake can result in calcium deposition into soft tissue and can also impair absorption of other minerals such as magnesium, zinc, and iron.  If taking calcium supplements, you should not eat large amounts of bran or whole grain cereals and breads because they may reduce absorption of calcium.  Similarly, consuming alcohol, large amounts of caffeine or vitamin D, or using tobacco products may also impair the absorption of calcium.
 
Silica: Silica, also called silicon, is an essential mineral and potentiator of other minerals like calcium for bones; glucosamine for joints; and antioxidants for healthier arteries and cardiovascular function.  Silica is a trace mineral required for the formation of healthy connective tissue, bone, skin, hair, and nails.  Silica is also essential for collagen formation, healthy arteries, and regulation of calcium deposition in the bones.  Absorption is critical to its effectiveness because dietary sources of silica such as those found in food, horsetail, and colloidal gel (silica) products are very poorly absorbed because of their insoluble, polymerized forms.  For optimal absorption to occur, dietary silica must first be converted to organic silicon (monomethylsilanetriol). This form of silica has excellent bioavailability and is found in premium product offerings such as Orgono Living Silica. Unlike the other nutritional supplements discussed for joints, silica has no known side effects.
 
In addition to knowing the differences between each option available, here are a few other considerations to keep in mind when selecting a nutritional supplement.
 
Quality: Is the company committed to observing Good Manufacturing Practices? Does the product contain pharmaceutical-grade ingredients?  Does it contain the recommended amount of each ingredient to be effective?
 
Delivery: Form is important. Powders, pills, tablets, and capsules all have little "extras" that can interfere with the body's ability to absorb supplements.  Liquid delivery of the supplement ensures your body can absorb the active ingredients quickly and effectively, without extra binders, fillers, and additives found in powders, pills, tablets, and capsules. 
 
Tolerability:     Is the product safe? Are there any side effects associated with the product? Have there been any drug interactions reported?
 
Reputation: Is the company reliable? Does the company feature testimonials from satisfied customers?  Does it have a negative reputation?
 
Customer care: This is particularly important in nutritional supplements, as many companies use independent sellers to distribute their product.  Is the company you purchase your supplements from an authorized distributor?  Do they stand behind their product?  Do they ship quickly? 
 
As you can see, there are many factors and options to consider when choosing a nutritional supplement for joint health. Being informed is the best way to decide which one is right for you.

McAlindon TE, et al. "Glucosamine and Chondroitin for Treatment of Osteoarthritis: A Systematic Quality Assessment and Meta-analysis". JAMA 283: 1469-1475, 2000.

Clegg DO, et al. "Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis". New Engl J Med 354 (8): 795-808, 2006.

Posterior Cruciate Ligament - Anatomy of the Knee Joint and Causes of PCL Injuries


Every healthy knee joint has two cruciate ligaments. These ligaments, Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL), make the bending and rotation of the knee possible. They connect the thighbone with the shinbone.

The PCL is about twice as strong and thick as the normal ACL, therefore PCL injury rarely occurs. Its width is almost 13mm and the length is almost equal to the length of the ACL which is 38mm. It originates from the back to the front, exactly opposite to that of the ACL.

The PCL injury causes less pain, less disability, less swelling as compared to the ACL. Still, it takes many weeks to recover from.

The PCL injury is also called knee injury-posterior cruciate ligament, hyperextended knee, and cruciate ligament injury-posterior. There are three main causes of PCL injury. The first cause is smashing the tibia or lower bone of the knee joint to anything that is hard. The second is falling on the bent knee while playing any game like football. The last one is as simple as a bad move or slipping.

Other causes of the PCL injury may include bending or moving your knee too far from its normal position, also called hyperextension. Symptoms may include severe pain, swelling up of the knee within 10 minutes of the injury, tenderness of the knee, difficulty while walking, and losing stability of the knee. Patients sometimes feel like the knee is giving out.

The symptoms of PCL injury may not be too bad, but if other ligaments are also injured with PCL then these symptoms will be more severe and the instability may remain for a long time. The ratio of PCL injury among men is greater than women. The risk of having PCL injury is high while playing games like cricket, football, among other contact sports.

Your physician will ask about your medical history or if you are having any problem with your knee and if you ever had an accident. Then physical examination of the knee will be conducted. It may include many tests. One of the most important tests is Posterior Drawer Test. Surgery may be suggested only if other ligaments get damaged, otherwise there is no need for it.

If you have injued your PCL you will want to consider getting a knee brace for support. This conservative measurement of treatment is useful in helping to support the knee after an injury has happened. They can also help reduce pain and help protect the knee as well.

The only purpose of this article is to provide information regarding PCL. For medical advice and in case of any suspected injury to your PCL, consult your doctor.

Free Online Surgery Games for Kids


Do you have a budding, young doctor at home? Or maybe you are a teacher with a classroom full of potential scientists? Instead of turning to a normal video game after school, there are many websites that offer free online surgery games for kids.

Edheads.org - Edheads is a website that has won numerous awards for their educational content. Their games and activities meet state and national standards, and they partner with school systems on the design and content of their games. Students can perform virtual hip replacement, virtual knee replacement, and even create a line of stem cells. They have other non-medical related games as well, such as design a cell phone and simple machines.

Oyuncex.com - Known for their entertainment games, Oyncex offers many online educational games. Kids can perform many types of surgery, such as dental, stomach, leg, hip, knee, brain, and heart surgeries. Flashplayer runs all games, and there is no software to download.

Virtualsurgerygames.net - This site hosts many games and offers links to other sites with surgery games. You can choose from plastic surgery, knee replacement, and general dentistry games, just to name a few. The site also offers many other educational and entertainment based games.

Be certain to check the website and game prior to letting your child play. There are a few sites that offer rather gruesome images instead of more clean, cartoon images. These games are also for children who are slightly older. Many have a suggested age listed on the website.

Tuesday, February 4, 2014

Medial Collateral Ligament Injury - How Knee Braces Can Help


The Medial Collateral Ligament is one of the four primary ligaments to stabilize the knee joint. A ligament is the strong fibrous material to control the excessive motion of the knee by restricting the joint flexibility. The other three ligaments are Anterior Cruciate Ligament (ACL), Posterior Cruciate Ligament (PCL), and Lateral Collateral Ligament (LCL).

MCL connects the end of the femur (thighbone/upper bone of the knee) and top of the tibia (shinbone/lower bone of the knee). As the term "medial" means "inside," so it is on the inner side or medial side of the knee joint. Its basic function is to prevent the forces on the outer surface of the knee joint and does not allow the medial or inner side of the knee joint from broadening up under stress/pressure.

An MCL injury occurs when the outer side of the knee is hit. This collision widens the inside of the knee joint. This usually occurs during penalty in the football game, known as clipping. The patient would experience pain, swelling, and may feel that the knee is not stable and about to give out.

The medial injury is classified into three grades. Grade I includes incomplete MCL injury. The patient would have pain with pressure or load on the MCL. He may come back to normal activities in two to three weeks. In case of Grade I medial injury, ice and mild pain medications would help to reduce the swelling and pain.

A Grade II medial injury also includes incomplete MCL injury but there would be significant pain and swelling and the patient may come back to normal activities in a longer period of time, from three to four weeks. When Grade II MCL injury occurs, a hinged knee brace may be helpful. Hinged knee brace provides the best support for the knee.

A Grade III includes complete MCL injury. The patient would have significant pain and swelling and would feel like the knee is unstable and about to give out. In case of Grade III MCL injury, the patient is advised to use a knee immobilizer. It is different from hinged knee brace because it not only supports the knee but also prevents the knee joint to bend. It is to be removed several times a day for exercise of bending the knee.

According to some surgeons, a Grade IV MCL injury includes the MCL injury along with other ligament injuries. In these cases, some surgeons recommend surgery while others prefer non-operative treatment. This is health information regarding MCL. For any medical advice concerning your particular situation, consult your physician.

How to Gain Happiness During Your Life Crisis - FamilyVision Column


Everyone loves 9 years old Allison. Allison lives with Mark, a confirmed bachelor. The story goes that when Alison's parents died in an auto accident, her parents identified Mark as the guardian in their will. Allison's biological family hates it. Mark discovers that Allison is dying. Everyone has an opinion. No one can agree on the best solution. This creates a very stressful time in Mark's life. Any decision he selects will generate criticism. As Mark ponders these thoughts in his heart, he wonders if he will survive this crisis.

The Panic Button

How do you deal with a serious crisis? Does it bring you to tears or do you grow stronger? How does a person make a critical decision with little time on their hands? That is the question that I pondered in my heart as I reflected on the many critical decisions made over the last several years. Unfortunately, many of those decisions were life threatening ones that required immediate action.

As I think about my decisions as the head of my household, I knew everyone did not agree with my decisions and as a consequence created strained relationships. In the role of a church leader and in my job, I constantly come across people who must make decisions in a crisis. Decisions made in very short timeframes create much anxiety. Some of these decisions relate to personal health, death in a family, relationship drama, and financial obstacles.

Any of these situations can knock a strong person to their knees. Before I discuss some helpful tools, let's discuss some practical facts that make a crisis difficult for us. A crisis is defined as a decision point in an unstable condition involving an impending abrupt or decisive change. Living in a crisis can cause an emotional or traumatic change in a person's life.

A decision is defined as an act of reaching a conclusion or making up one's mind. When you add a crisis, with its emotional baggage, to a decision, you have created a situation that most people find difficult to cope. Dr. William Black, author of Finding Strength, explains, "The reality of our existence is that life can be hard. We have difficulties to face....For each of us, life's trials may be detrimental to our ability to function in everyday life."

The Crisis Club

If you are a human being, your life will include of a series of easy to complicated decisions. Some critical decisions include selecting your life insurance, buying a home, or accepting a job offer. A rational approach to decision-making under a normal situation would be: (a) define the problem, (b) weigh the pros and cons, and (c) select the best solution. Given this simple process, what then makes a crisis difficult? There are several things that make a crisis a challenge for most people, which are: (a) shortness of time, (b) the emotional component, and (c) the immediateness of a response by the individual involved.

Wouldn't it be easy to just deal with a crisis in a logical manner? In most cases, this is difficult to do. For example, a doctor is faced with disconnecting his mother from life support. His head tells him that it's the logical thing to do, but his heart tells him that she's his mother. Therefore, the emotional drain and the additional adrendine clouds our sense of judgment in a crisis. However, individuals can take comfort that you can take some positive steps in making a good decisions. Here are some proven methods for getting through these crucial times:


  • Seek comfort through pray and meditation. These solutions have stood the test of time.

  • Determine how much actual time you have to make the decision. If possible, use all of the time you have to make a good decision.

  • Write down the problem. Can you define the actual decision that needs to be made?

  • Write down the possible options to your problem. Do you have enough information? Is more research needed?

  • Weigh your options by analyzing the advantages and disadvantages.

  • Get advice from reliable sources you trust. Can you trust Aunt Susan to give you her best advice when she's emotionally attached to your problem (she may)?

  • Trust God. Although this may not be popular in our culture, the reality is that people, as humans, are limited. It better to believe that God will correct the situation.

  • Make the best decision, move on, and accept the consequences.


The Right Perspective

Fortunately, a crisis is not the end of the world. You might actually view it as a new beginning because you will gain strength through these ordeals. There are countless stories of marriages torn apart and families destroyed due to a faulty decision mode in the heat of a crisis. Don't make that mistake. Keep a positive outlook on life. Start today!

Consider planning out how you will address a crisis before it happens. Talk with others who have been "battled tested" through a crisis and learn from them. Remember, good things can come from bad situations. Be encouraged and start planning today.

What to Look For in a Knee Scooter Or Knee Walker


So you've been told you will need to stay off your foot or ankle for an extended period of time. This could be due to surgery, injury or a wound. If you've used crutches you know how difficult they can be to use and the limitations they put on your lifestyle. Don't be condemned to crutches. You have choices. Perhaps your healthcare provider suggested a knee scooter or a knee walker. You've searched the Internet and are left with even more questions.

This article will outline what a knee scooter is, features to consider with the device and services to consider with the supplier.

What is a Knee Scooter

A Knee Scooter is a wheeled cart-like device that completely unloads (takes weight off) the user's lower limb as they bear weight on their knee. It is also commonly referred to as a knee walker.

Features to Consider:

While all knee scooters are similar in basic function there are important design features that directly impact safety, comfort and mobility.


  • Does it turn? The original model required the user to lift the front to pivot left or right. Not only did this take strength, but balance which can often be compromised due to medications (i.e. painkillers). Newer models turn like a bicycle to improve safety and ease of use. This feature is so vital that some insurance companies will not reimburse for non-steerable (non-turning) models and many suppliers no longer offer them. Beware of models that use caster like wheels similar to those found on a shopping cart (www.rolleraid.com) as these can unexpectedly move sideways (laterally away from you), causing your legs to split apart and maybe even fall.

  • How big are the wheels? The bigger the wheels, the easier it will be to move through carpet or over uneven surfaces like cracks in the sidewalks or thresholds of a doorway. Small wheels will stop abruptly when they encounter a crack or obstacle. Some insurance companies will not cover units with wheels smaller than five inches in diameter. Large or fat off road tires are available but are rarely necessary as they are intended for rough terrain or for soft sand. The ideal standard is the eight-inch wheels.

  • How stable is the unit? Safety is paramount in any unit. Stability comes from both the width of the unit and the offset of the knee platform. The higher-end models allow the knee platform to be easily offset towards your good leg. Not only does this allow more of the unit to support your injured leg, it also keeps your pushing leg from kicking the knee scooter (an annoying, painful and potential danger). Width can be judged by the separation of the front wheels, although wider is not always better. You will find units so wide they won't fit through a doorway (Kneal) or so narrow as to be unstable (Invacare).

  • How adjustable and comfortable are the knee pads? Your needs can change as your cast or dressing is adjusted, so it is important to look for a unit with two adjustable pads. The ability to adjust the location of the pad can greatly affect your comfort. Avoid units that only offer a single fixed pad (Kneal or Wiel).

  • Does it fold down for easy storage? Most units will fold for easy storage and transportation. They can be put in the back seat of a car, a trunk or even in the first class closet on an airplane. Beware the very large units (Kneal) that are too big for most cars and any plane.

  • Do I need tools to assemble? Make sure that the knee scooter can be adjusted without tools. Amazingly enough, some models (Invacare) and especially older units require wrenches (not included) to adjust for your height and size.

  • What accessories are included? Think of what you might need: a purse, phone, book, lunch, laundry, etc. Some knee scooters offer small black bags while others provide large removable baskets. Both could be helpful to free your hands while moving, but the removable basket has proven to be more useful and versatile.

Services to Consider

Now that you know what to look for in the product, consider the supplier as both price and service can vary greatly.


  • Rent or buy - If you only need the unit a short time, renting might be an option. Rental prices range from $35 to $80 a week and $100 to $300 a month. Deposits can be very costly, up to the full purchase price of the knee scooter. Look for suppliers that don't charge a deposit. Some suppliers will allow you to apply rental charges to the purchase should you need it longer than you first thought. Purchase price of a new unit ranges from $400 to $800. If purchasing makes sense, you might consider a used or refurbished unit. Make sure it is safe and meets all the manufacturer's specifications.

  • Insurance - Insurance companies generically refer to knee scooters as Crutch Alternatives under HCPCs Code E0118. They may cover them for patients who must keep weight off of their healing foot or ankle AND are unable to use crutches due to balance issues, upper body limitation or other issues. While some suppliers will bill your insurance company, many will provide you with a blank Letter of Medical Necessity for your doctor to complete. This will help you in submitting for consideration of reimbursement. Even if the knee scooter is not a paid benefit, it may count towards your deductible or be able to be charged to your healthcare spending account

  • Delivery and Return - You could try to find a local supplier with knee scooters in stock. Styles, price, quality and service vary greatly. Availability is limited and you could be placed on a waiting list. Even after you find a supplier it could require three visits to their location during their business hours to order, pick up and return the unit. Some stores will deliver to your home or hospital for a fee. An increasingly attractive option is ordering online and having the knee scooter shipped directly to your home, office or hospital room. Look for suppliers that offer free shipping. Once back on both feet, units can be easily returned via UPS or USPS mail. Having your knee scooter shipped directly to you is especially convenient if you are already injured, can't drive, live in a rural location, have a busy schedule or other limitations.

  • Satisfaction Guarantee - Make sure you can return any knee scooter you rent or buy if it doesn't fit your needs. Be cautious of suppliers that don't even allow you to try it outside or offer less than a three day trial period.

  • Customer Service - When using your knee scooter and you have a question or a need (which you will), who will you call? Working with an expert that specializes in crutch alternatives should ensure a better experience offering knowledgeable staff available to answer questions and share tips. You may be alone with a "big box" supplier that has everything from beds to bedpans, with business hours that don't coincide with your needs.

In summary, look for these for an ideal recovery:


  • Price

  • 8" wheels

  • No deposit

  • Offset knee platform

  • Free, convenient shipping

  • Two adjustable knee pads

  • Rental fees apply to purchase

  • Folds for transportation and storage

  • Satisfaction guarantee

  • No tools needed adjustment

  • Customer service

  • Large removable basket

  • Crutch Alternative Specialist

  • Returns

Recovering from surgery or injury can be a trying time and full of unexpected challenges. Choosing a knee scooter that helps you stay off your foot or ankle may help you heal more quickly, more completely and more correctly. Choosing the knee scooter that best fits your individual needs from the supplier that serves you best will allow you to maintain your active life, your lifestyle and your livelihood.