- Arthritis of the knee: Ten exercises
- Osteoporosis and Arthritis: Two Common but Different Conditions
- For your information
- Massage Therapy for Sports Injuries: Knee Pain
- Is the Injury Acute or Insidious?
- Assessment and Treatment
- Stop living with knee pain. Schedule Your Appointment Today.
- KNEE MASSAGE
Arthritis of the knee: Ten exercises
People with arthritis should always consult a physician before beginning any exercise routine.
In addition to a doctor’s recommendations, there are important things to consider:
- Start slowly. It is important to proceed slowly. People with arthritis should be highly attentive to their body’s signals and stop if they experience any pain.
- Incorporate movement into daily life. People should try to keep joints limber by adding movement into their overall lifestyle. They should not just set aside a specific block of time for rigorous exercise while being inactive the rest of the time.
This list is compiled with that goal in mind. It includes a variety of movements that can be practiced at home or work, while standing, seated, and even lying down.
As people get used to the exercises and discover which ones work best for them, they should try adding them into daily activities. Many of these activities can be carried out during household chores or while sitting at a desk.
Any movement practice for knee pain caused by arthritis should be low-impact and easy to perform.
Each of these exercises will help with building strength, improving flexibility, or increasing stamina. This list also includes which muscles are targeted and any precautions to keep in mind.
The most important piece of the puzzle
If you’re overweight or obese, the most effective treatment is weight loss. This isn’t surprising. Every extra pound of weight adds two to four pounds of excess pressure on your knees.
“Losing weight is probably the most difficult part of the treatment puzzle, but it’s also the most important,” says Dr. Day.
A weight loss program should include both diet and exercise. Some people have difficulty exercising to lose weight because their knees hurt. But any type of exercise can help, even strengthening the upper body.
The role physical therapy plays in the process
Physical therapy is definitely beneficial. “Improving range of motion and strength in the knee are helpful, but physical therapy for knee osteoarthritis has a large focus on strengthening the hips,” explains Dr. Day.
Weak hips put more pressure on the knees. If your hips are strong, when you get up from a chair or go up and down stairs your knees have less work to do.
Everyone with knee osteoarthritis should consult a physical therapist, according to Dr. Day. Not only will you be taught the right kinds of exercises, a physical therapist also provides valuable instruction about using assistive devices (such as a cane or walker) and modifying activities (such as climbing stairs or getting in and out of a car) to reduce pain.
How to get moving every day
In addition to physical therapy, it’s critical to incorporate regular exercise into your daily routine.
“Joints are built to move,” says Dr. Day. The evidence shows that people who are least active have more arthritis pain than people who do some form of exercise. Choose lower-impact activities, such as bicycling, swimming or exercising in a pool.
Talk to your doctor about a knee brace
Often a knee brace can help. “There’s evidence to show that even a simple compression sleeve can decrease pain,” says Dr. Day. These are a good way to start because you can get one at the drugstore.
You can also talk to your doctor about a more customized unloader brace. These take pressure off a portion of the joint. The brace that’s right for you will depend on the severity and location of arthritis, whether primarily in the inner or outer side of the joint or in the kneecap.
Supplements for those with mild pain
For people with milder pain, Dr. Day suggests trying supplements, such as the combination of glucosamine and chondroitin or the spice turmeric.
The evidence for glucosamine and chondroitin is mixed, but they are safe. So it might be worth trying. However, people with a shellfish allergy may not be able to tolerate them. Any effect won’t kick in right away. Dr. Day recommends trying it for six to eight weeks. “If you notice improvement, great; if not, then stop it,” she says.
Turmeric has anti-inflammatory properties, and there is some evidence for its usefulness for painful knee arthritis. You can add turmeric to your food or take it as a supplement. It can thin blood, so people who take a blood thinning medication should not use turmeric.
How to use pain medications properly
There are two types of over-the-counter pain medications that can be used for osteoarthritis. Acetaminophen (Tylenol®) is a pain reliever but not an anti-inflammatory. It may help with mild knee pain.
NSAIDs can be more effective because they both relieve pain and reduce inflammation. However, they come with potential side effects and risks. NSAIDs can irritate the lining of the stomach, which may lead to an ulcer or other stomach problems. They also can impair kidney function. Some NSAIDs can increase blood pressure. And they’ve been linked to an increased risk for heart disease.
Because of the risks, Dr. Day cautions against using NSAIDs regularly over long periods of time. Instead, she uses NSAIDs for her patients in two ways. First, people who have a flare-up of pain can take them regularly (meaning every four to six hours, depending on the drug) for three to five days and then stop. Second, they can be used over the long term, but only occasionally, maybe a couple of times a week as needed.
If you’re taking NSAIDs several times a day for long periods of time, Dr. Day advises reducing their use by maximizing the other treatment strategies. She also suggests trying a topical NSAID, such as diclofenac (Voltaren Gel®, Pennsaid®), which has fewer potential side effects.
Opioid pain relievers are discouraged for long-term treatment of chronic knee pain. “The milder narcotic tramadol might be appropriate for occasional use in some people,” says Dr. Day.
Injections are another low-risk option
If other strategies don’t provide enough relief, injection therapy is an option with low risk.
A corticosteroid injection involves delivering this anti-inflammatory drug directly to the knee. The benefits are typically short lived. But it varies from person to person. “I tell my patients the pain relief can last anywhere from a week to a year,” says Dr. Day. One cautionary note with corticosteroids is the potential to increase blood sugar, which is a concern for people with uncontrolled diabetes.
For a possibly longer lasting effect, an injection of hyaluronic acid (also called viscosupplementation) can be tried. “Hyaluronic acid is a substance that healthy joints have a lot of and arthritic knees don’t,” says Dr. Day. It takes longer to start working than a corticosteroid injection, but the effect often lasts six months to a year.
Two other injection therapies are platelet-rich plasma (PRP) and stem cells, neither of which is covered by insurance. PRP involves drawing some blood, spinning it in a centrifuge, and injecting part of it into the knee. “There’s currently more science backing up the effect of PRP than stem cells,” says Dr. Day.
If you’re not able to get your symptoms under control with a combination of these measures, she says, it could be time to talk to your doctor about surgery.
This article originally appeared in Cleveland Clinic Arthritis Advisor.
Osteoporosis and Arthritis: Two Common but Different Conditions
Many people confuse osteoporosis and some types of arthritis. This fact sheet discusses the similarities and differences between these conditions.
- For your information
Osteoporosis is a condition in which the bones become less dense and more likely to fracture. In the United States, more than 53 million people either already have osteoporosis or are at high risk due to low bone mass. In osteoporosis, there is a loss of bone tissue that leaves bones less dense and more likely to fracture. It can result in a loss of height, severe back pain, and change in one’s posture. Osteoporosis can impair a person’s ability to walk and can cause prolonged or permanent disability.
Risk factors for developing osteoporosis include:
- Thinness or small frame.
- Family history of the disease.
- Being postmenopausal and particularly having had early menopause.
- Abnormal absence of menstrual periods (amenorrhea).
- Prolonged use of certain medications, such as those used to treat lupus, asthma, thyroid deficiencies, and seizures.
- Low calcium intake.
- Lack of physical activity.
- Excessive alcohol intake.
Osteoporosis is known as a silent disease because it can progress undetected for many years without symptoms until a fracture occurs. Osteoporosis is diagnosed by a bone mineral density test, which is a safe and painless way to detect low bone density.
Although there is no cure for the disease, the U.S. Food and Drug Administration has approved several medications to prevent and treat osteoporosis. In addition, a diet rich in calcium and vitamin D, regular weight-bearing exercise, and a healthy lifestyle can prevent or lessen the effects of the disease.
Arthritis is a general term for conditions that affect the joints and surrounding tissues. Joints are places in the body where bones come together, such as the knees, wrists, fingers, toes, and hips. Two common types of arthritis are osteoarthritis and rheumatoid arthritis.
- Osteoarthritis (OA) is a painful, degenerative joint disease that often involves the hips, knees, neck, lower back, or small joints of the hands. OA usually develops in joints that are injured by repeated overuse from performing a particular task or playing a favorite sport or from carrying around excess body weight. Eventually this injury or repeated impact thins or wears away the cartilage that cushions the ends of the bones in the joint. As a result, the bones rub together, causing a grating sensation. Joint flexibility is reduced, bony spurs develop, and the joint swells. Usually, the first symptom of OA is pain that worsens following exercise or immobility.
- Rheumatoid arthritis (RA) is an autoimmune inflammatory disease that usually involves various joints in the fingers, thumbs, wrists, elbows, shoulders, knees, feet, and ankles. An autoimmune disease is one in which the body releases enzymes that attack its own healthy tissues. In RA, these enzymes destroy the linings of joints. This causes pain, swelling, stiffness, malformation, and reduced movement and function. People with RA also may have systemic symptoms, such as fatigue, fever, weight loss, eye inflammation, anemia, subcutaneous nodules (bumps under the skin), or pleurisy (a lung inflammation).
Although osteoporosis and osteoarthritis are two very different medical conditions with little in common, the similarity of their names causes great confusion. These conditions develop differently, have different symptoms, are diagnosed differently, and are treated differently.
Osteoporosis and arthritis do share many coping strategies. With either or both of these conditions, many people benefit from exercise programs that may include physical therapy and rehabilitation. In general, exercises that emphasize stretching, strengthening, posture, and range of motion are appropriate. Examples include low-impact aerobics, swimming, tai chi, and low-stress yoga. However, people with osteoporosis must take care to avoid activities that include bending forward from the waist, twisting the spine, or lifting heavy weights. People with arthritis must compensate for limited movement in affected joints. Always check with your doctor to determine whether a certain exercise or exercise program is safe for your specific medical situation.
Most people with arthritis will use pain management strategies at some time. This is not always true for people with osteoporosis. Usually, people with osteoporosis need pain relief when they are recovering from a fracture. In cases of severe osteoporosis with multiple spine fractures, pain control also may become part of daily life. Regardless of the cause, pain management strategies are similar for people with osteoporosis, OA, and RA.
For your information
For updates and for any questions about any medications you are taking, please contact
U.S. Food and Drug Administration
Toll Free: 888-INFO-FDA (888-463-6332)
For additional information on specific medications, visit [email protected] at https://www.accessdata.fda.gov/scripts/cder/daf. [email protected] is a searchable catalog of FDA-approved drug products.
NIH Pub. No. 18-7893
Massage Therapy for Sports Injuries: Knee Pain
June 1, 2017 | By Physio Logic
Licensed Massage Therapist, Amy Montia reveals the different massage therapy methods used to release tension around the knee and explain how acute or insidious injuries are treated.
Knee pain is frustrating, especially when it starts to compromise form and hinder you from performing at your best. If you have a sports related knee injury, I suggest you treat it now. Don’t wait. Your body needs knees to function properly.
As the age-old song implies, your knees are indeed connected to the rest of your body. And the longer you try to push through the knee pain, the more likely you’ll be to find yourself seeking treatment later on for compensatory pain in your neck, shoulder, back, hip, arch, foot or toe.
Massage therapy is a great way to treat and better understand the root of your knee pain.
Is the Injury Acute or Insidious?
Was the pain sudden? Did pain occur following a quick movement, forceful fall, knee twist, kick to the side of the knee, etc? This is an acute injury and you should see a medical professional immediately, as there might be a diagnosis of torn meniscus, muscle strain or ligament injury. In the meantime, RICE (rest, ice, compress, elevate) is the way to go. Massage Therapy at this phase should only be gentle and light with a goal to promote lymphatic circulation and minimize swelling.
Or maybe your knee pain started as a niggling vague annoyance? Perhaps the pilot light was an old ankle injury, minor knee sprain in high school, a bad fall some years ago (that you thought healed just fine), or even poor posture? This type of knee injury is considered to be chronic (or insidious). Micro-trauma accumulates over time. If left untreated, the condition fueled by progressive muscle imbalance and chronic inflammation around the knee can turn into a full blown acute and stubborn injury.
Assessment and Treatment
Massage therapists try to unravel and release structures around your knee that are likely to exacerbate pain. Techniques like effleurage, petrissage, muscle stripping, trigger point therapy, myofascial release, cross-fiber friction, and ischemic compression are used to restore integrity and balance to the knee joint.
There are lots of contributing factors making every person’s knee injury unique. An orthopedic-trained Massage Therapist should first do a simple assessment, and then make a plan of action to work and build from.
The assessment gathers info about your injury history, pain patterns, joint movement and postural alignment. We also assess the length, strength and quality/feel/composition of the muscles and structures around your injured knee, and beyond into your hips, spine and ankles.
Therapists use clues like pain location, simple movements that recreate symptoms, and palpation as a starting point for relieving knee pain.
Along with myofascial work to address any scar tissue around the knee joint line (retinaculum), the following muscles are most frequently addressed during a knee injury-focused massage therapy session:
Quads are comprised of 4 muscles that originate toward the top of the thigh and insert into a single tendon above the patella, attaching to the tibia just below the patella. Overuse, imbalance and trigger points among the quads refer pain above and below the patella. Stretching, deep tissue techniques and gentle quad activation releases tension and pain around the kneecap.
Hamstrings are like the Yang to the quads’ Yin (according to Chinese Medicine, finding Yin/Yang balance is a cornerstone of health). Hamstrings are comprised of 3 muscles that originate at the sit bones and insert behind and just below the knee. For several reasons, hamstrings tend toward hypertonicity (too much tension and overuse). If the hamstrings overpower the quadriceps’ strength, the patella may rub against the tibia, causing pain just below the patella. Deep tissue work into the hamstrings and stretching shortened muscles is helpful in this case. Trigger Point therapy, petrissage and compression along the lower portion of the lateral hamstring (Biceps femoris) may provide relief from pain felt at the lateral side of the knee.
IlioTibial Band (IT Band)
This flat wide band of connective tissue runs, like Adidas stripes, along the lateral side of the upper leg from the top edge of the hip bone down to the outside lower edge of the knee on the tibia. It keeps communication in check between hips and the knees, maintaining baseline tension, especially when moving forward. Due to its composition (connective tissue), job (maintaining tension), and location (overlays the powerful lateral quad, vastus lateralis), the ITB frequently develops fibrotic patches and adheres to the overworked vastus lateralis muscle beneath it. These adhesions then generate increased tug at the tibia and hip attachments, and irritate the nearby structures, causing pain and inflammation. Myofascial Release along the IT band is helpful to minimize the inflammation and pain
The gastrocnemius is a bulky muscle that connects the ankle and knee. It’s the muscle that we see and consider to be “the calf”. Trigger points and adhesions in the upper half can refer pain to behind the knee and into the arch of the foot. Trigger Point therapy, muscle stripping, petrissage and myofascial release, although intense, almost always provide pain relief.
Popliteus is a small strong muscle that crosses from upper lateral edge to lower medial edge behind the knee. Popliteus enables the knee joint to rotate slightly, giving it stability when initiating knee flexion. With knee injuries, popliteus is almost always hypertonic because it tends to overfire in the presence of knee instability and glut weakness. Tendon release and trigger point therapy on Popliteus are notorious for being painful, intense and highly beneficial for most knee injuries, especially ACL injuries.
After reading this article, hopefully you’ll give Massage Therapy a shot for sports-related knee pain. I recommend scheduling regular sessions 1-2 times per week with the same therapist for at least 3 weeks to determine its effectiveness for your injury.
Massage Therapy for knee pain is ideal in conjunction with a corrective exercise plan designed by a chiropractor with a sports injury specialty or a physical therapist, both services available to you at Physio Logic in Downtown Brooklyn.
You’ll be a happier person and perhaps a better athlete if you aim to understand what’s causing (contributing to) your knee pain, and treat it properly.
Stop living with knee pain. Schedule Your Appointment Today.
CATEGORIES : Health Knee Pain Massage Therapy Physical Therapy Pilates PT Rehabilitation
BENEFITS OF MASSAGE
Aside from the skinned knees that accompany learning to ride a bike, knee pain comes more often from inside the body than outside. Your knees bear the entire weight of your body, and they don’t always respond well.
Adults are often troubled by osteoarthritis as their cartilage – which acts as the shock absorber for joints – begins to wear down. In fact, the American Pain Institute says that around 30 percent of people age 65 and over report feeling pain or stiffness in their knees during the past month.
Total Knee Replacement surgery has become increasingly common, but stiffness is a troubling side effect. The scar tissue caused by surgery will vary from patient to patient, but this tough fibrous material can limit your range of motion.
Massage therapy has proven effective in breaking down scar tissue, which improves the recovery process. Another advantage of massage, according to Dr. David Katz of Yale University’s medical school, is that it’s “free of any known side effects and, according to our results, clearly shows therapeutic promise.”
BENEFITS OF MASSAGE
A study of patients diagnosed with knee osteoarthritis looked at the effects of massage. Those who received a 60-minute Swedish massage once or twice a week for two months reported less pain and improved knee function. The researchers concluded that “massage therapy seems to be efficacious.”
Even for people whose knees feel fine, massage increases serotonin which acts as a natural pain reliever, reducing anxiety and promoting deep sleep. Anyone facing stress on knees, joints or anywhere else can benefit from the effects of a relaxing massage at Massage Envy.
Everyone loves a good rub down. Not only does a massage feel good, but it also stimulates blood flow, loosens muscles, and can be very relaxing. The same goes for knee massage.
Massaging the knee allows blood and oxygen to get into the joint, which makes your knee’s job of healing itself a lot easier. Massaging the knee will also help the knee to relax and take the pressure off those nerves that are causing you pain.
You can experiment with different motions and how much pressure you apply to find a rhythm that feels best for you. If certain areas are tender, try to massage around them so you don’t cause yourself any further pain.
If your knee injury is more severe, knee massage may not be advisable. The rule of thumb is that if it hurts, don’t do it. This type of stimulation may be too intense for your knee and if this is the case, you may want to look for a more gentle treatment option.
For those who think that knee massage may be too painful, I have a great alternative. My passive stretches are the perfect way of relieving stress in the knee without the intensity of massage. Passive stretching allows the knee to find comfort where it once felt only pain. This relaxation allows the nerves in your knee to calm down, creating space so that they are not being squeezed. Click here for information about The Comfort Zone.
While both passive stretching and knee massage are effective tools for anyone having knee pain, it is up to you to decide which one is best for you. Just remember that the end goal of both activities is comfort and relaxation so that your knee and your body can work together to reduce the pain.