Hi doc, as precautions so as to prevent further wear and tear of cartilage and the pain ,can we take calcium and vitamin d, glucosamine, supplements to help in maintaining bone health. At present my mom is on metoprolol 50 mg medication (mastectomy done in 2006), has severe knee pain (arthritis) please suggest if she can take calcijoint (dosage-o.d/b.d ?) and also can she use biojoynt tabs along with calcijoint tabs? If so what should be d dosage ?how long should the tabs be taken (any break needed in between - before re-starting the medication like 1 month gap for every alternate 3 months?). Or any other alternative medicines or nutritional supplements you wd recommend. Although it will not reduce pain by much even if it gives some relief should be good. Thanks in advance.

Dr. Julie Mercy J DavidPhysiotherapist23yrs exp

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Ice therapy would definitely help to reduce the inflammation. We also advise you to use knee cap which would help to prevent the knee from damaging further and also to maintain the quadriceps muscle tone. Stiffness have developed due to weakness of the ligaments & inflamed cartilage. Specific knee exercises will also help ie. Keeping ball underneath the knee and keep pressing it. That's the simple exercise which will help you to strengthen the knee a variety of physical therapy techniques can help reduce the symptoms associated with patellar tendinitis, including: strengthening exercises. Weak thigh muscles contribute to the strain on your patellar tendon. Exercises that involve lowering your leg very slowly after extending it can be particularly helpful, as can exercises that strengthen all of the leg muscles in combination, such as a leg press. Half squat (do 2 to 3 sets of 10 repetitions)calf raises (do 2 to 3 sets of 10 repetitions)hamstring curl to do this exercise: 1.Stand facing a wall or use a chair for support. Your feet should be hip-width apart. 2.Lift one foot up, bend your knee, and raise your heel toward the ceiling. Go as far as you can, while keeping your upper body still and hips pointing forward. 3.Hold for 5 to 10 seconds. 4.Relax and lower to the starting position. 5.Do 2 to 3 sets of 10 repetitions for each leg. Leg extensions to do this exercise: 1.Sit up tall in a chair. 2.Put your feet flat on the floor, hip-width apart. 3.Look straight ahead, contract your thigh muscles, and extend one leg as high as possible without raising your buttocks off the chair. 4.Pause, then lower to the starting position. 5.Do 2 to 3 sets of 10 repetitions for each leg. Straight leg raises to do this exercise: 1.For this exercise, you can use a mat to add cushioning under your back. 2.Lie down on the floor with one leg bent and one leg straight out in front of you. 3.Contract the quadricep of your straight leg and slowly raise it up off the floor until it?s the same height as your bent knee. 4.Pause at the top for 5 seconds, then lower to the starting position 5.Do 2 to 3 sets of 10 repetitions for each leg. Side leg raises to do this exercise: 1.Lie on your side with your legs stacked on top of each other. Cradle your head in your hand, and place your other hand on the floor in front of you. 2.Raise your top leg as high as you comfortably can. You should feel this on the side of your hips. 3.Pause briefly at the top, then lower your leg. 4.Do 2 to 3 sets of 10 repetitions for each leg. Prone leg raises to do this exercise: 1.For this exercise, you can use a mat to add cushioning beneath you. 2.Lie on your stomach with your legs straight out behind you. You can let your head rest on your arms. 3.Engage your glute and hamstring muscles in your left leg and lift your leg as high as you comfortably can without causing pain. Be sure to keep your pelvic bones on the floor throughout this exercise. 4.Hold your leg in the lifted position for 5 seconds. 5.Lower your leg, rest for 2 seconds, then repeat. 6.Do 2 to 3 sets of 10 repetitions for each leg. Stretching exercises. Regular, steady stretching exercises can reduce muscle spasm and help lengthen the muscle-tendon unit. Don't bounce during your stretch. Heel and calf stretch to do this stretch: 1.Stand facing a wall. 2.Place your hands on the wall and move one foot back as far as you can comfortably. Toes on both feet should be facing forward, heels flat, with a slight bend in your knees. 3.Lean into the stretch and hold for 30 seconds. You should feel the stretch in your back leg. 4.Change legs and repeat. 5.Do this stretch twice for both legs. Quadriceps stretch to do this stretch: 1.Stand next to a wall or use a chair for support. Your feet should be shoulder-width apart. 2.Bend one knee so your foot goes up toward your glutes. 3.Grab your ankle and gently pull it toward your glutes as far as you can comfortably. 4.Hold for 30 seconds. 5.Return to the starting position and change legs. 6.Repeat 2 times on each side. Hamstring stretch to do this stretch: 1.For this stretch, you can use a mat to add cushioning under your back. 2.Lie down on the floor or mat and straighten both legs. Or, if it?s more comfortable, you can bend both knees with your feet flat on the floor. 3.Lift one leg off the floor. 4.Place your hands behind your thigh, but below the knee, and gently pull your knee toward your chest until you feel a slight stretch. This shouldn?t be painful. 5.Hold for 30 seconds. 6.Lower and change legs. 7.Repeat 2 times on each side.  

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