Exercise for Knee Health

I am Dr Rakesh Nair. I am an exclusive knee replacement surgeon. Today I am basically going to talk about how to prevent damage to the knees by doing the right type of exercises.  So, the topic today is going to be Osteoarthritis and Osteoporosis. How are they interconnected? How are both important in terms of treatment?

Let us start initially with Osteoarthritis. What do I mean by Osteoarthritis? 

Osteoarthritis means a worn out joint. The same knee which has souls start wearing out as you get older. Therefore, it is called a Primary. So, whether you have a problem at some age or not, this pain is going to happen to you, whether it happens at 25, 35, 40, 45 years. It might also happen at the age of 75 years. Most of my patients are going for surgery between the age group of 75-85 years. So here I am going to show you the right forms of exercises where your knee can last for the lifetime. So, we are looking at an average of 8 spans of 80-85.

So, will your knee last long?

The chances are very less because the present data says that the 80% of the general population has artificial knees because we are out living our knees. We are living much more than our knees can last.

What is Osteoarthritis? means what exactly happens to the joint?

The knees are made up of bones which are a thigh bone which is on the upper side and it is covered with the fine layer of the cartilage which is hardly 1 cm. The same thing is with the bone which is the Shin bone which is the lower part, again which is covered with the cartilage. Between these layers, we have a lubricant fluid connecting both the legs on the side we have strong ligaments which hold the joint together.

What exactly happen in Osteoarthritis?

In Osteoarthritis, the same cartilage which you see starts wearing out. There are small pieces which start wearing out. The joint which straight started getting bent which either like a bow like a deformity or a knock knee deformity depending on how strong or how weak your muscles are. When a  straight knee finally become bent then we have to look for some surgical options.

What are the symptoms of pain in the knee?

The first and the foremost symptoms are when a patient feels pain while climbing and getting down from stairs. So this is the first sign of Arthritis when you get to know that your knee is wearing out. Then they complain of pain, swelling. In the advanced stages, we will see the patients with bent knees, either bent inwards or outwards.

Today, I am going to tell you that can we prevent this damage?

For this, I am going to stress on exercise protocols for strengthening. Now, you need to understand that there is a difference between cardiac training and muscle strengthening. Most patients believe in walking as an exercise. But I would say that walking is the main form of exercise if not balanced properly with strengthening is going to cause wear and tear on the knees.

First, you need to strengthen the muscles which are there in the front and the back of the knees. So we are talking about strengthening the cardio steps and about strengthening the hamstrings. I would be giving you the practical demonstration of how we can do the same. 

These are the normal exercises which I ask 70 years old individuals to do.

• Initially, the patient is lying down and push the knees downwards. Neeche dabaav daalo or thoda dheela karo. Push down and relax and do it till the count of 50. So, this is the basic first exercise you should do when you start any other exercise. 
• The second exercise is leg race. This should also be from 5-50 counts. When you can comfortably do 50 counts at a time then we start the same in sitting posture.
• Lie down with the face down and start bending the alternate knees upwards and then release. This is what you would do for a hamstring strength

So these are the exercises which you can do from the age of 20 years to 80 years. Depending on the muscle strength, you can gradually increase the intensity of an exercise and take it to the next level.

If you are able to strengthen your knees simultaneously as you increase your cardio activity, that would be the best form without any damage to your knees. Another thing is that if you can balance your cardio in terms of saying that if you could do cycling, swimming, walking or running and balance all 25% of your work out when you are working out in the gym. So when you are going to the gym, the first thing should be doing is not going to the tread mill, you should start with the cycling as it is non-weight bearing exercise. Do it for 10 minutes, gradually as you warmed up you can do cross stepper and lastly, you can go to the tread mill. That is the commonest mistake when we talk about cardio. Tread mill should not be the primary exercise when you go to the gym.

Maximum work can get by the trainers in the gym because most of the times you end up doing squats and crunches. Basically, your lower body is not that strong to take the whole grant of the weight. So, I would suggest that if you are 35, 40, 45 years and if you are little heavy in the upper body then please do not start with free hand squats.

First, do the machines. On machines, you can do leg extensions, hamstrings and press rings. And when you start feeling that your lower body is capable of taking weight then start doing squats and lunges. And if you are going to avoid it, it will not make much difference, you can increase your muscle strength in terms of your leg extension and hamstrings.

Running can cause irreversible damage to the knees after the age of 40-45. The 25-year-old individual can run because at the young age, the cartilage has the tendency for the recovery. But after the age of 35 years, there is degeneration. If you want your knees to stay healthy between the age of 35-80, then you need to take care good care of it.

Let me give you some tips on running.

It is important that you wear good running shoes while running and walk on a good walking track. Avoid walking on the roads. Please try to walk on the grass or a mud track. Because walking on the road may cause nerve stress. 

Before you start indulging into exercise, I would suggest you to have blood tests of  Calcium, Vit- D3 and Vit- B12. You will be surprised, when you are deficient in either of these and you are going to take the exercise to the next level, then you will face some damage. Only if the reports of these blood tests are normal then only take your exercise to the next level. Otherwise, there will always the chance of injury.

I always ask females to do basic bone density along with the blood tests which I told you previously. Maximum damage to the female body is done during menopause. But if your basic density of Vit- D3, Vit- B12 and calcium is normal then you will suffer from least damage even after the menopause.

All the above mention tips will definitely help you.

For further information, you can contact me through Lybrate.