Running doesn’t ruin your knees

It has been a long standing myth amongst non-runners that running (specially long distance running e.g. marathons) can cause arthritis and damage the knees. Infact one of my friends who is an ergonomist and occupational therapist also said the same thing to me. She is an ardent cyclist and swears that pounding the knees on the roads is not her idea of exercise as its going to have a significant impact on her knees and leave her with early onset of osteoarthritis in the knee. She has even encouraged me to consider giving up running and take up cycling as an exercise instead as it is potentially less strenuous for the knees.

One can be forgiven for believing these contentions. It is easy to imagine ballistic forces moving through our knees when running and since the knees of long distance runners undergo these mechanical forces repetitively, it can be assumed that it would lead to degeneration and therefore knee osteoarthritis.

Full story at PhysioGuru

Study: For Individuals With Knee OA, 3 Tests Can Predict Ability to Walk 6k Steps a Day

Getting individuals with knee osteoarthritis (OA) to walk regularly is a crucial component in reducing knee pain, improving physical function, and staving off comorbidities such as cardiovascular disease. But how can a clinician know if a patient is capable of meeting minimum walking recommendations? Authors of a recent study believe it may come down to performance on 3 simple tests.

In a study of 1,925 participants with or at risk for knee OA, researchers sought to link performance on the 5 times sit-to-stand test, the 20-meter walk test, and the 400-meter walk test to walking patterns outside the clinic. Participants ranged in age from 56 to 74 years, with an average age of 65. The study was e-published ahead of print in Arthritis Care and Research.

Full story at APTA

Sleep therapy may help ease knee pain troubles for some

Patients with knee osteoarthritis and insomnia may be less troubled by joint pain after they get treatment to help them sleep better, a recent study suggests.

Knee osteoarthritis, a leading cause of pain and disability in older adults, occurs when flexible tissue at the ends of bones wears down. While it can’t be cured, physical therapy or anti-inflammatory medications are often prescribed to relieve pain and improve mobility.

More than 70 percent of people with knee osteoarthritis also suffer from sleep disturbances, researchers note in the journal Pain.

Full story at Reuters

NYT Article Questions Arthroscopic Surgery, Acid Injections for Knee Pain

New York Times (NYT) writer Jane Brody engaged in a lot of what she describes as “wishful thinking” about how best to treat her knee pain. One surgery, 1 hyaluronic acid injection treatment, and 2 knee replacements later, she’s wondering what might’ve been had she avoided interventions that “have limited or no evidence to support them.”

In her July 3 NYT piece titled “What I Wish I’d Known About My Knees,” Brody recounts her journey through meniscal tear arthroscopic surgery and “painful, costly injections,” only to lead to knee replacement, and compares her results with a friend who opted for physical therapy when he was diagnosed with a meniscus tear and is now pain-free. The stories highlight what Brody calls “serious questions” about the benefits of arthroscopic procedures people pursue “in hopes of delaying, if not avoiding, total knee replacements.”

Full story of knee pain treatment in question at APTA

More Evidence Questions Benefits of Arthroscopic Knee Surgery

The case continues to mount around the lack of evidence to support arthroscopic surgery for degenerative knees—this time, by way of research that calls for a “reversal of a common medical practice,” even among patients with knee osteoarthritis. Authors of the article write that the procedure produces “small inconsequential” benefits in pain and that surgery produced no benefit in function.

In an article published in BMJ, researchers share the results of a systematic review and meta-analysis of 9 trials, involving 1,270 individuals, that looked at the benefits of knee arthroscopic surgery in middle-aged and older patients with knee pain and degenerative knee disease. Patient data were analyzed in several different ways, including in terms of those with no knee osteoarthritis (OA) found by radiography, those with knee OA confirmed through radiography, and a mixed OA and no-OA group.

Full story of benefits of arthroscopic knee surgery at APTA

Flex CEUs: New Courses for February

Knee Pain – Autologous Chondrocyte Implantation

$27.00 [3.00 CE Hours]
This course reviews rehabilitation guidelines following Autologous Chondrocyte Implantation (ACI) on the tibiofemoral joint. This surgical technique, which has become an established technique for repair of full-thickness chondral defects, is discussed as well as the factors proposed to influence patient outcomes. Components of pre-operative patient education and conditioning are presented as well as the 7 stages of post-operative rehabilitation.

Cervical Radiculopathy – Exercise and Traction as Treatment

$18.00 [2.00 CE Hours]
This course reviews a clinical study that evaluates the effectiveness of cervical traction in addition to exercise for patients with cervical radiculopathy. This common diagnosis is based clinically on the presence of neck pain extending into the arm accompanied by signs of nerve root compression during physical examination. Patients were randomized to 4 weeks of treatments with exercise, exercise with mechanical traction, or exercise with over-door traction. A discussion of the results indicate which treatments demonstrated lower disability and pain.

For these new courses and many more, visit Flex CEUs

HHS Updates Practice Guidelines on Knee OA, Falls Prevention

Aerobic walking programs for the management of knee osteoarthritis (OA) and recommendations for falls assessment and prevention are among the clinical practice guidelines recently approved by the federal Agency for Healthcare Research and Quality’s National Guideline Clearinghouse (NGC).

The NGC’s update of the Ottawa Panel evidence-based clinical practice guidelines for aerobic walking programs in the management of osteoarthritis focuses on the efficacy of various programs for adults over 40 with knee OA, and analyzed outcomes for walking programs that feature any combination of strength training, health education, behavioral components, and multicomponent exercises. The review evaluated outcomes based on pain level, quality of life, and functional status.

Full story on updates on knee and fall prevention at APTA

FLEX CEUs: New Courses for November

Tennis Elbow – Treatment Approaches

Tennis elbow, also know as lateral epicondylalgia or lateral epicondylosis,  is a prevalent disorder characterized by degeneration of the extensor tendon resulting in biomechanical and sensorimotor deficits that may interfere with occupational tasks, activities of daily living, and sports. This course reviews two articles; the first evaluates relationships between self-reported pain and function, and measures of tendon pathology and biomechanics in individuals with tennis elbow. The second presents an unconventional treatment approach to the commonly used intervention by examing the effects of exercises that change scapular strength and position on an individual with tennis elbow.

Knee Pain – Surgical Options for Meniscus Repair and Articular Cartilage Injuries

This course reviews two articles that explore surgical options for meniscus repair and articular cartilage injuries. Innovative approaches to treating symptomatic lesions of the knee’s articular surface are discussed in the first article. Surgical options reviewed include; arthroscopic lavage and debridement, microfracture, autologous chondrocyte implantation, osteochondral autograft transfer system and osteochondral allograft transplantation. The second article reviews clinical signs found during a clinical evaluation that indicate a meniscus tear. The indications for meniscus repair and/or meniscus transplantation are presented and both of these operative techniques are discussed in detail.

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Knee Osteoarthritis Treatment: Methotrexate Drug Could Ease Joint Pain

A clinical trial could ease the joint pain of millions of Brits living with osteoarthritis of the knee.

Methotrexate is already successfully and widely used to treat people with the condition of rheumatoid arthritis, a completely different condition to osteoarthritis.

Both conditions can lead to severe joint pain and stiffness but while rheumatoid arthritis is a serious autoimmune condition that causes inflammation in the joints, osteoarthritis is a degenerative joint disease in which cartilage wears away at the ends of bones.

However, according to Professor Conaghan who will lead the clinical trial, recent studies suggest that inflammation also causes pain in osteoarthritis.

Prof Conaghan and colleagues have already performed a pilot study which showed that 37% of patients with knee osteoarthritis who took methotrexate had a 40% reduction in their pain.

“Current drug treatments for knee osteoarthritis are limited in that they have significant side-effects and are not suitable for many people,” he explained.

Full story of knee osteoarthritis treatment at Huffington Post UK

Study: 10 percent weight loss may relieve arthritic knee pain

Older people with a weight problem can relieve knee pain from osteoarthritis if they lose just 10 percent of their body weight through diet and exercise, a new study finds.

Overweight and obese people 55 or older who participated in a diet and exercise program reported less pain, better knee function, improved mobility and enhanced quality of life when they dropped one-tenth of their weight, according to the study in the Sept. 25 Journal of the American Medical Association.

“We’ve had a 162 percent increase in knee replacements over the last 20 years in people 65 and over, at a cost of $5 billion a year,” said lead author Stephen Messier. “From our standpoint, we think this would be at least a good way to delay knee replacements and possibly prevent some knee replacements.”

The 18-month study followed up on earlier findings that showed a 5 percent weight loss decreased knee pain and increased function in older folks, said Messier, a professor and director of the J.B. Snow Biomechanics Laboratory at Wake Forest University.

“We thought, well, 5 percent did great — what if we did more?” he said. “Would a more intense weight loss prompt more improvement on clinical outcomes?”

Full story of weight loss and knee pain at Asbury Park Press