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Archive for September, 2012

OA and Inactivity

September 29, 2012

Osteoarthritis of the knee can be painful.  It can cause pain in many different activities of daily living.  This does not mean that it should be debilitating.

A recent article in the Cape Gazette addresses the “ceiling” effect.  The “ceiling” effect is where individuals suffering from osteoarthritis limit themselves to the activities that are comfortable.  While this may make things easier in the short term, it can be bad in the long term for several reasons:

1:  Avoiding painful activities can mean missing out on life.  As osteoarthritis progresses, the number of painful activities increases and the you will be increasingly limited.

2:  When you prevent yourself from exercising, you lead an inactive lifestyle.  Inactivity can lead to obesity, which makes the osteoarthritis worse.

3:  Inactivity can stiffen joints, reducing range of motion.  This further increases the pain and discomfort with motion, leading to more restricted activities.

So instead of avoiding knee pain, consider your options for pain management.  There are many types of physical therapy, bracing, medications, and even surgeries that can help you return to your desired activities.  Don’t let osteoarthritis keep you on the couch.

Joint Supplement

September 26, 2012


There are several important factors to consider when choosing a joint supplement:

1.  Look closely at products that encourage “the same dose for everyone” approach.  Bodies absorb nutrients differently depending on age, weight, and how bad the arthritis is.

2.  The quality of ingredients is more important than the quantity.

3.  Joint supplements usually take weeks to start working not days – so be patient and consistent.

4.  Be sure the supplement contains what your joints need.

5.  Is the supplement a pain reliever or is formulated to help your cartilage defend itself against knee osteoarthritis?

6.  Where is the supplement manufactured?  The supplement you take needs to be manufactured as if it were a pharmaceutical, in an FDA registered lab.  If this information isn’t readily available on the supplement you are looking at then it probably is mixed together in an unregistered site.

7.  Read the label.  Know what you are taking.



OA and Obesity

September 23, 2012

Obese individuals apply much more weight and stress to their knees.

Osteoarthritis is a degeneration of cartilage, leading to increased friction and decreased shock absorption in joint spaces.  It is unsurprising that osteoarthritis of the knee is often present in overweight or obese individuals, since they apply more stress to their  knees.  In fact, a recent article in the Huffington Post reports that just 10 pounds of excess body weight can produce 30-60 pounds of extra force on the knee.  This means that obesity can have an exaggerated effect on joints supporting body weight.

Knee osteoarthritis is particularly troublesome in obese individuals because the pain it causes can prevent them from exercising to return to a healthy body weight.  Osteoarthritis and obesity have a cyclical relationship, which means that they make each other worse in a descending spiral.  While exercise can still help people with osteoarthritis and obesity, it is most helpful before the symptoms are severe.  Recent work at the Johns Hopkins arthritis center suggests that the risk of developing osteoarthritis may be reduced by 50% for every 11 pounds lost.

The connection between worsening obesity and osteoarthritis cannot be overstated, but it can be avoided.  By committing to weight loss and healthy exercise, individuals at risk for developing osteoarthritis can improve their health in the long run.


New OA Treatment!

September 20, 2012


Provailen is a new joint health supplement.  This new product for arthritis pain relief will help reduce swelling and stiffness.

Provailen is comprised of pharmacy grade ingredients:  Reishi, Tongkat Ali, and Capsaicin.  This new supplement is produced in a pharmaceutical lab registered by the FDA.  It works by reducing swelling, balancing your immune system, and strengthening the bones and muscles around your painful joint.

Some patients experience temporary side effects as their bodies adjust to Provailen.  Rash, headaches, a temporary increase in blood pressure, dizziness, and diarrhea have been reported.  If you are pregnant, have high blood pressure, if you’re nursing or have a serious health condition make sure to check with your doctor before trying Provailen, or any other joint health supplement.

A squat produces high forces on the knee when it is bent.  This puts a lot of friction on the knee.

Osteoarthritis usually develops as the result of mechanical stress.  This means that while some people are diagnosed with osteoarthritis, everyone is susceptible to it.  While certain people are more likely to develop osteoarthritis, certain activities have been shown to increase the risk.  Specifically, exercises involving large or repetitive forces on the knee.  If done appropriately, exercise can be helpful for osteoarthritis.  Unfortunately, excessive exercise can be harmful.

Exercises like squatting and running can hurt your cartilage.  Each squat or jarring landing can cause micro-trauma, leading to inflammation.  Inflammation leads to osteoarthritis of the knee.  Squats are particularly dangerous for individuals with osteoarthritis because of the significant forces placed on the knee while it is bent.  This pressure can tear your cartilage.

A neoprene knee sleeve can be helpful for individuals with knee osteoarthritis.  It can support the knee and restrict motion at the most extreme angles.  This reduces shear forces on the cartilage.  Neoprene knee sleeves can also support the knee while running.  This reduces the impact on the cartilage from each step, minimizing the micro-trauma and bringing down the swelling and inflammation in the knee.

OA and the Quadriceps

September 14, 2012

Quadriceps Musculature

The quadriceps is a muscle group in the front of the thigh.  It is composed of the vastus lateralis, vastus intermedius, vastus medialis, and the rectus femoris muscles.  The vastii connect the thigh bone to the knee-cap and shin bone.  The rectus femoris stretches from the pelvis to the shin.  The primary function of the quadriceps is to straighten the knee, but because of the rectus femoris’s origin on the pelvis, it can also bend the leg at the hip.  The quadriceps are often used with the foot on the ground but can fire when the leg kicks.  When the foot is on the ground the quadriceps will contract to control knee bending and leg straitening.  This means that the quadriceps are important in activities like climbing and descending stairs, and sitting down and getting up from a chair.

Because the quadriceps muscles cross the knee, when they contract, they increase forces on the joint.  This extra pressure can increase friction, which can put stress on cartilage.  This means that using the quadriceps can increase pain for individuals with osteoarthritis of the knee.  Tension in or spastic firing of the quadriceps can put prolonged stress on the inflamed joint.  Individuals with weak quadriceps hyper-extend their knees when they walk.  This promotes stability but is damaging to knee ligaments and the hamstring muscles.  This also dramatically increases the stress on the cartilage and bone in the front of the knee.

Excessive tension in the quadriceps may be treated with slow stretching.  Spasticity and quadriceps weakness have more rigorous treatments, often including bracing.  For quadriceps weakness, bracing is often implemented to support the knee and prevent hyper-extension.  More sophisticated braces provide that support only when the leg is supporting body weight, while other braces may lock the knee full-time.  Quadriceps strengthening exercises are often recommended for individuals with osteoarthritis of the knee in order to avoid the pathological gait associated with quadriceps weakness.



OA Signs And Symptoms

September 11, 2012

Knee Pain

Osteoarthritis refers to inflammation of a joint and its surrounding bone.  It often results from the accumulation of mechanical stress on the joint.  In most cases, there is degradation of the articular cartilage in the joint.  Articular cartilage is important because it is slick, and lets joints move with very little friction (less than ice rubbing against ice).  Articular cartilage lets a healthy joint move smoothly, and also has a limited role as a shock absorber.  In people with osteoarthritis, swelling in the joint increases pressure on the cartilage and can lead to break down.  Once the surface of the cartilage is broken, friction rapidly increases and the cartilage may wear away.  This is why OA can often be classified as degenerative.

Knee pain can often result from osteoarthritis.  As the osteoarthritis gets worse, the cartilage becomes less effective at reducing friction when the knee bends.  This is particularly problematic when the knee is supporting body weight.  Eventually, all of the cartilage in the knee may rub off, resulting in direct bone on bone contact.  This can significantly increase knee pain.

Knee pain from osteoarthritis is often treated with non-steroidal-anti-inflammatory drugs like Advil or Tylenol.  Knee braces are also an effective treatment option because they can help “unload” the knee joint.  This reduces the stress and pressure on the joint surfaces, and can prevent the bones in the knee joint from rubbing against one another.  Osteoarthritis can also be treated with cortisone injections.  Mild forms of osteoarthritis may be effectively treated with rest, ice, elevation and compression.


September 9, 2012


Aspirin is in a class of drugs called Anti-inflammatory medications.  Other drugs in this class of medicine  can include ibuprofen and acetaminophen.   Anti inflammatory medications like aspirin help reduce swelling.  Over the counter pain relievers like Bayer are commonly used with success to treat the knee pain associated with osteoarthritis. Aspirin has potential side effects and your body can build up a tolerance. It is important to understand that even over-the-counter medications like aspirin can interact with other medications you may be taking.  Make sure you follow the instructions on the bottle and consult with your primary care physician about aspirin use.


Cortisone Injection

Has your doctor recommended a cortisone shot for your knee pain?  The human body produces cortisone naturally when under stress.  Cortisone is a steroid manufactured in the adrenal gland.  It is delivered through the blood stream and its affects can last for minutes.

The cortisone your doctor wants to give you is synthetic.  Though man-made, it closely resembles the steroid made in your body.  The big difference is that the injected version is delivered directly to where the pain is and it lasts a lot longer.  How long the pain relief lasts will vary from person to person.

Knee Support

September 3, 2012

Knee Support

Knee support braces made from neoprene are common treatment options for osteoarthritis.  It is important these knee braces have covered seams because lots of times loose threads on the brace can cause irritation.  Also the edges of these knee braces should be bound.  The binding gives the braces a much cleaner look and also ensures the braces last longer.

A neoprene knee support should last about one year.