Mend and Bend

If your knees are holding you back, try these suggestions and get active again

There are a number of things you need to do to take care of your knees.

A bad knee or trick knee doesn’t have to turn you into a couch potato for life. If you’ve been happy to use your knee as an excuse to channel surf instead of exercise, you shouldn’t do that either.

If your knee is holding you back, first determine what your goals are, says Dr. Samuel P. Robinson of the Jordan Young Institute for Orthopedic and Sports Medicine in Virginia Beach. Do you want to play basketball without your knees buckling?

Ballroom dance with your spouse? Jog a couple miles a day or run well past the three-mile mark when your knee gives out? Or do you just want to walk across the room?

An orthopedic surgeon can evaluate your knee (likely including X-rays), determine its status, talk about improvements and let you know if your goals are realistic, Robinson says.

Among your doctor’s first goals for treatment will be to get you on a bridge from the painful place you are now to a state where you can exercise again, says Dr. Boyd W. Haynes of Orthopaedic and Spine Center in Newport News.

The doctor may want you to take Naproxen (brand names include Aleve) and other medications to take away inflammation, Haynes says. Ice, compression and braces also help, Robinson says.

Once the knee stabilizes, your doctor will want to get you on an exercise program. You need strong muscles to better support an arthritic knee, Robinson says. But when your knee first started hurting, likely you subconsciously began favoring it, he says. “You baby it,” he says. “You don’t use that leg as much going up and down stairs. It ends up with the muscles getting weak.”

But not just any exercises will do. “You have to do exercises a certain way or the knee gets worse,” Haynes says. Your doctor may give you a list of exercises and/or gym machines to do ... and to avoid. For example, “Avoid leg extension exercise; it tends to irritate the knee,” Haynes says.

Once the knee starts feeling better, patients can move in two directions,—either of which is bad. Overly enthusiastic athletes can get back into the action too soon, Robinson says. “People don’t give their body a chance to completely heal,” he says.

On the other side, some non-active patients are ready to give up the exercises and return to the couch once their knee feels better, Haynes says.

The middle ground involves listening to your doctor. (Surprise).

If you’re a hardcore runner, you may not have to give it up. But a doctor likely will recommend changes to your routine. “You can change the surface you’re running on or —run on a high school track made of squishy rubber instead of hard pavement,” Robinson says. “Sometimes people need orthotics in their shoes. Some people are just running too much and need to cross train with swimming and biking for cardiovascular fitness.”

Professional athletes have an offseason where they rest or do another form of training so their bodies can recover. The rest of us should adopt that plan, Robinson says. “Runners don'’t ever schedule themselves an off-season,” he says. “We need to rethink the way we exercise.”

Finally, 10 percent of patients may need surgery. Most replacement knees last about 20 years—then you might need what’s called revision surgery. If you’re under 50, your doctor may not want to do the surgery yet.

“If you do it too early, you can set people up for long-term problems,” Robinson says. But on the other hand, if you’re 50, have tried all the conservative treatments and nothing else works, the philosophy often is: “I don’t want to wait until I'’m 60 to feel better,” he says. “People want to enjoy their lives, enjoy their knees, be healthy.”

Your doctor can help you consider the pros and cons of surgery at any age.

“Knee replacements are wonderful surgeries,” Robinson says. “It really gives people their lives back, gives spouses their lives back. Surgery allows people to participate in ballroom dancing, walking, lose weight and get other medical conditions under control.”

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