Nude Woman on Her Knees by Michelangelo
“If you do not have bone-on-bone arthritis, in which all of the cushioning cartilage in the knee is gone, think about consulting a physical therapist about exercise programs that could strengthen the joint, reducing pain and disability, Riddle says.” —New York TimesI’m sure that by now we all know someone who has had a knee replacement due to arthritis of the knees (see Arthritis and the Knee and Yoga for background information). And while some this procedure is a clearly life changing for people who advanced knee arthritis, there is growing evidence that people may be electing to have the procedure prematurely gaining limited benefits from it. So many people considering the procedure might be better off finding other ways to improve their knees, such as strengthening the muscles around their knee joints and moving their knee joints regularly through their complete range of motion.A recent article in the New York Times Think Twice Before Choosing Knee Replacement discussed two major studies published this year, in which researchers at Virginia Commonwealth University in Richmond conducted a surgical-validity assessment. In the studies Use of a validated algorithm to judge the appropriateness of total knee arthroplasty in the United States: a multicenter longitudinal cohort study. and Using surgical appropriateness criteria to examine outcomes of total knee arthroplasty in a United States sample., the researchers concluded that knee replacements should be judged appropriate for only those whose arthritis in the knee was “medically proven to be advanced.” (“Medically advanced” in this context means not just having severe pain but also being impaired in your physical functioning as well, such as, being unable to climb stairs, get out of a chair, or walk without aid.) The reason for this was that only those with advanced arthritis actually saw significant benefits from the surgery:“The same researchers also found that people who were good candidates for surgery — basically, they had really bad knees — benefited substantially from the surgery, reporting much less knee pain and much better physical functioning in the months immediately following the procedure and again two years later. On one commonly used measure of knee function, their scores improved by about 20 points on average. By contrast, subjects whose surgeries the scientists deemed inappropriate did not improve much. After a year, their scores on knee function had risen by only about two points.” —New York TimesFor people whose arthritis of the knees is not advanced, the New York Times recommended questioning the need for surgery and consulting your doctor to learn how advanced your arthritis really is. And if you make a decision to postpone the surgery and try exercise instead, yoga has a lot to offer you. Start by reading Baxter’s article on knee arthritis Arthritis of the Knee and Yoga for background information on the condition and to see which poses and practices he recommends in general.
Although this NY Times mentioned only strength building as a way of helping to manage arthritis of the knee, Shari says in her post Yoga for Osteoarthritis that moving joints through their range of motion is also essential for keeping them healthy. And this is where yoga can be especially beneficial, because the wide variety of poses allows you to move your knees through their full range of motion.“People stop moving with arthritis because it hurts, but when you stop the joint motion you decrease the nutrition to the joint structures. The body tries to repair the area by laying down more bone to protect the area and the result is spurring, which then cause more irritation from the “bones rubbing.”When the cartilage has deteriorated and there is no movement, the synovial fluid that bathes the inside of all synovial joints decreases, which then decreases nutrition to the joint and the cycle reinforces itself with pain=no movement=more pain with swelling and inflammation=even less movement. Yoga is so perfect for arthritis because it can stop that cycle by providing infinite variations in joint mobility and ways to maintain the joint alignment to improve joint weight bearing. You need to keep the joint moving in its full range of motion to keep the joint healthy, and yoga allows you to do that.” —Shari SerYou should also consider your particular anatomical structure when thinking about managing your arthritis of the knee joints. Do you have bowlegs or knock-knees? Or do you typically hyperextend your knee joints? (If you don’t know, ask your yoga teacher or health professional to help you assess your knees for these conditions.) Because these three conditions are quite common, we’ve written specific posts on them. See:
- Hyperextension of the Knees and Yoga by Nina
- Bowlegs, Doctor Who, and Yoga by Nina
- Knock-Knees, Lady Gaga, and Yoga by Baxter
