Osteoarthritis: What should the patient know?

Human joints are wonderful anatomical formations. What man-made machine can exist and work for dozens and dozens of years? To better appreciate the work of such a wonderful device, as joints, consider the following facts. If the body weight of a person is 50 kg, with each step on his knee joint, the load is more than 150 kg.

Most people make an average of more than 8,000 steps a day, which means that the knee joint should absorb over 600,000 kg. If the body weight of a person, which during the day makes the specified number of steps, is 75 kg, his knee joint absorbs the load of more than 900,000 kg. Now you can imagine what kind of load amortizes the knee joint of an athlete or a person engaged in heavy physical labor. Not surprisingly, despite the strength, the knee joint is vulnerable, prone to injury and disease.

Osteoarthritis is one of the most common diseases of the joints, in which the cartilage covering the contiguous bone structures inside the joint is affected. The exact cause of its development is unknown. Two most likely reasons are hereditary predisposition (inherited defect in the structure of the articular cartilage) and excessive microtraumatism of the joint tissues (for example, with excessive body mass of the streets of some professions, etc.). As a result, the cartilage wears out, thins, and in the underlying bone, osteophytes are formed - the so-called spines. The joints carrying the largest static (knee, hip and spinal joints) or dynamic (some joints of the wrist) load are most often affected.

The most characteristic symptoms of osteoarthritis are pain in the joint with prolonged standing, walking, running, which passes at rest. For osteoarthritis of the knee joints, pain occurs when climbing the stairs. In patients with osteoarthrosis of the joints of the hands, the fingers acquire a characteristic "knotty". Today, this disease is not completely cured, but with regular treatment and observance of certain rules of life can slow down and even stop the progression of the disease.

A patient suffering from osteoarthritis should carefully follow the doctor's recommendations. Treatment of osteoarthritis usually involves taking pain medications, the right combination of rest and exercise, which is extremely important for maintaining the functioning of the affected joints. It must be remembered that pain medications for patients with osteoarthritis are prescribed to relieve pain, and not to put their joints under even greater strain. Do not kneel while cleaning the apartment, pull out the drawers with your knees and close the doors, etc.). It is necessary to avoid long vertical static loads on joints, i.e. Do not stand for long, you should try to sit down, if such an opportunity is supposed. Do not run to the bus, it's better to slowly come to a stop, sit down on a bench and wait for the next one. When walking, do not rush, make fast turns and stops, walk along the uneven road. When you return home, you need to rest on a high chair with armrests or armchairs so that, after getting up after rest, you can help yourself with your hands.

It is recommended to avoid hypothermia of the extremities and use such procedures as hot wraps, hot baths, dry heat. To wrap up knee joints old woolen things will do.

If the local doctor diagnosed you with osteoarthritis of the hip joints, try to visit the orthopedist as soon as possible. Unfortunately, this is the most unfavorable variant of the disease, characterized by rapid progression. Therefore, the most radical method of treatment in this case is prosthetics. The "new" joint will give you the opportunity to fully experience the pleasure of being able to move independently without pain and using additional devices. If the operation is postponed for some reason, remember that the only way to slow the progression of osteoarthritis of the hip joint is to change the way of life. First of all, when walking, always use a cane, it will relieve the joint by 50%. Distribute static (standing) and static-dynamic (walking) loads during the day so as to minimize the load on the affected joint.

Sometimes, after excessive loads, infectious diseases, hypothermia, etc. The affected joint can grow in size ("swell"), the skin over it becomes hot, the pain intensifies, arises at the slightest movement, and sometimes at rest. These symptoms indicate the development of inflammation in the joint and the accumulation of fluid in it. This is a serious problem, you should not wait for her self-permission and self-medication, but you should immediately go to a doctor. Postponing a visit to a specialist can lead to irreversible changes in some structures within the joint, which will contribute to a protracted or only partial resolution of this inflammation, its frequent and prolonged exacerbations.

In persons with overweight, its normalization will help reduce pain in the joints. It is recommended to exclude easily digestible carbohydrates from the daily diet (sugar, baking, potatoes, rice, chocolate, etc.), fatty meats and animal fat.

Physical exercises are extremely important for patients with any pathology of the knee joint. Of particular importance in the treatment of osteoarthritis is the strengthening of the quadriceps muscle of the hip, located on its front surface, extending the knee joint and stabilizing it. Performing exercises to strengthen this muscle leads to a significant reduction in pain in the joint. It must be remembered that with osteoarthritis, any exercises should be performed only in a sitting or lying position.

On the back of the thigh is a group of muscles flexing the knee. Usually these muscles are much stronger than the quadriceps muscle, which extends the knee and straightens the leg. That is why in case of trauma or inflammation of the knee joint, the lower extremity tends to bend, since the muscles - hip flexors in this case form a permanent flexion contracture.

To prevent the contraction of flexor muscles, it is useful to perform an exercise to stretch the "chill (heel) tendon.

Stand at a distance of 40 cm from the wall (or cabinet), the feet are snug against the floor, knees are bent; lean your arms out against your wall; bend your arms in the elbows, try to touch the chest walls, then return to the starting position. When this exercise is performed, the Achilles tendon is stretched, the calf muscles and muscles - the hip flexors. Another exercise to strengthen the muscles - flexors of the knee joint: the initial position, lying on the stomach; slowly bend and unbend the legs in the knee joints. This exercise is desirable to perform with loads of bracelets on the ankles.

Correctly organized program of medical gymnastics is the most important part of rehabilitation measures for osteoarthritis after joint inflammation. If in the process of performing you have unexpected difficulties, you can not keep balance or do not mark improvement, consult your doctor.

Passive exercises are the first stage of the recovery period, since they do not require any effort on the part of the patient. The assistant (nurse, physiotherapist) flexes and unbends the patient's lower limb as much as the knee joint and relaxed muscles allow.

Half-active exercises are the next step. With the help of an assistant, you (actively) bend and unbend the limb in the knee joint.

Active exercises are performed without anyone's help. There are two types of active exercises: isometric and isotonic.

Isometric exercises are used as transitional between semi-active and active isotonic exercises. When performing them, you strain and relax the various muscle groups, while the limb remains immobile. To perform them, you must rest your feet in a stationary object (wall, cabinet, bed) and stretch the opposite groups of muscles that perform flexion-extension of the legs in the knee joints, or press both limbs tightly to each other at different angles. Consult a physician or physiotherapist about what sports equipment can be used to perform these exercises.

Isotonic exercises involve active body movements. The exercises described below will help you to strengthen the knee joints. The doctor will advise you which ones to perform, and also recommend additional exercises.

1. The starting position is lying on the back, the legs are bent at the knees. Lower the bent legs to the floor first to the left, then to the right and return to the starting position. The starting position is lying on the back. Raise the straight leg 50-70 cm above the floor and return to its original position.
2. The starting position - sitting on the table, one leg freely hangs, the other - lies on a chair, standing side by side, under the knee joints, put the roller from the towel. Raise the leg lying on the stool by 10-20 cm and return to its original position.
3. The starting position - sitting on the floor, the emphasis of the hands behind. Spread the straightened legs so that between the knee joints there is a distance of 35-40 cm and tie the legs with a strap or rope over the knee joints. Try to maximally spread your legs to the sides, overcoming the resistance of the belt or rope.
4. The starting position is lying on the back. Do not tear off the heels from the floor, bend the leg in the knee joint and pull the heel to the buttock, return to the starting position.
5. The starting position is lying on the back. Bend the leg in the knee joint and with your hands, press it to the stomach, return to its original position.
6. The starting position is lying on the back. As much as possible, straighten your legs and bring them back again.
7. Starting position - lying on the back, legs are divorced so that between the heels distance 25-30 cm Turn the foot inside, try to touch with your thumbs, then maximally turn the feet out and try to touch the little fingers of the floor.

How often can you perform these exercises?

The most reasonable recommendation is to perform them until the next morning the feeling of light stiffness and soreness in the muscles, but so that you can fulfill them again. The doctor will give you more exact advice. Complicate exercises gradually, do not overload the joints. Try to warm the knee joint or the entire limb before performing the exercises.

Swimming is not only a great sport for strengthening the muscle, it is a great way to unload, rest the joints of the lower extremities and the spine. In the pool, you can do special exercises for the knee joint. For example, walking in water that reaches you to the hip or to the waist (you get extra load due to water resistance). In doing so, try to walk without bending your knees and maximally raising your legs ("goose walk"), which will significantly strengthen the quadriceps muscle of the thigh.

Biking is a very useful sport for osteoarthritis: on the one hand, the muscles of the lower limb become firmer and more elastic, on the other hand, the knee joints do not experience such stress on the foot as in running or fast walking.

An important point is the height of the bicycle seat. It is necessary that when the pedals are rotated, the legs in the knee joints are slightly bent. To determine the required height of the bicycle seat, it must first be lifted so that the leg hangs, not reaching the pedal, then lower it slightly.

If the bicycle has a device for switching the speeds, the optimal driving speed for a patient with osteoarthritis is 80 revolutions per minute. If, after riding a bicycle, there is pain in the joints, then you need to lift the seat a couple of centimeters. To place the feet on the pedals is necessary so that the foot is turned slightly inward. Before riding, you should do warm-up and stretch exercises. It must be remembered that driving at high speed in cold weather is an additional cooling factor, so it's necessary to dress warmer.

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Some devices for the protection of knee joints

1. "Warmer for the knee." Knee joints should not be supercooled. To do this, use a heating pad, special knee pads, which can be bought at the pharmacy or made from the oldest warm clothes. 
2. Elastic stockings, bandage and bandage will help you with instability of the knee joint. However, they are not recommended for use in the development of inflammation in the joint, after surgery and trauma accompanied by swelling of the joint, as this can lead to a deterioration in the supply of tissues with blood.
3. A walking stick is a simple but very useful device. When choosing a cane, consider the following:
   • Make sure that it is strong enough. If you are a fat person, you need a stronger stick.
   • At the end of the cane should be a tip to prevent it from sliding.
   • The cane should fit you along the length (the elbow should be bent by 10 ° when you lean on the cane). Do not use other people's canes.
   • Make sure that the handle of the cane is comfortable and the cane itself is not heavy for you.
   • When walking, hold the cane in your hand, opposite to your aching leg.
4. Crutches. Their goal is to reduce the weight load on the joints. Crutches should be comfortable, fit you are authentic, should not slip.