This is the first installment in a series of blogs about cartilage. If any of you road warriors were looking for an Orthopod around town early this month you may have been out of luck. Many of us were playing hooky and attending our annual meeting in San Francisco. This annual event is a time for old friends, peers and even rivals to come together and share the latest advances in musculoskeletal research. The next several blogs will cover a hot topic at this meeting -- cartilage care.
Aging cartilage is a big problem in the general population, but it can be especially vexing for the Masters athlete who has no time nor inclination to be slowed down by the pain or swelling that often accompanies cartilage that is “running out.”
Cartilage is normally the glistening, smoother than ice, biomechanical wonder that lines the ends of our bones -- until it starts to break down. Technically, the definition of cartilage wear is osteoarthritis. Yes, I said the awful word. For most of you this cartilage break down is most problematic in the knees and hips.
These cartilage-care blogs that I'm going to write will cover the following topics:
1. Do it yourself cartilage care.
2. Help from a friend…your doctor.
3. Surgical interventions for cartilage gone bad
4. Microfracture
5. Cartilage transplantation
6. Natural and synthetic plugs
7. Joint replacement
First, do it yourself cartilage care,Caring for your knees and hips begins at home. The following is a short list of treatments you can try on your own.
1. Heat
In the morning or prior to exercise when you are trying to loosen up your tight joints heat is a good fix. A slow steady application is the best way to get your circulation going, relax your tight joints and get ready for activity. There are a variety of ways to accomplish this -- from heating pads, hot water bottles to thermal wraps. In general, I prefer the thermal wraps. Several companies make these but the concept is the constant application of approximately 104 degrees of heat over time. Some of these wraps last up to 12 hours and are perfect for getting on the go (versus a heating pad that leaves you plugged into the wall). Although they may feel warm and definitely smell funny, the heating gels that you rub into your skin do not reach deep enough to increase the circulation around your joint.
2. Ice
After activity, at the end of a long day or anytime your joints ache, ice is an excellent remedy. Not only does this simple solution calm the inflammatory process going on in your knees but it confuses the pain pathways and decreases pain. A minimum of 20 to 30 minutes is necessary. Apply the ice pack or simply a bag with ice onto a thin towel over your joint. Our skin gets thinner with age and this will prevent damage.
3. NSAIDS (Non-steroidal anti-inflammatories)
Now I know most of you will say that you are not “pill people,” but this class of drugs does not simply mask the pain but actually treats the source. Before you take these suggestions you should make sure with your doctor that this class of drugs is all right for you. This is especially key if you have stomach problems. In general, these medications are taken several times a day and take several days to build up a therapeutic level in your blood.
4. Do resistance training!
The key to healthy knees is strong quads and the key to healthy hips are strong cores and buttocks. If you are a typical Masters athlete -- or at least like the many I see each day in my practice -- you do your sport and little cross training or resistance work. All yes, all -- of my patients with cartilage wear are sent to the gym to lift with their quads, cores and butts. This will improve your game and keep your joints healthy. Note: if your knees hurt, especially in the front, NEVER do another knee extension. This exercise loads your kneecap 10 times whatever the weight is you are lifting.
5. Active Rest
If you have pounded out an intense workout and your joints are sore, rest them. This does not mean sitting on the couch for several days. Instead get on a bike and spin, row, use the elliptical, workout your upper body alone one day. Rest is great -- when it is active.
Next time: A little help from your friend, your doctor
Tags: Knee Osteoarthritis
