General Knee Health
General Knee Health
Activity Classification,
Chondroprotective Agents,
Conservative Management,
General Knee Strengthening
Methods To Decrease Swelling.
Activity Classification
In order to help you avoid knee damage, we have classified some of the most common sports and recreational activities into 3 basic levels according to the stress they impose on the knee. Level I activities apply generally safe stress on the knee. Level II activities apply moderate stress. Level III activities apply high stress to the knee and/or involve a higher risk of ligament or cartilage injury. By consulting with your physician and using common sense, you can minimize your risks of knee damage.
Level I:
Bicycling (road), bowling, golf, kayaking, rowing, scuba diving, swimming, walking (level ground), yoga, classic cross country skiing.
Level II:
Aerobics (low impact), skate skiing, diving, racquetball, roller skating, running (soft surfaces, 5-10 miles/wk), hiking/backpacking, horseback riding, hunting, ice skating, bicycling (mountain), sailing, softball (conservative, no cleats), waterskiing, wind surfing.
Level III:
Ballet, baseball, basketball, downhill skiing, football, gymnastics, handball, hang gliding, ice climbing, ice hockey, karate & judo, snowboarding, lacrosse, motorcycle (dirt biking), rock climbing, rugby, running (hard surfaces >10 miles/wk), soccer, softball (with cleats), tennis, track & field jumping events, volleyball, wrestling, wakeboarding.
Chondroprotective Agents
Articular Cartilage
Articular cartilage, or chondral cartilage, is a smooth, low friction surface that caps the ends of our bones and helps our joints move smoothly. It also distributes forces evenly throughout the underlying bone. When this chondral surface breaks down (chondrosis), either through injury or gradually over time, the joint loses its ability to effectively handle the forces placed upon it. This results in initial degenerative changes in the articular cartilage that lead to osteoarthritis. Chondrosis is graded into four different categories ranging from Grade I (minimal changes to the chondral surface) to Grade IV (significant damage to the chondral surface with underlying bone visible).
To date, treatment for these conditions has included lifestyle changes such as weight loss and activity modification. Medications such as Tylenol, or anti-inflammatory agents (Celebrex, Diclofenac or Voltaren, Ibuprofen or Advil) can also reduce symptoms. Chondroprotective agents such as glucosamine and chondroitin sulfate may provide another effective treatment.
Glucosamine
Glucosamine stimulates the production of proteoglycans and collagen (materials that are building blocks of articular cartilage) and, therefore, increases the strength of articular cartilage. Glucosamine is found naturally in the body. By increasing the amount of glucosamine present in our joints through supplements, we may allow the body to produce more proteoglycans and collagen to make our cartilage stronger. Osteoarthritis occurs when our body’s ability to make cartilage is exceeded by the amount of breakdown of cartilage. Glucosamine may help slow or stop this degenerative process.
Chondroitin
Chondroitin Sulfate is the most prevalent proteoglycan in articular cartilage. As we age, the amount of chondroitin our bodies produce decreases. Though chondroitin sulfate’s main role is to help provide strength to the cartilage, it has also been shown to be effective in inhibiting enzymes which break down articular cartilage. It is also theorized that chondroitin helps to increase blood flow to the bone underlying the articular cartilage, making this bone stronger and more resilient to osteoarthritis.
Recommended Dosage
Glucosamine and chondroitin sulfate together comprise a more effective supplement than either taken alone. Both products have been proven in clinical trials to be safe. These supplements are recommended for people whose cartilage is in the early stages of breakdown. They may also be used after surgery to enhance the healing response. Cartilage protective agents are not as effective when cartilage damage is severe and widespread
Conservative Management
To improve your knee function, follow the measures listed below. They may seem inconsequential, but together they can improve the quality of your knee and your life.
Achieve an optimal body weight. A reduction of one pound of body weight can relieve four pounds of pressure on your knee.
Wear shock-absorbing shoes and avoid hard surfaces.
Methods To Decrease Swelling
Modified Rest
Avoid activities that promote increased swelling in the knee and lower leg. It is best to avoid sitting or standing for long periods of time (over 10-15 minutes).
IceIce the knee intermittently during the day for 20-30 minutes. Allow 2 hours to elapse between each icing session. One recommended method is to use the large bags of frozen peas. Place one bag on the top of the knee and one under the knee for 20-30 minutes. Then re-freeze the bags to use again. NOTE: Once re-frozen, do not consume. Caution: Freezer ice packs and peas can be excessively cold at first. Place a wet towel between your leg and the pack to avoid frost nip.
CompressionKeep the lower limb elevated to avoid pooling of fluids in the knee and lower leg.
ExercisesMedications
Anti-inflammatory medicine (Diclofenac/Voltaren or buprofen/Motrin) as
prescribed by your physician.