Knee Arthritis|Knock Knees|Virtual Knee Surgery

People who have problems with blood clots, fluid accumulation in the arms or legs, or who must remain immobile for long periods of type may need to use a type of medical pump called a sequential compression device, or lymphedema pump.

What is it?

A sequential compression device helps improve circulation in the feet, arms or legs. The device comes with a sleeve that is placed on the affected body part. The sleeve connects to an air pump. Once it's turned on, the lymphedema pump pushes air into the sleeve at varying intervals, which milks the arm or leg. It feels like a gentle squeeze. This opens up the veins and allows blood and fluid to flow more easily. Sometimes doctors refer to these pumps as intermittent pneumatic compression systems.

Who needs it?

Because being immobile for long periods of time increases the risk of blood clots, people who are having surgery (especially hip surgery or hip replacement surgery) may need these sequential compression devices. Also, people who are obese, have blood clotting problems, deep vein thrombosis, or arm or leg swelling may also find relief and better circulation if they use lymphedema pumps.

Research studies have also found these pumps to help people with a circulatory and sleep disorder called restless legs syndrome.

How much do they cost?

It depends on how many chambers they have. More chambers are more expensive, but also generally more effective. Health insurance may pay for a portion of a sequential compression device, which range from $600 to $3,000.

Fact: forty-two percent of all injuries from overuse affect the knee joint, and runner's knee (a.k.a. patellofemoral pain syndrome or PFPS), is the most common injury among runners.

PFPS can effect both knees, though more commonly it is more painful in one knee. According to the British Journal of Sports Medicine PFPS hinders more young and active people, and twice as many women as men. This is most likely because women tend to have wider hips, resulting in a greater angling of the thighbone to the knee, which puts the knee cap under more stress. The symptoms of PFPS are caused by the irregular tracking of the patella (kneecap) in the femoral groove.

What are the common symptoms of PFPS?

The most common complaint of those suffering with PFPS is tenderness behind and around the knee. Some also experience pain on the posterior side of the knee capsule as well. Instability and cracking could also be signs of PFPS. Although symptoms will be different in each case, running on hills and uneven surfaces often aggravates PFPS symptoms.

What are possible causes of PFPS?

Determining a single cause of your knee pain can be quite difficult. A good approach to eliminating your pain is having your knee assessed by a physical therapist. Anterior knee pain could be a biomechanical problem. Biomechanical issues that may be causing your pain include: excessive internal rotation of your hip, your knee cap may sit too high or too low in its groove, worn cartilage in the knee joint which reduces shock absorption, high arches of the feet providing less cushioning and flat feet, or knees that turn in or out excessively can pull the patella sideways. There could also be muscular issues contributing to your PFPS. Tight hamstrings and calf muscles, in particular, can put excessive pressures on the knee. Weak quadriceps muscles can also cause the patella to track out of alignment, creating painful friction and rubbing.

What can I do to help with PFPS?

A good physical therapist can perform a thorough assessment and determine what factors could be contributing to your knee pain. They would also evaluate your running stride while running on a treadmill to determine if there are any problems with your running technique and gait which may be the culprit of your pain. Treatment will likely consist of exercises to focus on correcting existing muscle imbalances and improving strength in weak muscles. You will also perform a flexibility program for the hamstrings, calves and hip flexors, and education on proper footwear and referral for orthotics to correct your foot positioning, if necessary. The rule is if your feet have good form, your knees will follow.

Some smart ways to prevent PFPS is to try running on softer surfaces like grass or trails. Also, don't do too much. Increasing your weekly mileage more than ten percent each week is too much. And lastly, running on hills can be good for your heart but hard on your knees; make sure to introduce a hill routine slowly! For the best advice contact a good physical therapist who can analyze your running gait and provide strengthening exercises to prevent future pain in your knees.

Osteoarthritis is the most common type of arthritis in older people. It is sometimes known as degenerative joint disease because in Osteoarthritis the cartilage of the joints continues to degenerated causing pain, stiffness and swelling as bone scrapes over bone.

People often have limited movement and pain but there is no redness, heat nor does it affect the internal organs like other arthritic diseases do. Osteoarthritis is the most frequent cause of disability in older adults. It affects more men before age 45 and more women after age 45. The disease causes not only changes in the person abilities but also their lifestyle and finances.

The joints commonly affected are the knees, hips, hands and spine. Patients start to notice a difference in their comfort level as they rise to standing from a sitting position, in the morning getting out of bed or after exercise.

Warning signs of Osteoarthritis include crackling joints, stiffness after getting up from a chair or from bed in the morning, pain, swelling, and tenderness. In Osteoarthritis there isn't redness or heat from the joint.

Doctors don't have a single test that will identify this disease. They rely on several methods to identify the changes and determine a course of treatment.

They will take an indepth clinical history to determine when the symptoms started, how they've been treated thus far and how they affect the patient's lifestyle.

Doctors will also include a physical exam, x-rays and other tests. X-rays aren't conclusive since most people over 65 have osteoarthritis in the joints but are not symptomatic. Blood tests can help to rule out other diseases that cause joint pain and swelling. Joint aspiration may also be performed to evaluate the fluid in the joint.

Osteoarthritis happens in the hands greater in women than men. There also appears to be a genetic factor as it seems to 'run' in families. Medication, splinting and moist heat give patients with arthritis in their hands the most relief.

Osteoarthritis in the knees is very common since the knees are the largest weight bearing joint and therefore commonly affected. The arthritis is not symmetrical and can occur in one knee or the other but not usually both at the same time. The knee becomes stiff, swollen and painful but isn't red or hot. The pain can lead to significant disability and a disruption in the patients lifestyle.

Therapy for Osteoarthritis in the knee often includes medications, necessary weight loss, walking aids and in extreme cases a joint replacement. Over weight and obese patient have an increased rate of Osteoarthritis. Decreasing the weight load that the knees and hips carry will treat the pain and disability of the disease. In fact, people who are over weight will decrease their chances of having painful Osteoarthritis just by maintaining a healthy body weight.

Osteoarthritis in the hip can be felt as pain in the hip, knees, groin, inner thigh or buttocks. When arthritis settles in the hip it can cause stiffness, pain and severe disability. The pain limits movement and bending which makes dressing and caring for the feet a real challenge.

Patients with Osteoarthritis in the hip often respond well to medications, exercise, walking aids and in severe cases a joint replacement. Again, patients with Osteoarthritis in the hip respond very well to weight loss.

Spinal Osteoarthritis may cause numbness or weakness in the arms or legs. Patients often report relief when sleeping on a firm mattress, using back support when sitting in a chair, and warm moist heat. Exercise can be incorporated to strengthen the back and abdominal muscles.

Osteoarthritis commonly affects four different joints in the body; knees, hips, hands and spine. With the proper identification and therapy people suffering from arthritis can delay the progression and pain of the disease.

Are you looking for the best treatment of knee joint pain? Most people suffer from minor or major knee problems particularly after a certain age. Sometimes, it can be a challenge to find out what the real cause of the problem is, whether it is due to sudden injury, an underlying condition like arthritis or an injury due to overuse of the knees.

How To Treat Knee Joint Pain

There are several treatments ranging from medication to natural remedies which can give relaxing and soothing effect to your soaring knee pain. Treatments for knee pain vary according to the cause of the knee pain, with some of the most effective treatments listed below:

1) Medication
This option involves getting some effective medicines prescribed by a doctor.

2) Therapy
- Orthotics and bracing: Braces, arch supports or wedges to shift the pressure from the knee joints are used.
- Physical therapy: Training and exercises to improve and strengthen the muscles around the knees, such as the quadriceps and hamstrings, are given to the patients.

3) Injections
Knee joints are treated with injections containing drugs like corticosteroids or hyaluronic acid which reduce the flaring pain of arthritis. These shots are very painful as they are injected in the knee joints.

Disadvantages Of Using Medication Or The Above Methods For Knee Pain
• May cause side effects
• Overdose of injections or medicines can trouble the person
• Slow healing process

4) Natural Remedies
Studies at a reputable Health Institute have discovered powerful herbal ingredients which include Lachesis Mutus, Naja, Belladonna, Rhus Tox and others. When these homeopathic ingredients are combined in one, it has the ability to stop pain and inflammation of joint pain quickly without any side effects. It has become one of the most popular options for many knee joint pain sufferers because of its effectiveness and speed in treating knee pain.

Advantages Of Using A Topical Cream As Treatment Of Knee Joint Pain
• Instant relief as soon as you apply it on the affected area.
• Carry it anywhere and use when needed.
• It does not irritate the skin or upset the stomach which some medications do.
• Zero side effects.

Going for natural treatments which contain homeopathic ingredients as mentioned is one of the most sought after remedy because of it zero side effects and ability to stop pain quickly. The breakthrough of discovering these homeopathic ingredients make such a natural remedy more favourable than medication or other therapies. It is definitely something worth looking at for those who are seriously looking for a safe and effective treatment of knee joint pain.

How are your knees doing lately?

Something tell us that you would not be here if everything was fine.

We are sorry that you are having knee issues, but while you are here lets discuss some important information.

The truth is, some knee pain is temporary and insignificant. - The problem is that you should not think like this when you have knee pain problems; we will tell you why.

1.) The pain might be a sign of something that is actually more serious.
2.) Instability issues should be examined before they worsen as well.

Braces can help in both of these instances.

When you have knee instability or knee pain problems one of the best things you can do is take your time. Surgery is not always the answer. At least not the first conclusion that a person should jump to. Upon speaking with your physician they will discuss the need for surgery, but often times they will look to more conservative measures of treatment for you.

When someone speaks of "conservative measures of treatment" for your knee, what do you think they mean? - Well we will tell you.

1.) Rest
2.) Improving your knee support with a brace

These are two helpful options for anyone to consider. - We actually like the idea of rest, but have problems with it alone. The reason why rest is helpful but not always a definitive treatment method is because people just don't have time anymore. Can you disagree? Do you have a ton of time to waste everyday? - Well ,if you do consider yourself lucky.

If you have time to rest your knee constantly then great, but even if you do you should seriously consider getting some knee support. We will tell you why.

Many people will look back at their choice to get a knee brace and feel good about the decision. People who get a well designed knee support will often say that their pain is reduced and that they have increased confidence as a result of wearing the brace. Not because the brace is magical or something, but it is because the brace will help to provide you with some extra support. This support will help maintain a proper knee alignment and also it will help to reduce your discomfort.

Some people also refer to their brace as a "pain pill". If this were the case then the extra benefit of a knee brace would be that you do not have to wait for the pain pill to kick in. Once you have the brace on, many of your pain symptoms can reduce due to the support it can provide. These braces can be obtained very quickly and you should consider getting one when your knee hurts.

There are a lot of different forms of tendonitis, all of which can cause quite a bit of pain in joints as well as other complications if the condition is ignored. Tendonitis can usually be diagnosed during a regular examination at a visit to the doctor's office.

X-ray machines and MRIs are not necessary, but an x-ray may be used to make sure that there are no other injuries to the area, such as broken bones, that could be the cause of the tenderness and swelling. MRIs may be used to identify where exactly the swelling is located in order to be treated more directly.

One of the many forms of tendonitis affects the wrist, which would cause a localized pain in the joints in that area. Wrist tendonitis can also be identified as tenosynovitis, a very common condition caused by the inflammation or irritation of the tenosynovium. These are a sort of tendon sheath that allows the wrist tendons to slide and allow the tendons to move smoothly with very low friction. If the condition is left unattended, it can lead to a far more serious condition from the thickening of the tenosynovium, which can keep the tendons from moving as smoothly as they should.

Symptoms of wrist tendonitis may vary, but the most common are swelling around the tender area. There are several forms of treatment, including the use of a wrist splint, which would immobilize the joint and allow it time to heal since the tendons are not being used. Applying ice to the tender area is also an option. This will stimulate blood flow to the area to assist in healing. You may also decide on an anti-inflammatory medicine which will help ease the pain, as well as control the inflammation and give the tendons the opportunity to heal.

Achilles tendonitis affects the large tendon that runs from the back of the ankle up the back of the leg. The condition seems to be more common in middle-aged recreational athletes. If the tendonitis goes untreated, it may lead to tears which could weaken then tendon even more, and make it more susceptible to rupturing.

The most common cause of Achilles tendonitis is a lack of flexibility. Other possible causes of joint pain caused by this form of tendonitis is a change in footwear or an exercise or training routine that the individual is not used to. As people get older, they begin to lose flexibility, which makes them more susceptible to injury-this is why middle-aged people are more likely to get suffer from this condition.

An important thing to remember is that the joint pain is caused by forms of tendonitis that won't go away on their own. Though it may stop hurting for an hour, or maybe even a couple of days, if the inflammation is not taken care of and the tendons healed, the pain in joints may cause other problems on top of the tendonitis.

Pain in the knee can be extremely distressing. The structure of the knee is such that many areas of the joint are susceptible to severe pain as they readjust or wear away. Knee pain could be caused by accidents, sports related injuries, and slips and falls. If neglected, it could result in many problems in the knees such as cartilage or ligament tears, inflammation, sprains, tendonitis, dislocation, joint infection, ligament injury, bone bruises, edema, sub-articular stress fracture or collection of fluid in the joint.

Knee pain can interfere with your daily activities and make your life difficult. You must ensure that you do not neglect it because lack of medical attention might further worsen the condition.

Treatment Options

There are many ways of treating knee pain, and most of these aim at breaking the inflammatory cycle. If the pain has just begun, you could try some home remedies such as over-the-counter anti-inflammatory pain medication, protection with knee pads, rest, ice packs, compression with a wrap or brace, and elevation. But if the pain does not respond to these remedies within a week, you would need to consult a physician or an orthopaedic specialist for further evaluation of your condition and the recommendation of the ideal treatment option. Only then would you be able to get effective and lasting relief.

A proper treatment plan is designed only after your physician diagnoses the root cause for the pain. An x-ray or MRI of the knee is required in most cases.

Physical Therapy as a Treatment Option

It is essential to mobilize and strengthen the muscles surrounding the knee during treatment. Therefore, the entire program of physical therapy is designed in such a manner that the pain can be reduced and at the same time, greater flexibility can be brought about. This in turn, can also improve the function. Apart from that, some other knee pain treatment methods include:

• Massage and Myofascial Release
• Transcutaneous Electrical Nerve Stimulation (TENS)
• Ice or heat to eliminate muscle spasm and inflammation
• Ultrasound to treat soft tissue injuries
• Traction

Other Pain Management Techniques

There are many more knee pain treatment options available. Some of the most common of these include:

• Exercise
• Transcutaneous Electrical Nerve Stimulation (TENS)
• Manual Techniques
• Administration of analgesics, NSAIDs, narcotic medications, muscle relaxants, and anti-convulsants and antidepressants
• Radiofrequency radio ablation
• Surgically implanted electrotherapy devices
• Prolotherapy
• Injections

However, it is always advisable to seek the help of the expert before deciding upon any of these options for treating knee pain.

A physical therapist working with a patient in hip replacement rehab will introduce the patient to a variety of exercises; exercises that may include both standing and lying flat.  Initially it may seem as if all the exercises introduced are only benefiting the successful movement and use of the hip. However, these exercises your physical therapists introduce are known to help a lot more areas of your body.

Gluteal sets is an exercise that requires an individual to lay flat on their back, preferably on the floor, while squeezing the buttocks for an interval of time before releasing.  The  move is to be performed several times in succession.  Whether starting out slow with just a few reps or digging in to do 10 reps in 4 sets, a person doing this move will appreciate the results. 

This exercise is designed to work 3 muscles at once: the gluteus maximus, medius muscle, and minimus muscle.  These muscles work together and help make everyday situations easier to handle, like climbing stairs and getting up from a seated position.  By mastering this routine, you're doing more than making sure life is easier, you're helping the look of a very prominent part of your body.

Arc quad sets is another exercise you may be introduced to.  You complete this exercise by lying flat on the floor while tightening your thigh muscles and straightening your knee.  This is a power move that strengthens all four muscles that run up the front of your thigh. 

If an individual is introduced to this exercise, they can rest assured that walking, running, or even jumping will be a lot easier to do.  When looking at someone standing sideways wearing a pair of shorts it's, easy to see if there's a defining line from working out; this is one of those moves that can help you achieve that look.

The standing knee raise exercise is as simple as lifting one knee at a time upward towards the chest.  This move can be done standing free or with the assistance of a chair.   The importance of this exercise during hip replacement recovery is that it works vulnerable skeletal muscles that surround the hip joint area.  These skeletal muscles are what keep your hip joints from feeling or remaining stiff. 

Everyday movement often taps into the flexibility of the hip joint and if the joint is in pain, the movement is painfully hard to achieve.  The great thing about working on this activity is that you actually begin to work stomach muscles.  While it may not be the move that can turn a stomach into an instant six-pack, it is one that well help you on your road to achieving it.

Facing your physical therapy appointment with the understanding that your whole body can benefit is one way to make sure that your hip replacement rehab visit is a productive one.

Have you ever witnessed one of those moments at a glittering event, where the company envoy ostentatiously hands over the enormous polystyrene dummy cheque to the suitably grateful charity representative. The cameras flash, the recipient's knees bend a little, the company boss swells and flashes a self satisfied smile. People clap and everyone swoons in awe at the selfless generosity of business. Onlookers declare: "They do have a heart." And "It's not just about the money." Let's not pretend that business doesn't need positive affirmation from the community. Face it; we all like a good pat on the back.

Which brings up a growing trend in the world that has found its feet in South Africa. Green Buildings. If ever there was a way of scoring points with the community, government and those with not only green fingers but whose superhero sports green underwear - the environmentalist, this is it. IF you're a land lord don't knock, because something in it for you.

In the news at the moment is the latest extension to that Mecca of upmarket shopping, Sandton City. A splendid dome graces the new Protea Court. This crowning expansion, involves interior refurbishments and 30,000sqm of new retail space. The Protea Court roof has been created with a product called Texlon, which is made up of multiple layers of foil known as ethylene-tetra-fluoro-ethylene (ETFE) it's so green it could be mistaken for peas.

"Texlon is an innovative technology used worldwide but has been used for the first time in South Africa at Sandton City," affirms architect Tia Kanakakis from MDS Architecture. "It was selected as a suitable roofing material as it is lightweight and an environmentally-friendly climatic envelope".

Kanakakis pointed out excitedly: "The ETFE material is unique in that it does not degrade under ultraviolet light or atmospheric pollution. " The material doesn't harden, yellow or deteriorate. Furthermore, as the surface is very smooth and has anti-adhesive properties, the envelope self-cleanses in rain." For Sandton City this means going Green and they are being richly rewarded already. Sandton City Manager Sharon Swain was able to announce the arrival of international names like Dumond, Inglot, Carlo Pignatelli, Miguel Vieira and Kurt Geiger to the centre.

Of course Green buildings aren't new. Twenty-one years ago two initiatives were launched which were foundational to establishing the concept of energy-efficient buildings and green building: BRE (British Research Establishment) released BREEAM, and BREEAM became the basis for a host of other rating tools including LEED in the US and the much talked about Green Star in Australia.

What about the landlord cost/tenant benefit scenario? Investors landlords may well ask what's in it them, surely more of a good old pat on the back? The Australian Financial Review explored the importance of green-star ratings, which basically determine how Green a building is, in attracting tenants to buildings. When looking for leasing locations tenants are now demanding at least a four star rating. In Australian cities the demand for the now-coveted green buildings is driving up costs in refurbishing and retrofitting older buildings. Greener adds value and demands higher rents.

According to property investment analysts IPD, Green Star buildings are outperforming non-rated buildings on a financial basis by a significant margin.

Here in South Africa, Llewellyn van Wyk, Editor at Large for Green Building South Africa writes: "Ultimately I believe green building is in the national interest, and should be an issue driven by Government: for this reason, I strongly supported the establishment of a Part X "Environmental Sustainability" to the South African National Building Regulations and look forward to it being populated with the full range of deep green building imperatives in due course."

In the US the Green standard is held up by LEED, which has not been without it's squabbles: Henry Gifford has made his living designing mechanical systems for energy-efficient buildings in New York City. And he admits the (LEED) program has popularized the idea of green building: "LEED has probably contributed more to the current popularity of green buildings in the public's eye than anything else. It is such a valuable selling point that it is featured prominently in advertisements for buildings that achieve it. LEED-certified buildings make headlines, attract tenants and command higher prices."

By mean of counter point Ben Ikenson reports on the current controversy embroiling LEED and hence whole Green Building bureaucracy in the US: "But for years, Gifford has been a tenacious and vocal opponent of LEED, claiming that the program's "big return on investment' is more a matter of faith than fact, and that LEED simply "fills the need for a big lie to the public." Last October, Gifford filed a class-action lawsuit for more than $100 million against the USGBC, accusing the nonprofit of making false claims about how much energy LEED-certified buildings actually save and using its claims to advance a monopoly in the market that robs legitimate experts - such as himself - of jobs. We may ask ourselves if we need this in South Africa.

Back to the benefits, conventional wisdom has it that not only does the environment benefit from the carefully considered construction that goes with Green building, but that people are generally happier and more contented working or living in Greener buildings. Comments Dr Suzan Oelofse, IWMSA Central Branch Chairman, "The environmental benefits derived from green buildings can further be enhanced by including waste minimisation and recycling principles in this type of environment."

Further to this, Oelofse believes that Green buildings should be orientated in such a way as to reduce the heat load and to optimise shade and thereby enabling the use of more energy efficient lighting systems and air conditioning. This makes economic sense in the light of increasing Eskom electricity costs to be implemented shortly, and it makes sound economic and environmental sense to use renewable resources and to become as energy efficient as possible.

It seems the devil may be in the bureaucracy and that making buildings greener may require state rather than private regulation if the LEED struggles are anything to go by. But there are clearly many practical and financial benefits to Greening up the workplace. Besides there's nothing quite like that warm approval that comes from cosying up to a superhero or heroine in green tights.

Pronation is the natural rolling of the foot from outer to medial part when it impacts the ground during a single running stride. To illustrate it better, imagine focusing on the heel of a runner as his foot impacts the surface on which he is running on. You will notice that the heel, when viewed from behind, will act to roll from the outside towards the inside of the foot.

This action protects the major joints and bones on your foot, legs and knees from the damaging forces they could have been exposed to. Without the rolling motion of the ball of the heel you could wreck your feet when running quite quickly.

What Is Overpronation?

When the foot rolls excessively towards the medial part of the sole, this is called Overpronation. This is very apparent when you see the ankle collapse towards the inside of the foot. Too much rolling of the foot can have detrimental effects on your biomechanical system.

Who suffers from it?

Although pronation is a natural biomechanical occurrence, a few runners pronate a little too excessively. More and more runners suffer from overpronation because the national weight average has increased over the years. Heavier runners are prone to excessive pronation which can be a serious threat if not addressed immediately.

Does it affect many runners?

Overpronation may sound like a rare phenomenon but it is estimated that almost half of all runners experience it. There are about as many people who suffer from overpronation than those who do not.

What are the risks associated with Overpronation?

Quite a few injuries can be developed if the overpronating runner continues to run. Plantar fasciitis is a common problem that most runners with overpronation face. Excessive rolling (of the foot) twists the foot, leg muscles and tendons of the lower leg all the way up to the lower back. This causes a lot of problems which include shin splits, tendonitis and bunions.

Over time overpronation can totally alter the biomechanical structure of the runner. Quite often knees knock on each other when the person runs. It is important to prevent this from happening as it may affect not only the running career of an individual but also his day to day life.

How can these risks be minimized?

Fortunately, the running shoe industry has developed tons of products to help with overpronation. Since it is quite a common occurrence there is an abundance of shoes, insoles and other products devoted to alleviate excessive pronation.

A more careful shoe selection process can help reduce, if not totally eliminate, the ill effects of overpronation.