Arthritis in the Knees...

[sidonia]

I was diagnosed with arthritis in both of my knees. It is worse in the right knee.

My knee pain started a few years ago after working with a trainer who had me doing 60-80lb overhead squats that I had never done before. I was probably around 345lbs at the time. Because of this pain, I cannot walk up and down stairs without holding onto the banister, and I definitely cannot squat down on the floor or get up like I used to! It has gotten worse since I first noticed it years ago, but lately it’s pretty much the same dull annoyance. If I don’t move it’s fine, when I move I feel it!

I am usually fine while I am exercising, but the following morning and next day I have pain mostly getting up and sitting down and stairs are especially not fun! The pain seems to be mostly in the front of the knees, although I occasionally overextend the left knee and then I have some pain in the back of the knee, and it feels pretty pulled. I do wear slip on knee supports from Doc Ortho: Safe-T-Sport Neoprene Knee Support - Open Patella : Back Brace, Knee Brace, Posture Support, Compression Socks :Sports Medicine Supports : Back Brace, Knee Brace, Posture Support, Compression Socks :Sports Medicine/Occupational Supports : Back Brace, And they feel good and seem to help stabilize while I am working out. What I will usually do when I come home after working out is ice the knees 20 mins on 40 mins off till bedtime.

My question is this…I can’t take Advil or any anti-inflammatory drugs on the account of my gastritis, it will aggravate my tummy! What else can I do for the pain?…Other than lose weight…which is why I am grinning and bearing it for the time being!

I have been doing some body weight squats recently, and strengthening my legs seems to be helping a little, but are there other exercises that I can be doing to help the knee pain by strengthening the right muscles? Are there other meds I can take that will take the edge off without attacking my stomach?

I appreciate your help I hope I was specific enough!!!

[LisaS]

I'm sure Julie (UConnJulie) will chime in here shortly but I'm thinking that you might not be firing your glutes as you should be (pretty common situation). Are you doing things like glute-bridges and clamshells and other glute activating stuff? (if I'm way off here in my thinking Julie will correct me)

Do you get pain doing step-ups where you can put your whole foot on the step and push thru the heel? (this being different than the toe pushing when you use regular stairs)? What about on a lower step or even lateral step ups rather than facing front? (again, if this is offbase for you Julie will correct me)

[sidonia]

Hi Lisa! Thanks so much for your help....

I am ashamed to say I didn't know what a glute-bridge or clamshell was... At least not by name...I just looked them up tho...and they definitely look like things I can do!

I used to do a little bit of the stepper machine...but I stopped because it bothered my knees...I am assuming because of the push off from my toes...never thought about that! The low step ups are something I can definitely try...concentrating on keeping my feet flat tho and pushing through the heel like you say...more like what I do with my squats I guess. I used to do step ups on the bench before my knees went, I just assumed these would be bad...but I guess I was wrong!

I am willing to do anything to strengthen whatever I can so I can take some pressure off of the knees!

[Aoife]

I was thinking the same thing, Lisa... from personal experience. Both Otto and I have had knee issues (Otto's was considered by our doc to be the beginnings of "gettin old") and it really just wound up being (at least partially for him, all for me) an imbalance. (Glute/ham vs quad.) Now that we've both corrected it with things like glute bridges, birddogs, leg curls, rdls, etc... no problems. (Otto also has had ankle issues, which when the ankle is weak can be seen in some knee pain if not careful.)

Sidonia, best way I've found to be sure I'm activating glutes on stepus and the like is to pull up the toes a bit. It instantly makes it feel better.

[sidonia]

Originally Posted by Aoife

Sidonia, best way I've found to be sure I'm activating glutes on stepus and the like is to pull up the toes a bit. It instantly makes it feel better.

I will definitely keep that in mind when I am doing my exercising...I think also I need to focus on my foot position on the elliptical...I tend to go forward on my toes a bit there too!

[UConnJulie]

Getting the glutes firing properly is going to make a big difference, but you can also have some isolated quad weakness which might contribute.

Avoid any exercises FOR NOW which aggravate the knees. This might be 2-4 weeks or longer.

Stretch your quads. Twice daily. 30 second hold repeated 2-3 times per leg. (Let me know if you need a link).

What does your current program look like?

I'd like to add an extensive pre-hab warmup ... and this can actually be done daily.
1. Prone glute activation: lie on your belly with your toes curled under (so that you are resting on the bottom of your toes) and slowly squeeze ONE glute, raising that knee off the ground. Concentrate on keeping the quad relaxed and lifting with just the glute. 10 reps each leg.
2. Clamshell 10 reps each leg.
3. Glute bridging. Double leg to start. Move to single when this gets easy. 10 reps.
4. X-band walking. 10 big steps to each side.
5. Straight leg raise: in supine with the other knee bent. Squeeze quad and keeping the knee straight, lift it until your thighs are parallel. Slowly lower. 10 reps each leg.

Keep up with the icing.

Do you have a foam roller? It might be a good idea to foam roll TFL, glutes, quads, etc.

Let me know how it goes ...

[sidonia]

Thank you so much Julie!!

I don't do too many exercises that really aggravate the knees at the moment...so I can back off for a bit. I just started doing some body weight squats...not going all the way down of course...but I can lay off for awhile.

I can definitely get these exercises done! My husband actually does have a foam roller for his back...so I can borrow it. He does a lot of stretching at night when we are watching tv, so I guess we'll be trading off!

Thank you again...

[UConnJulie]

You are most welcome. Please keep me posted on how things are going!

[maggieandmommy]

I'm going to start trying that pre-hab warmup, Julie. I've got arthritis (pretty much all over, but it's bugging my knees right now) and Stage 3 of NROL4W is giving my old knees fits. Plus I've been running trying to get ready for a 5K race at the end of June (seriously--I'm a glutton for punishment!). I'd bet that I'm not always firing my glutes and that isn't helping. I've noticed just in the last week or two that I get occasional twinges in my knees as I'm walking (maybe overextending). I might have to go back to wearing the knee braces all the time. Anyway, thanks for that pre-hab warmup. I'm going to give it a try this next week!

[UConnJulie]

Sinead,
Let me know how it goes!
Julie

[maggieandmommy]

Julie, I think that the prehab is helping. I have taken the last two weeks off from lifting (partially thanks to a crazy hectic "now we're out of school for the summer" schedule) and just done the prehab exercises and some bodyweight stuff. Today I did a modified version of a Stage 3 workout--avoiding any of the squatting movements because they had been bugging my knees--and things went well. The knees are feeling pretty good tonight. I'll probably start back with some squats and lunges next week and see how they go.

Thanks again for the advice!

[UConnJulie]

Sinead, that's great! And when you do go back, start slowly and really focus on squeezing your glutes with every lunge/squat. That will help take the pressure off your knees.

[maggieandmommy]

So I'm not the brightest bulb in the pack...

I've been doing the prehab/rehab stuff and the knee has been feeling much better. I've been careful with it, too. Saturday was the 5K race that I signed up for ages ago (my first), and I decided to go ahead and give it a try. My knee felt twingey but ok. Until the 1st mile mark. Then I got the danger danger signals in my brain and decided quickly to stop running. I have pain in the front (and top) of my knee now. Hopefully it's just aggravated arthritis knee pain...I'm assuming some rest and then more of those prehab/rehab exercises will help.

Am I way off base, Julie? Oh, and for what it's worth, I'm done with running, at least for now.

[UConnJulie]

Definitely spend a fair amount of time icing ... but also look for some trigger points in your quads. They can refer pain to all sorts of places. I usually sit with my legs extended out in front of me, and then take a tennis or lacrosse ball and roll it around on my thigh until I hit a sore spot. Then I roll it over the spot 10 or 20 times. Rinse, repeat. Also look around in your calves, especially the back of them.

Give your legs a few days rest, then start back into the prehab stuff (gently).

HTH,

[maggieandmommy]

Thanks, Julie! I've been thinking that I need to do some rolling but haven't tried it yet. I'll give it a go tomorrow. The pain is better today, so I might get by without the icing...we'll see. Thanks for the great advice!