Helping yourself in knee arthritis

Dr. Kaleel Cassim (MBBS, MD) - Consultant Rhenmatologist

You can make a major difference to your arthritis of the kneew in two ways:

Losing weight (if overweight)

Many people with osteoarthritis of the knee are overweight. Studies have shown that people who can lose weight have less knee problems in the future than those who cannot. There is no special osteoarthritis diet but it is always good to eat a healthy diet containing lots of fruit and vegetables as well as white meat and fish, and to avoid high calorie foods.

Quadriceps

(thigh muscle) exercises

The quadriceps muscles become weaker in everyone with arthritis in the knees, because the normal nerve supply to the muscles is reduced. To overcome this it is essential to carry out quadriceps muscle exercises as often as possible. It has been proved that strengthening these muscles not only improves your mobility but also reduces pain.

Which exercises are the best?

Straight-leg raise - Sitting. The most important thing is to choose exercises which you can do regularly. The easiest one to do is when sitting down in a chair. Get into the habit of doing this everytime you sit down. Sit well back in the chair with a good posture. Straighten and raise the led, hold it for a slow count to ten, then slowly lower it.

Repeat this several times with each leg-at least ten times with each. If this can be done easily, repeat the exercises with a weight on the ankle (buy ankle weights from a sports shop or improvise with a tin of e.g. peas in a carrier bag wrapped around the ankle.)

Straight-leg raise - lying. Get into the habit of doing straight-leg exercises in the morning and at night whilst lying in bed.

With one leg bent at the knee, hold the other leg straight and lift the foot just off the bed. Hold for a slow count of five then lower. Repeat with each leg five times every morning and evening.

Muscle stretch. At least once a day when lying down, do the following exercise. First, place a rolled-up towel under the ankle of the leg to be exercised. Then bend the other leg at the knee. In the leg to be exercised, use your leg muscles to push the back of the knee firmly towards the bed or the floor.

Hold for a slow count of five. Repeat with each leg five times.

Not only does this exercise help to strengthen the quadriceps muscles, but it also prevents the knee from becoming permanently bent. Clenching exercises. During the day, get into the habit of clenching and releasing the quadriceps muscles. By constantly stimulating the muscles, they become stronger.

What else can you do?

There are a number of things you can do:

* Make sure you do not keep your leg bent in the same position for long periods. For example, do not put pillows under your knee at night.

This may ease your pain for a while but, if you do it regularly, it will affect the muscles and may leave your leg permanently bent. Even if the pain is severe, always fully straighten the knee several times a day.

* Wear cushioned training shoes as much as possible to act as a shock absorber for the knee.

* Keep using your knee, but rest it when it becomes painful and start again later.

* Use a stick to take the weight off the joint if you need to, but keep moving!

* Use a hand-rail for support when climbing stairs. Go upstairs one at a time by good, always using a rail for support.

* Keep the knee warm. It can help relieve pain and stiffness.

Hit baths, hot-water bottles, a heat lamp or a rub with a suitable cream can all bring relief. It does not cause any harm to use heat even during a flare-up.

Are there any likely complications with osteoarthritis of the knee?

Most people do not suffer any complications. The problem often settles down to be a nuisance rather than a major problem.

However, complications do occur occasionally in some people.

To be continued

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