Category Archives: knee pain

How Can You Weight-Train Your Legs If You Have Bad Knees?

I’m not sure. Consider working with a physical therapist or sports medicine specialist. I know nothing about Jeff Cavaliere, but here’s a video with his recommendations:

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Avoiding overweight and obesity helps protect against knee arthritis. Losing excess weight will take some of the strain off already bad knees.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com in the U.S.

Paul Ingraham on Patellofemoral Pain Syndrome (PFPS)

Patellofemoral Pain Syndrome is probably the most common cause of knee pain in younger folks. I precipitated in it myself by accelerating my training program too rapidly in preparation for my last mountain climb

I just ran across this long PFPS article and didn’t want to lose track of it, so here’s the link.

The author is a (former?) massage therapist who thinks like a scientist.

OMG I’ve Got PFP

My daughter and I at Tom’s Thumb on June 3. She got her good looks from her mom, obviously.

I posted this here a couple weeks ago:

I’ve developed over the last month some bothersome pain in my right knee. It’s not interfered much with my actual hiking, but I pay for it over the subsequent day or two. I’m starting to think this may put the kibosh on my Humphries Peak trek next month.

The pain is mostly anterior (front part of the knee) and is most noticeable after I’ve been sitting for a while with the bent knee, then get up to walk. The pain improves greatly after walking for a minute or less. It also hurts a bit when I step up on something using my right leg. If I sit with my knee straight (in full extension), it doesn’t hurt when I get up. The joint is neither unusually warm nor swollen. Ibuprofen doesn’t seem to help it. These pain characteristics seem classic for something, but I don’t know what, yet….My twice weekly hikes always include a fair amount of elevation gain. I suspect an over-use syndrome, basically a training error. I plan to take an entire week off from hiking and Bulgarian Split Squats, and taking ibuprofen 600 mg three times a day.

The view looking south from the base of Tom’s Thumb

I did some research in the literature and think I’ve got patellofemoral pain, aka PFP or PFP Syndrome. Can’t say I’d heard of it before. Sounds more like a description than a diagnosis. Like saying someone has fever.

This guy posed for my daughter

I got most of my info on PFP from UpToDate.com, but you probably don’t have access to that. You healthcare professionals, click for a 2007 article at American Family Physician. Mayo Clinic has info for muggles. So does American Academy of Orthopaedic Surgeons.

I hope she thinks of this hike when she sees Tom’s Thumb from Hwy 101

I may have some age-related osteoarthritis in both knees, but that’s not causing this pain.

My PFP was caused by over-use. Too much hiking with elevation gain and  accelerating my program too rapidly. Also, prior experience taught me that using trekking poles helped take strain off my knees, and I have not been using them.

The newest resident at the Parker Compound. He’s eight weeks old.

I took a week off from hiking while taking ibuprofen 600 mg three times a day, when I could remember it. The combo helped, probably the rest more than the NSAID. Then I did two six-mile walks on the flat without much trouble. On June 3, I hiked Tom’s Thumb trail with my trekking poles, 4 miles round trip, and only had mild discomfort. Most importantly, I learned that I get relief from icing down the knee for 30-45 minutes after I get home.

I’m disappointed I can’t climb Thompson Peak in preparation for Humphries Peak. It would probably kill my chance to summit Humphries (right now I put those odds at 50:50).

Steve Parker, M.D.

 

 

Osteoarthritis: Strength Training of Knee Extension Muscles Improves Pain and Preserves or Improves Functional Status

Osteoarthritis, aka degenerative joint disease, is quite common in folks over 45 and eventually may require knee replacement surgery. Recovery from that surgery is slow and painful; best to avoid it if you can.

Having good strength in the muscle that extends the knee helps to preserve the knee joint. That muscle is the quadriceps.

Click below for the evidence:

“Although limited, the reviewed studies suggest that participation in a resistance training program can potentially counteract the functional limitations seen in knee osteoarthritis; positive associations were found between increased muscle strength and walking self-efficacy, reduced pain, improved function, and total WOMAC score. Notably, improvements were greater in maximal versus submaximal effort testing, possibly due to a ceiling effect.”

Source: Strength training for treatment of osteoarthritis of the knee: A systematic review – Lange – 2008 – Arthritis Care & Research – Wiley Online Library

To get started on strengthening the quadriceps muscle, consider the following four-minute video that is two minutes too long:
Note her mention of ankle weights.

Steve Parker, M.D.

PS: If you’re overweight or obese, you lower limb joints will last longer if you lose the fat by following one of my books.

What’s the Best Treatment for Knee Osteoarthritis?

Well, I don’t know about the best, but the American Academy of Orthopaedic Surgeons has looked at lots of different options and summarized their recommendations about what to try and what to avoid. They considered:

  • NSAIDs
  • exercise
  • acetaminophen
  • glucosamine and chondroitin
  • accupuncture
  • hyaluronic acid injections
  • chiropractic
  • steroids
  • platelet rich plasma
  • many others

Science-Based Medicine has an at-a-glance review.

Read the rest of the Academy summary.