Tuesday, April 27, 2010

Preserving your knees and hips - avoiding the joint replacement syndrome

On my way back from the New Orleans Jazz Festival, I read an interesting article in the NY Times called Caring for Hips and Knees to Avoid Artificial Joints (http://www.nytimes.com/2010/04/24/health/24patient.html).  This is an area of great interest to me because as the article points out, 400,000 of these procedures for bad knees and hips are done yearly.  The article is typical advice that I see from the medical community that thinks inside the box.  They recommend the following which you can read in the article

  1. Control Your Weight
  2. Go Low Impact
  3. Avoid Injury
  4. Get Fit
  5. Be Skeptical

Overall, most people will read this and since it really is very general, most people will not learn much from this.  Since this is my blog, I will go much further and perhaps, not make too many friends in the orthopedic community.  I will address each of these points and give you much better direction on this.

We are all built differently and body style determines how we are to function throughout our lives and also predisposes us to having problems in our knees and hips.  This is especially true for those of you who are built asymmetrically (most chiropractic clientèle). Early detection and intervention with foot orthotics, education and  even myofascial therapy goes a long way to preserving our body parts.  We can start by screening kids at the age of 6 either in the chiropractors office or teach pediatricians a little about the musculoskeletal system so they can give advice that is better than the typical growing pains diagnosis I hear from many patients.If we addressed body style early on, we could eliminate many of the suggestions in the article.


  • Control Your Weight - It has been established that being overweight, especially severely overweight will wear down the joints.  While this is certainly true, many overweight people never need joint replacements.  What is different about them?  The bottom line is structure determines function.  If you have poor structure, and you add weight to it, it will fail much sooner.  If you lose the weight, and have poor structure, your joints will likely go bad anyway.  My recommendation is that you address structure first and our office specializes in this.  During the months of May and June, we are having our annual Spring Feet Checkout so people can be looked at for free to determine of foot problems are leaving them prone to having knee, hip and back problems.

  • Go Low Impact - Many people go high impact and never need joint replacements.  On the other hand, Sports like basketball, especially in adolescent girls is known to damage cruciate ligaments because as they mature, their hips get wider and any foot problems will exacerbate this.  The ultimate cause has to do with the way their core responds to their body style.  Ultimately, girls with these issues have an unstable core which loads the knee joint.  Recommending a sedentary lifestyle is not a great idea.  Why not actually understand, diagnose properly and then come up with an intelligent solution to a functional problem.

  • Avoid Injury - Duh. Get your body mechanics checked out, get it fixed and then load it up.  Common sense at its best. Certain sports like football take out knees from impact by others upon the knee.  Tackle football is likely not healthy for knees as many pro football players will attest to in their later years.  Many baseball players on the other hand still have their original knees and hips into their golden years.

  • Get Fit - A stable core will improve knee function.  Foot orthotics will improve knee function.  If your core is unstable, it will load the knee, the legs will tighten and so will your shoulders and neck.  The knee is rarely the problem, and the structure usually is

  • Be Skeptical - Sure, there are many things like Condriotin Sulfate which have been said to help arthritic knees and other joints as well as other potions.  Taking this further, many people with knee pain going to orthopedic physicians have meniscus surgery again and again and again.  Eventually, at great cost, they replace the once healthy joint with another prosthesis that comes with no warrantee and will likely need replacement again years later.  Since the original body mechanics that destroyed the joint in the first place were never addressed, these joints are likely to fail sooner than later because we addressed the symptom of the bad knee and not the real problem of how did it get there in the first place.



  • My advice for people with bad knees is not to let that happen to their children.  Make them aware that unless they have themselves checked, they too are likely to suffer from this since they come from the same gene pool and are likely not only looking like you but are walking like you too.

    Check out out website at www.backfixer1.com or our site for runners at www.njrunningdoc.com for further helpful information.