The No. 1 knee disease

Dr. Victor Ti / Khmer Times No Comments Share:
Cycling offloads a substantial fraction of our body weight on the saddle of the bicycle while allowing the knees to peddle with control force of both our leg and thigh muscles. Photo: Xinhua

Our ‘wheels’ roll on, all day long, with 80 percent of our body weight on them. Faithfully they carry us, negotiating our life journey through rough terrains and curves, throughout our lifetime, with care and love. Whatever extra load our body may choose to carry and whatever torment and torture they may have to go through, our ‘wheels’ accept them wholeheartedly, neither whining or wincing.

These ‘wheels’ are our KNEES. Its name befits its very function for kneeling, signifying humility and loyalty. They kneel down to their master, faithfully accepting whatever duties bestowed upon them.

Subjecting to years of wear and tear of the hostile conditions of life, our knees may soon give way to the overwhelming assaults of life. Their gliding ‘ball-bearings’ may lose their smoothness and their ‘lubricating grease’ deplete with time. Thus, they may become rougher and drier as the clock ticks on. They may hurt or swell up, and unable to move as fast as they used to be. Soon, at some point of time, it may be our turn, to care for them in return. After all, reality prevails. Being mundane, they too, are subjected to disorder, disease and ageing.

Osteoarthritis, the progressive degeneration of the knee due to wear and tear over many years, is the most common disease of the knee. Thus, it deserves special attention and emphasis in this column. Knowing the disease well before it inflicts us is like knowing an enemy before it strikes us. If we know them well early enough, and take all the necessary precautions, surely it shall not hit us as hard, or perhaps we may be able to avoid the attack all together.

Many factors contribute towards osteoarthritis. Our genes play a part. Genes are what we are born with.

Nonetheless, our genes can be switched on or off depending on what we eat and do (known as the epigenetic factors). The epigenetic factors such as our nutrition and lifestyle are within our control. So, don’t blame the architect of the genes, your ancestors or the creator, whoever they may be.

We are given the push button to switch off the bad genes at our own will. But why aren’t we doing it? Ignorance perhaps, but in reality, ignorance does not exempt us from suffering. So, we ought to know what we need to know. Look! An innocent baby who is ignorant of the fact that hot kettles burn, will still get burned if he touches it. This is the fact of life. Thus, health education is indeed very important. Everyone should try to know as much of it as possible, to be as healthy as possible and to avoid unnecessary suffering.

Certain factors are known to predispose us to osteoarthritis. They include being overweight or obese, repetitive overuse of our knees, injuries to our knees, muscle weakness, decreased bone density, knee joint instability and the ageing process.

If we have too frequent meals and eat too much high calorie foods, we tend to grow big, round and heavy. As we continue to balloon up, we shall put more and more weight on our weight-bearing-knees. Unfortunately, our knees wouldn’t grow proportionally with our increasing size and weight. If we are like a heavy truck running on sedan wheels, how long can the sedan wheels last? So, let’s not just enjoy ourselves. Our greedy mouth should sometimes pause, to care for our knees.

Contrary to the popular misconception that exercise is deleterious to one’s joints, in the absence of injury, there is no evidence to support this notion. It has been shown that in the absence of normal knee loading or exercise, the rate of cartilage thinning in our knees is worse. Thus, sitting too long or being sedentary is a disadvantage to the health of our knees.

Nevertheless, repeated overuse of our knees, knee injuries and instability can contribute towards the quicker development of knee osteoarthritis. Thus, certain types of exercise are friendlier to our knees than others. If your knees already show some signs of early osteoarthritis such pain and swelling, perhaps it is time to be a little more particular about the type of exercise to do.

Jogging and hill-climbing may not be the suitable exercise for people who are already experiencing some pain in their knees. In these two types of exercises, 80 percent of our body weight are on our knees while we exercise.

Perhaps the better choice for this group of people is cycling as cycling offloads substantial fraction of our body weight on the saddle of the bicycle while allowing the knees to peddle with control force of both our leg and thigh muscles. For those who have more advanced knee disease, swimming would be a better choice as it completely offload the body weight to the buoyancy of the water.

Lately, anti-ageing scientists like Prof. David Sinclair of Harvard University are actively researching on ways to delay ageing with the hope of not only delaying ageing but also delaying all ageing-related diseases. Osteoarthritis is one of these ageing-related diseases.

Perhaps we are at the horizon of discovering the fountain of youth that will also stop the pain in the knee. Kindly read ‘The secrets of anti-ageing’, in the Facebook group named ‘Health & Fitness by an expat Dr in Cambodia.’

For those who are already suffering from this debilitating disease, there is much that can be done by your family physician. Osteoarthritis can be treated with appropriate nutrients, anti-inflammatory medications and intra-articular injections. Physiotherapy to strengthen the muscles around the knees is also helpful. For advanced disease, knee replacement with knee prosthesis may be necessary.

My next column will be on ‘Tips for a healthier heart’.

Dr. Victor Ti, MD, MFAM (Malaysia), FRACGP (Australia), Dip P Dermatology (UK), Dip STDs/AIDS (Thailand), Dip. AARAM (USA), LCP of Aesthetic Med.(Malaysia) is an experienced expat specialist generalist (Family Physician) of BH Clinic, Phnom Penh. As a specialist generalist, he is skillful at diagnosing all general diseases and excluding the sinister ones. Apart from the general diseases, Dr. Victor is also known for his skill in skin diseases, sexually transmitted diseases, minor surgery and aesthetic medicine. He can be contacted via email [email protected] Tel: 023900446 or Whatsapp: +60164122977

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