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Knee joint osteoarthritis

12/16/2013

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A 2010 National Institutes of Health study on people with osteoarthritis showed that having poorly aligned joints increases stress on the cartilage and leads to increased wear and tear. This was big news for the researchers, but shouldn’t be for anyone with common sense (I’m assuming you fall into this category). Here are some highlights from the study:
Outward knee alignment increases arthritis risk, finds NIH-funded study. Existing arthritis worsens when poorly aligned joints bear increased stress.

The study authors found that the higher risk occurred among those with an outward-facing alignment—knees relatively far apart and ankles closer together. Known as varus alignment, the knee configuration resembles bowleggedness, but is not as extreme.
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Osteoarthritis results from the deterioration of cartilage, the hard, slippery material that cushions the ends of bone at the joints.
Ever wonder why the cartilage wears out on one side of the joint and not the other? Ever wonder why it’s only in one knee? Ever wonder why an “old person's disease” can show up in a 25 year old NBA players and other young people?
The researchers also confirmed earlier findings that for people who have arthritis, varus alignment as well its opposite, the valgus, or inner facing, alignment contribute to worsening of the condition on the side of the knee bearing more stress.
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Again, common sense tells us this, but sometimes I guess it takes a study to say the same thing before people will believe it.
Nancy Shinowara, Ph.D., “Future research may lead to new ways to reduce the stress that the condition places on knees and, in so doing, prevent osteoarthritis or lessen its severity.”
Nancy Shinowara and the NIH, I'd be happy to help you develop a quick, easy, and highly effective research study about the effects of improving postural alignment and function and knee pain and osteoarthritis. Just give me a call (503-899-2821). 

Let’s do an anatomy, physiology and biomechanics review (common sense included) just to make sure everyone understands exactly why posture and alignment are so important.

Your knee is a hing joint made up of 3 bones: femur, tibia and patella (fibula doesn’t play directly into the knee joint). Here’s what it looks like:
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You can see and feel how your knee joint works by doing a simple experiment. Make is fist with both hands and put them together like this: The first two knuckles of one hand are the femoral condyles and the flat spaces between the knuckles on your other hand are the tibial plateaus. Now open and close your fists and this is normal flexion and extension of the knee joint. The cartilage in your knee is designed to not only withstand this motion without damage for as long as you live, but movement and activity (walking, running, jumping) actually strengthens the cartilage! The problem occurs when your knee is no longer aligned the way it is designed. This can show up as varus or valgus knee alignment (see photos above) and/or as internal or external femur rotation (see photos below).
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To see how these positions wear down the cartilage and create osteoarthritis put your fists back together, but move them in each of the alignments above. You’ll quickly see how damage occurs to the structures of the knee where the most friction and stress is. When a persons knee is internally or externally rotated we know that the knee is no longer functioning like a hinge joint, but rather has a rotational stress put on the structures of the knee (you will feel the stress with your fists). Varus (bowlegged) alignment causes the breakdown of cartilage on the inside of the knee. Valgus (knock-kneed) alignment causes breakdown on the outside of the knee. You can see in the x-ray below how the valgus alignment of the right knee has caused the cartilage on the outside of the right knee to wear away and his doctor considered him “bone-on-bone” and in need of a total knee replacement.
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Now that we know the true cause of your knee pain and damage, it’s easy to see that pain killers, steroid injections, microfracture surgery, and knee replacement are only trying to help the symptom and do nothing about the cause. If you want long term relief and a permanent solution to your pain you must correct your posture and alignment.
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You can see the results of doing Postural Alignment Therapy in the clients x-ray that was taken after 14 months of consistent Postural Alignment Therapy. As the client’s muscular imbalances were corrected his posture improved (no longer valgus in the right knee) the results speak for themselves.
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At Oregon Exercise Therapy, I would be happy to offer you a free posture evaluation on Zoom (can be done from anywhere in the world) to discuss your situation. During your free consultation we will take pictures of your posture, take you through some functional tests, and do gait analysis to help explain why the pain is really there. If it makes sense and you want to proceed, I will set you up with a program to realign your posture and restore your function allowing you to return to a pain free and active life.
Related articles:
Preventing ACL injuries
Meniscus surgery ineffective
Patellofemoral pain syndrome and your posture
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    About Matt Whitehead

    I'm an Egoscue Institute certified Postural Alignment Specialist (PAS) and Advanced Exercise Therapist (AET), certified personal trainer, PatchFitness performer, FiveFingers wearer, trail runner, mountain biker, dad, music lover, environmentalist, and wanna-be slam dunk champion. I will be providing you with the latest posture exercises to help you live, play, and be pain free.

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