Q: I am a 74-year-old male and have needed new knees for some time. I had to give up playing tennis 10 years ago. Pursuing my passion for walking has become increasingly uncomfortable. However, the number of my friends whose new knees haven’t worked as desired and a natural resistance to surgery have kept me from the operating table. And, the entire range of doctors I have consulted over these years has offered me only the alternatives of surgery or medication. None have even come close to suggesting not-for-profit alternatives.
A chance discussion with a trainer whom I was seeing for another issue has given my knees a new lease on life – and at no expense. He simply told me to strengthen the muscle that runs down the inner side of my legs. I do it by lying on my side and lifting the leg closest to the floor. I built up gradually to 100 repetitions for each leg and over the month or so that it took me to get there, the discomfort when I walk has diminished dramatically as the strengthened muscles take pressure off my knees. Much of the time I can even get up from a sitting position without using my arms to support me.
Surely the highly trained doctors I have visited must be aware of this benefit. Are they unable to prescribe effective exercises, or do economics rule their decisions? More to the point, do you know if there are medical specialists beyond the level of therapists I can consult with for further professional advice?
I do a series of exercises to tone my body and to keep a bad back at bay. It would be wonderful to be able to develop a physician-prescribed exercise program so my aging body could benefit more fully from its natural capacity to offset some of the problems of aging. Both Medicare and I can easily afford the occasional aspirin instead of large medical bills.
A: You are one phenomenal guy! You are articulate, well-versed and a pleasure to hear from. And, perhaps even more important, you have taken measures into your own hands to back away from a possible surgical procedure after speaking with others in the same situation.
Knee replacement surgery a/k/a arthroplasty is an invasive procedure that actually resurfaces the knee when damaged by arthritis. This particular form of surgery is often performed on individuals who have suffered from a severe knee injury or who has severe arthritis, the most common form of which is osteoarthritis. When osteoarthritis is present, there is a breakdown of joint cartilage that commonly causes pain. Individuals with severe cases of degenerative joint disease often have their quality of life compromised, simply because they cannot walk, climb stairs, bend at the knee, and more. Then there are varying forms of arthritis such as rheumatoid arthritis that may occur. Thus, the purpose of knee replacement is to relieve the pain that cannot be controlled by other forms of treatment and to improve function and quality of life.
Simplistically, there are two groups of muscles in the knee – the quadriceps at the front of the thighs that straighten the legs and the hamstring muscles on the backs of the thighs that help bend the leg at the site of the knee. Then there are tendons and ligaments. Tendons hold muscles to bones and ligaments resemble elastic bands that connect bone to bone.
Medical treatment is recommended by orthopedic specialists prior to deciding on surgery. Such considerations include physical therapy, anti-inflammatory OTCs such as glucosamine/chondroitin, or prescription drugs, cortisone injections, the use of a cane, and weight loss to name a few.
As with any procedure, the benefits must outweigh the risks. Complications including infection, blood clots, an adverse reaction to general anesthesia, pain and stiffness, and more must be a part of the equation before this or any other surgical procedure for any reason is initiated. Then, once the procedure is completed, physical therapy will be coordinated. So, this is no small thing to think about. Fortunately, you chose to opt for leg strengthening exercises that virtually eliminated the thought of surgery. Because I do not know what part of the country you are from, I cannot recommend a specialist beyond the expertise of a physical therapist or a physiatrist who specializes in rehabilitative medicine. I can only suggest you contact your nearest large, teaching hospital and ask for a suggestion. You’re a great guy. Stay well!
