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October 2009
Yoga for Aching Knees
Dr Jyothsna & Dr Sreedhar Pulipati
 
Are you worried about the long hours you need to sit down with your bad knee for those elaborate Diwali pujas? Here are ways to reduce the pain of osteoarthritis affected knees and strengthen them…

The word 'arth' means joint, and 'itis' means inflamed. It is a very common affliction all over the world, a common cause of misery and disability, affecting thequality of life to a great extent. Of the different types to a great extent. Of the different types of arthritis, the most common types are rheumatoid arthritis, osteoarthritis and gout.

Osteoarthritis is a degenerative disease of the joints, accompanied by pain which appears with activity and subsides with rest. It is common in the middle aged and elderly and is related to the ageing of the joints. The most common joints affected are the weight bearing joints, like knees, hips and spine.

Causes
Primary osteoarthritis occurs due to degeneration of bones and cartilage due to ageing. Secondary osteoarthritis can occur in any joint that might have sustained injury, due to trauma or gout or an old inflammation which goes on to produce wear and tear changes.

Osteoarthritis is becoming a common problem of sedentary life habits - a testimony of our times. Obesity is another factor that hastens the rate of joint damage. Excessive mental stress, strain and erratic lifestyle further hasten joint damage.

Symptoms
The symptoms are gradual in onset. Pain at first is intermittent. It increases as you use the joint, and reduces on resting. As the disease progresses, movement of joint becomes grossly restricted due to excruciating pain and muscular spasm.

The Painful Process
As age advances, the rate of repair of cartilage is not in proportion to the daily wear and tear. Gradually, the water content in the cartilage increases and becomes vulnerable to rapid wear and tear changes, leading to formation of pits on the smooth surface. As this process continues over the years, the bone becomes exposed at the margins. To cover up this exposed area, extra bone gets deposited in place of healthy smooth cartilage. This thinning of cartilage and extra deposits of bone causes gradual reduction in the joint space.

The joint starts creaking due to roughened surface and extra bone deposition at the margins. When the bones rub against each other, the pain sensitive nerve endings get stimulated and send messages to brain - leading to pain. This pain reflex is a natural preventive mechanism, to inhibit movement of the affected joint. This can gradually lead to acute pain with swelling and inflammation of the joint requiring rest and medical intervention.

Physical therapies
All treatments are aimed at proper rest, pain relief, and rehabilitation. Various treatments like local heat by fomentation, wax bath, infra red radiation, TENS, IFT, ultrasound, wraps, packs, oil massages, vibratory massages, acupuncture, magnetotherapy, hydrotherapy and exercise therapy are used for pain relief. Various aids from knee braces and knee caps, to advanced gadgets are available to stabilise the joint and give it support. Surgical replacement of the joint is done when all other measures become ineffective.

Half Butterfly
Sitting straight with the legs stretched out, bend the right leg and place the right foot as far up on the left thigh as possible, with the right heel touching the groin. Place the right hand on the right knee and hold the right foot with the left hand. Gently move the right knee up towards the chest and then push it down to touch the ground. Repeat 10 times. Inhale while bringing the knee up and exhale while bringing the knee down. Repeat with the left leg.

Full Butterfly
Bend both knees, draw the legs closer, bringing the soles of the feet together. Relax the inner thigh muscles. Clasp the feet with both hands. Gently bounce the knees up and down with normal breathing. Try to touch the knees to the ground on the downward stroke. Practice 30-40 times.

Yoga Therapy
Yoga can be very effectively used, for both prevention and treatment of degenerative and ageing arthritis. Yogasanas, when practised regularly from a young age, offer smooth, healthy movement of the joints, preventing their wear and tear process at an early age. It also helps in maintaining hormonal balance and ideal weight of the body.

The various non-weight bearing exercises strengthen the joints, increase the mobility of stiff joints, increase the blood supply and prevent further ageing process. The conscious breathing during asanas and pranayama increase the oxygen supply and decrease the damage due to free radicals.

In chronically damaged joints with pain, inflammation and deformities, the surrounding muscles would become weak due to in activity. Yogic practices when repeated regularly may strengthen the muscles around the cartilage, providing the much needed support to the damaged joints. It also relieves the pain and inflammation of the joint without straining it.
Dr Jyothsna and Dr Sreedhar Pulipati are Consultant naturopathy and yoga physicians at Sree Amrutha Nature Cure and Yoga clinic, Secunderabad

    
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