Hey, I’m Shelley from Miami Physio and Lakelands Physio. Today I want to talk to you about why your surgeon may have said surgery won’t help or isn’t the best solution for your knee pain (and what might help instead).
Firstly, why has your surgeon said that surgery won’t fix your knee pain?
The Scan Doesn’t Match Your Symptoms
One of the biggest reasons is that sometimes the radiological imaging doesn’t match with your symptoms. That is, your pain and function might be quite affected, but on x-ray and scans, your joint actually doesn’t look so bad. We now know that pain is multi-factorial, meaning that lots of factors such as lifestyle, mental health, your beliefs around pain, general health and social wellbeing all contribute to your perception and experience of pain.
So, if your joint looks ok on scans, but your pain is bad, it may be that the soft tissue/joint tissue is a part of the whole picture, but not the only thing that is contributing to your pain. In this situation – if the surgeon “fixed” the joint, it would not give you the pain-free outcome that you are hoping for.
Does this sound familiar? If you’ve been told this, keep watching to find out your options…
How Can I Decrease Knee Pain?
So, what should you do instead to help decrease your knee pain and improve your function?
This depends on the factors contributing to your situation. With help, if you can work out what other factors are contributing to your pain, then we can help you to work on these factors. Some of the factors that are perhaps possible to change are – weight, smoking, general health and pain perception.
I’m not suggesting that this will be easy, but if this resonates with you, keep watching and let’s look at how one of the most common factors – weight – can influence your knee:
We know that obesity has a high correlation with poor outcome of surgery, but also a big impact on the load on your knee. Let’s break this down a bit further…
Being in the obese category of the BMI charts puts you at a 10fold increased risk of poor healing and a poor outcome following joint replacement surgery. This is such a high risk, that many surgeons will not perform a knee replacement surgery on someone with this level of obesity.
Let’s also look at the loads and force side of things. When you walk you are putting an average compressive force of 2-3x your body weight force through your knee. If you play golf, your lead knee will take 4.4x body weight. Going up stairs will put 3.3x body weight force through the knee. Squatting down to pick something up will generate between 4 and 6.7x body weight force.
On the upside – if you are carrying extra weight, and you have knee pain, and you manage to decrease your weight by even a small amount, you can see from the above examples, this can take a big load off your knee joint, and may in fact mean you can function with far less, or maybe even no pain.
So how can you decrease body weight when you have knee pain stopping you from exercising?
That’s where we come in. As physios, we can assess the movement, strength and function of your knee, and you in general. We can then design you an exercise program to both help strengthen the muscles around your knee (such as a GLAD-based program), and to help you work aerobically to lose weight. If land-based exercises are too much to start, we can begin with a hydrotherapy program where the effects of buoyancy take some of the weight off your painful joint whilst you are exercising. It’s definitely not a one exercise fits all approach, and we will work with you to get your program right and progress it, as you get fitter and stronger.
So, if you are struggling with painful knee arthritis and have been told you are not a surgery candidate currently, or you are on the waitlist and want to improve your current function and potential surgery outcome – give us a call at Miami Physio or Lakelands Physio and book in to have your knee assessed and get started.