Suggestions for arthritic knees please?

[jsflynn603]

Concept II, Model D. I have typical osteoarthritis, mild, no redness, no heat--my biggest problem is discomfort late at night after sleeping for four or more hours. I'm in my late 50's and have been quite sedentary having gone through major shoulder surgery about 8 months ago after suffering a massive supraspinatus tear which was caused by my falling down the side of a riverbank on the island of Bohol. It was extend arm...or bonk head on the rocks. My arthritis is largely caused by being somewhat bowlegged which puts most weight on one side of the knee, and has, over time, thinned cartilage on one side. I've had one cortisone shot in each knee--to amazing effect. But the discomfort after four hours of sleep bothers me a bit and I wonder--will rowing improve it, or worsen it?

The shoulder seems just fine. It gets a bit tender, but I think this is normal so I'm not worried about the shoulder at all.

Since I'm starting slowly having been too sedentary over the last many months, ~15-22 minute workouts a few times a day, I'll slowly extend that until I'm up to about 40 minutes.

My question is: Would taping it help? I also wonder if I should make an effort to keep my knees straight (instead of the ~4" space caused by the bowlegged) or simply let my knees do what's comfortable.

I'd appreciate any thoughts, suggestions, or advice that any of you might have.

Thank you.

[heroesfitness]

For starters I would go and see a registered physiotherapist as they would be the best to give you any advice.

Normally for your type of injury strengthening of the Quadriceps muscles would be implemented especially the Vastus Medialis but again you need clarification by someone who can physically see you and diagnose your condition for the appropriate rehabilitation.

I hope this is of help.

Spencer

[jsflynn603]

Thank you Spencer, but there is no real "injury," or if there is, it's a lifetime of wear on the cartilage causing thinning. There is no pulling, snapping, no pain or heat, only the fact that I wake up in the middle of the night apparently due to inactivity with pain, I'll take 2 naprosyn and I'm ok.

This sort of age related osteoarthritis must be very common, I was hoping, not for medical advice, but just some "this seemed to be what worked for me."

As for seeing anyone--I must chuckle. Since I am currently unemployed with zero income, under our wonderful ObamaCare I am eligible for nada...zip, nothing.. And heavens, I have resources and could pay $6-700@ month, but no Obamacare removes that option. The only option is private heath insurance and at my age it comes to about $1400/month and is not even very good. This is partly due to the state that I live in, in other states, such as Massachusetts, yes I could see a phyziatrist or physio-therapist.

Welcome to America where we aim to get everyone covered--or tax them to death and here I am totally naked for health care.

No matter, if I keep rowing, I'll probably not have a heart attack....*lol*.

Hmm...maybe I'm the only person on this forum with mild age-related osteoarthritis (specifically thinning of the cartilage).

[dwalk]

Don't know if a wider foot plate would help, but the people at Ucanrow2 have a fit-foot plate that widens it a few inches on each side. They developed it with Concept2 and it might help the knees feel better.

[Bob S.]

I am missing most of the cartilage in my right knee and the left is not a heck of a lot better. Rowing has been a lot easier on my knees than weight bearing activity. Running is now out of the question for me and my walking has slowed drastically. There are a lot of things that interfere with my sleep nowadays, knee soreness being one of them. The worst one now is hip pain. An MRI suggested that it was the result of some stenosis of the lateral nerve path that leads to the left hip. Nevertheless, I was able to complete a half marathon recently and it did not create any particular additional pain. Of course, I no longer have the strength to put a really heavy load on my knees. For walking, they have to bear my weight no matter what speed I maintain. but even when I first had a knee problem many years ago, rowing did not aggravate it.

Bob S.

[bernd57]

I am 57 also, physician, with awful knees due to a lifetime of use and abuse in my former sport. You describe the classic osteoarthritis knee with medial compartment deterioration. I used to be able to pass a goofball between my knees while standing, now it's more like a baseball
As for rowing, I find it doesn't bother my knees. I think there are several reasons... One, there is really no impact, just very controlled motion.
Also, the greatest force on the knee happens for me at the beginning of the drive. Therefore, the knees are in a deep flexion. but that is probably at a position where the cartilage is the best still for me. You may be different . A wider base plate will cause You to abduct your legs more, likely causing more pain in your medial compartment, so I would not do that. I find externally rotating my foot ever so slightly ( i.e. Toes out) is most comfortably for me, so you might try different degrees of foot rotation. I keep the knees relatively in line with the forces, meaning neutral, not too far apart, not too close.
You will know a good position for you when you find it; there is little to no increase in pain right after the workout or later that evening...
I guess, it boils down to personal preferences and experimentation. If it doesn't hurt you, it's good for you
Also, a recent study showed that even in patients with severe osteoarthritis of the hip done in Norway 2013 showed that continued exercise can delay the need for total joint replacement for years... That is significant to me, as I look at the knees as likely needing replacement at SOME point, but since I am getting older, and the technologies are getting better, maybe I can postpone long enough to where I may need to only get it done once in my lifetime. In other words, seeking your personal sweet spot between function, pain, and the need for surgical intervention.
I hope that helps your perspective.
Good luck...

[EricP]

I'm not a physician and my experience is based on chats with my doctor and reading a lot on the Internet (hah!). I think the suggestion of talking your specific condition over with a physio is a good one because the knee is complex and what works for me may be the worst thing for you. I'm 66 with osteoarthritis in both knees. I've been rowing for about 7 years between 30-45 mins/day. Here's how I deal with OA both when rowing and for life in general:
1) For when I'm actually rowing I wear MUELLER Adjustable Knee Supports http://www.amazon.co.uk/Mueller-4531-Ad ... knee+brace. I don't know if these are the best, worst or typical but they work for me. They're a bit fiddly but they're cheap and durable. Before I put them on I put on Boots knee supports http://www.boots.com/en/Boots-Pharmaceu ... -_1179224/ mostly just to keep the Mueller knee supports from chafing.
2) Personally I find that I have less stress on my knees if I don't bring my body quite as forward as one is meant to (that the knees be 90 degrees) in the recovery->catch phase. Much of the info on rowing is for people trying to optimise their training. I think you have to modify what you read to suit your body.
3) I stretch my hamstrings and quads many times a day. In fact, I find that the older I get the more a full set of stretches in the AM and other times during the day help with the general loss of suppleness that ageing has brought on me.

Continued

[EricP]

Continued from my last entry because of URL link limitations

4) Strengthening your hamstrings and quads is almost universally mentioned as a benefit to OA.
5) I found that taking a certain type of fish oil was helpful with the pain. First, fish oil itself is not the key issue, two Omega-3 fatty acids called EPA and DHA are the keys. You'll see tons of fish oil products even ones that claim to have high doses of fish oil but when you look closely the amount of EPA and DHA are low. I found that I need about 1800mg of EPA/DHA to make my knees almost pain free. I've only seen two products in the UK that have a high enough dosage to be practical. The first is a liquid which didn't work well for me http://www.hollandandbarrett.com/pages/ ... 022&cid=17 for reasons I can't explain and the one I do use, a Holland and Barrett product http://www.hollandandbarrett.com/pages/ ... 071&cid=17. I need to take 2 of these a day. From what I've read EPA and DHA are anti-inflammatory which is what I think helps with the pain. These will not cure or improve your arthritis though. The lost cartilage isn't replaced.

[EricP]

continued from my last post because of URL link limitations

Research on OA and DHA/EPA is inconclusive, its one of those if it works for you then it works situations. From what I've read doses of fish oil up to about 3.5grams is safe though it has a blood thinning effect at higher dosages and if you take blood thinners like Wayfarin you need to know what you're doing. High doses of EPA/DHA are prescribed in the USA for people with high triglicyerides and many other health claims are made. The European Food and Safety report on EPA and DHA is here: http://www.efsa.europa.eu/en/efsajournal/pub/2815.htm
6) There are lots of discussions about other supplements for OA including Glucosamine and Chondritin. The American Academy of Orthopedic Surgeons has a series of guidelines for doctors about what seems to work and what doesn't here: http://www.aaos.org/Research/guidelines ... ations.pdf. I don't have a reference at the moment but from what I remember there is a similar document from either the British Medical Association or a similar EU group that has a slightly different take on Glucosamine.

Hope some of this is useful
Eric

[Yankeerunner]

Eric,

Thanks for the comprehensive look at what you are doing for your knees. I'm also 66, with one bad knee (arthritis in the medial side of the right knee, with meniscus surgery at the site 2 years ago), and haven't found the right combination yet to deal with it. I will probably try some of your suggestions as I continue my search.

[heroesfitness]

Some good information posted on here for arthritic knees, I will keep these noted for when i am older and it happens to me, I expect it to with all the sport and martial arts I have done over the years

[jsflynn603]

Thank you all for your helpful posts.

It's almost two months after my initial post.

I'm pleased to say that now, after eight weeks, having started after being very sedentary at a rate of 1000C/week (C=kilocalories) I'm up to 4400C/wk ~6 hours rowing (which equals ~1 1/4 lb fat burn/week) . My knees have actually gotten quite better. One knee used to "snap" painfully on occasion, just walking around, that has stopped. I've tried to keep my knees from splaying on the erg and I think that has helped. It was a bit tedious to do so at first but now seems natural. I suspect that 6 hours a week of rowing has strengthened my quads. I've lost 21lbs which, of course, could be a big factor, at any rate, working hard on the erg has not hurt my knees, rather it seems quite the opposite.

Eric P's suggestion about fish oil is interesting. I just happen to be taking 4g Lovaza for high triglycerides. My Triglyceride level was 399 before I started taking them and last time I had blood work the triglycerides was 79--wow. 4g Lovaza = 1860mg EPA + 1500mg DHA. Lovaza is really nothing but highly fractionated fish oil. Perhaps the Lovaza is knee protective too. Lovaza runs about $1.25/tablet (gram) so it's expensive, but it just happened to be covered by my med insurance (which is now gone, so when I run out--who knows). Maybe the Chinese will start to fractionate fish oil, I doubt that Lovaza has a real patent that would prohibit it.

[blue_heron]

My knee is shot too due to thinned out cartilage. I've just gotten back on the last month or so, and got a suggestion from someone to try and row strapless. I'm finding it really helps. I have the flex feet on my erg (it's an old Model B, and I'm finding that strapless the knee doesn't extend to the point of locking the knee. It seems to work better for me. Good luck. I know how bad knees hurt.

[chrisa770]

I know knee pain from OA. I lived with it for 10+ years. It reached the point where an hour or two standing was all I could take. I finally had left knee totally replaced Dec. 2013, the right in may 2014. It is a new lease on life. I can walk all day long with no pain or limp. I was actually able to row within 6 week of surgery which helped my rehab. I'm 65 years old and have been rowing on my model D for 9 1/2 years. It was one exercise I could do without pain while I suffered OA.