# Osteoarthritis in knees



## Dan Morinary (5 Jan 2017)

I've been diagnosed with Osteoarthritis in my knees, the right one is causing the most problems. Getting x ray today to find out the extent of it. 
My job is manual work and it really does not help the situation! Bloody grinding pain is getting to me now! 
Looking at a couple of old threads, I see I am not alone. 
I'm no athlete, but I love cycling and I'm concerned the effect this will have. GP states, unless problem is chronic, I'm too young for knee replacement. (I'm over 50, this has to be the only thing in the world I'm considered young for!) 
I'm really worried about work, can't afford not to, but will look for something a bit kinder on my old bones. I don't want to lose my cycling, has anyone found certain coping mechanisms or tips to help?


----------



## ColinJ (5 Jan 2017)

Are you significantly overweight, Dan?

When I weighed 17+ stone, I was getting such bad knee pain that I had to walk downstairs backwards because it was gentler on the knees.

I now weigh less than 14 stone and the pain has completely gone.


----------



## Dan Morinary (5 Jan 2017)

No Colin, I'm 6 foot tall and under 11 stone, I'm like a rake! Think it's just wear and tear. I played football til quite late in life and years of manual work have caught up. I've just put up with the pain for ages, but now it's really getting bad. Can feel the grinding when my knees bend and it seems to be deteriorating quite fast.


----------



## ColinJ (5 Jan 2017)

Dan morinary said:


> No Colin, I'm 6 foot tall and under 11 stone, I'm like a rake! Think it's just wear and tear. I played football til quite late in life and years of manual work have caught up. I've just put up with the pain for ages, but now it's really getting bad. Can feel the grinding when my knees bend and it seems to be deteriorating quite fast.


Oh, well losing weight isn't an option then!

There isn't definite proof, but there is anecdotal 'evidence' that glucosamine sulphate and cod liver oil supplements may ease symptoms of OA. I had developed painful hips in my 30s with x-rays confirming that OA was setting in. My dad was crippled by it in his hips. He used one walking stick in his 50s, two in his early 60s (my age now!), and could barely walk by the age of 70. I have been taking the supplements for about 25 years and my hips hurt less now than they did when I was 35. I could stop the supplements to see what happened, but I think I will not take the chance!


----------



## Dan Morinary (5 Jan 2017)

Cheers. I'm off for further x ray on right knee at 2:15. Need to find out what doctors recommend after result.
Getting older has just ambushed me in the last year, everything falling to bits or dropping off! 
Will have a look at supplements, thanks.


----------



## vickster (5 Jan 2017)

Cycling and swimming are the best exercise for knees. Also important to have all of the muscles working as they should. If cycling is your main sport, find a sports physio who has a special interest in cycling, they should be good with knees too as a result

You probably could find a surgeon to do a knee replacement if considered a candidate, but you'd have to pay (around £8-15k a knee depending on type of implant, surgeon, hospital etc)
You might even find one on the NHS but they prefer not to do in the under 60s as you're likely to need some sort of redo/revision as they don't last forever

There are other surgical options, like realignment and partial replacements if the arthritis is limited to one compartment of the knee

There are other options if not too severe, such as hyaluronic acid injections, these help lubricate the joint and reduce inflammation. Work for me. Some NHS surgeons will offer, or again you can pay. I'd avoid steroids unless a lot of swelling and inflammation, a temporary fix. Can use pain meds under your GPs direction of course

There's a very good forum for knee conditions, with loads of info if interested
http://www.kneeguru.co.uk/KNEEtalk/index.php

Supplement wise, no strong evidence, but they might help in the right doses - Omega 3, glucosamine + chondroitin + MSM (avoid all if allergic to fish/seafood)

I have damage in the left knee and some in the right. Good luck, bad knees suck


----------



## dim (5 Jan 2017)

a recumbent trike that has hand pedals might be a good option aswell (divide the riding between a normal bike and the recumbent?


----------



## mjr (5 Jan 2017)

http://www.arthritisresearchuk.org/...cises-to-manage-pain/knee-pain-exercises.aspx and - as well as cycling - some say Pilates is good strengthening for knees and other joints, but don't do too much too soon - don't get competitive and feel you must do all the exercises in full the first session.


----------



## Dan Morinary (5 Jan 2017)

vickster said:


> Cycling and swimming are the best exercise for knees. Also important to have all of the muscles working as they should. If cycling is your main sport, find a sports physio who has a special interest in cycling, they should be good with knees too as a result
> 
> You probably could find a surgeon to do a knee replacement if considered a candidate, but you'd have to pay (around £8-15k a knee depending on type of implant, surgeon, hospital etc)
> You might even find one on the NHS but they prefer not to do in the under 60s as you're likely to need some sort of redo/revision as they don't last forever
> ...


Thank you, very informative. I'm hoping damage is localised and can be treated.
Unfortunately £8 to 15k a bit prohibitive at the moment for private treatment! 
Will check out forum. Thanks.


----------



## Dan Morinary (5 Jan 2017)

dim said:


> a recumbent trike that has hand pedals might be a good option aswell (divide the riding between a normal bike and the recumbent?


Unfortunately my left wrist was smashed to bits and, despite hip bone and steel, wouldn't take too kindly to this! 
Looking at other people's experiences, I'm sure I still have a good few years turning the pedals! 
Cheers for reply. My wife has never been too impressed when I add to the bike collection, I'm imagining her face as I proudly unveil my new recumbent!


----------



## Dan Morinary (5 Jan 2017)

mjr said:


> http://www.arthritisresearchuk.org/...cises-to-manage-pain/knee-pain-exercises.aspx and - as well as cycling - some say Pilates is good strengthening for knees and other joints, but don't do too much too soon - don't get competitive and feel you must do all the exercises in full the first session.


Thanks for link. Will look into Pilates. The moral here, I think, is if your going to smash your body about when young and invincible, it's going to be payback time as you age!


----------



## Dan Morinary (5 Jan 2017)

You got to take the positives, had a nice bike ride to and from hospital instead of being in work. Coming home gave me the chance to realise things could be worse than dodgy knees!


----------



## Alan5616 (6 Jan 2017)

Dan morinary said:


> I've been diagnosed with Osteoarthritis in my knees, the right one is causing the most problems. Getting x ray today to find out the extent of it.
> My job is manual work and it really does not help the situation! Bloody grinding pain is getting to me now!
> Looking at a couple of old threads, I see I am not alone.
> I'm no athlete, but I love cycling and I'm concerned the effect this will have. GP states, unless problem is chronic, I'm too young for knee replacement. (I'm over 50, this has to be the only thing in the world I'm considered young for!)
> I'm really worried about work, can't afford not to, but will look for something a bit kinder on my old bones. I don't want to lose my cycling, has anyone found certain coping mechanisms or tips to help?



A year ago I was diagnosed with a similar condition. The cartilage in my left knee has worn away. I couldn't stand up, or sit down, without holding onto a table or arm of a chair. What worked for me was to strengthen my quads and lose weight. I dropped from 16-8 to 14-5 in a few months. Apparently, according to some experts, for every 1lb you lose from the upper body, takes 4lb of weight from the knee joints. I still have some pain but, can now sit down and get up from the floor without too much problem. Something that I couldn't have considered a year ago. I hope this helps.


----------



## Dan Morinary (7 Jan 2017)

Thanks Alan. I actually can't really afford to lose weight, don't have any to spare! My job does not help matters, it has definitely contributed to the problem, and hurts more each passing month. Will find out how bad things are next week. I've changed my cycling style, no more grinding away on the big ring, more spinning now. Find that has helped.


----------



## dbeattie (7 Jan 2017)

I got my knees checked out by an orthopaedic surgeon a few years ago. X rays indicated arthritis in both. The advice he gave me was take vitamin d and omega 3, don't get fat, keep fit.

Since then I've looked into it a bit and came up with various people saying that most of the pain in arthritic joints comes from inflammation in tendons and isometric exercises will help.

I have a routine that I do every day. My knees feel much better now than they did 5 years ago.


----------



## Dan Morinary (7 Jan 2017)

Thanks @dbeattie, that sounds positive.


----------



## velovoice (7 Jan 2017)

I have osteoarthritis both knees, first spotted by xrays & MRI when I was 11. Arthroscopy left knee 6 years ago (age 42) removed most of the cartilage. I do not recommend surgery if you can avoid it - its only value was that it made me take the post-op physio seriously! And it was physio that "saved" me and kept me cycling. (A custom bike that actually fit me, didn't hurt either!)

Addressing muscle weakness/tightness/imbalances may be the single most helpful thing you can do for your knees (takes pressure off the joint, ensures good tracking, etc). Prolonged standing/walking/stairs will probably always be a problem for you but exercise does help. 

Pilates can help too if it's the right mix. It's hard to get "circuit" Pilates classes outside London, so beware those offering exclusively matwork or Reformer work, as they may overwork muscles that are already quite strong from cycling while not engaging the counter-acting muscles that often don't get a look-in from cycling but are essential to get engaged and working properly if your joints are to be well supported. 

No idea what part of the country you are in but if you can afford to go private, I highly recommend the physios at Balance in Clapham and also Nicole Oh who practices in Putney and Blackfriars (as recommended by @vickster in other threads - thank you @vickster!!)

Oh and that "you're too young for knee replacement" is total bollocks in this day and age. The materials used now will outlast you. My mother suffered for decades being told she was too young and "come back in 10 years". At age 60, the orthopedic surgeon said "OMG, why have you not come in sooner?" and she burst into tears and wailed "because you all said I was too young and not to bother you!" My sister had both knees replaced at age 52. The orthopedic surgeon and Xray technician said her knees looked like they belonged to someone in her 80s. She followed physio to the letter and went off on a walking holiday 6 weeks post-op and was back to high alpine hiking/climbing just a few months later. 

Also don't believe any surgeon who says "if you have knee replacement, you'll never cycle again". (My surgeon told me this, scared the sh*t out of me -- see above comment about the arthroscopy making me take physio seriously!!) Quick Googling will turn up cyclists who had bilateral TKP and were doing 200km audaxes within 6 months. 

Good luck!


----------



## Dan Morinary (7 Jan 2017)

Thanks @velovoice, I moved out of London many years ago! Will definitely do some research on pilates. 
I was shocked when told I was too young for replacement, as I know 3 people younger than myself have undergone the op. 
Cheers for very positive and informative reply. Planning on cycling, camping & hill walking, good to hear positive things.


----------



## vickster (7 Jan 2017)

There are plenty of cycling focused physios outside London too. Google and the phone are your friend 

If you go down the surgery route, find a surgeon who only does knees and does a lot of TKRs and even revisions


----------



## Dan Morinary (7 Jan 2017)

Thanks @vickster, I've entered a whole new Google world of knees! 
Cheers for really helpful replies.


----------



## velovoice (7 Jan 2017)

vickster said:


> There are plenty of cycling focused physios outside London too. Google and the phone are your friend
> 
> If you go down the surgery route, find a surgeon who only does knees and does a lot of TKRs and even revisions


I would also add, when surgeon "shopping", find one who has some idea of what post-op progress should look like. Many surgeons lose interest once the surgical wound has healed and have no idea of the rehabilitation that follows!


----------



## velovoice (7 Jan 2017)

FWIW, there is an orthopedic surgeon from Cambridge who comes on the annual Fridays Tour. I don't know much about the focus of his practice but if you're anywhere near Cambridge, I can certainly ask!


----------



## PK99 (7 Jan 2017)

vickster said:


> Cycling and swimming are the best exercise for knees. Also important to have all of the muscles working as they should. If cycling is your main sport, find a sports physio who has a special interest in cycling, they should be good with knees too as a result
> 
> You probably could find a surgeon to do a knee replacement if considered a candidate, but you'd have to pay (around £8-15k a knee depending on type of implant, surgeon, hospital etc)
> You might even find one on the NHS but they prefer not to do in the under 60s as you're likely to need some sort of redo/revision as they don't last forever



A friend in his 70s needing a new knee has been told he would have to give up cycling as it would wear out the knee.

I should add that he rides long club rides 3 days a week. Ctc 50/60 miles on weds. Easy club rid on Saturday 25/30 miles, ctc day ride on Sunday 50/60/70 miles. Not all that every week as he time trials on summer Wednesdays


----------



## velovoice (7 Jan 2017)

PK99 said:


> A friend in his 70s needing a new knee has been told he would have to give up cycling as it would wear out the knee.


Was this the NHS? I hate to say it (because the NHS is a wonderful thing, in principle if not always in practice - another discussion entirely!) but T/PKR on the NHS does not make use of the latest/best materials. The advice given by NHS professionals is often, well, a bit "dated" as a result. So their policy is not to do ops on 'young' and/or active people. The difference in materials (and therefore robustness and longevity) if you can go private is like, well, 20th century versus 21st.


----------



## vickster (7 Jan 2017)

My knee surgeon who operated recently on @PK99 is expert in TKR, both NHS and private. Whether he uses the same materials I don't know

@velovoice can I send you a PM shortly, would just like to pick your brains


----------



## velovoice (7 Jan 2017)

vickster said:


> My knee surgeon who operated recently on @PK99 is expert in TKR, both NHS and private. Whether he uses the same materials I don't know
> 
> @velovoice can I send you a PM shortly, would just like to pick your brains


Absolutely. 
In case it's any use to anyone, I just found a blog post I wrote 18 months ago about my knee history.


----------



## Dan Morinary (7 Jan 2017)

@velovoice 
I'm up north but, as a good friend has just undergone replacement, I have a good idea of reputable surgeons and physios. 
Interesting blog post, will check out links. Thank you.


----------



## PK99 (7 Jan 2017)

velovoice said:


> Was this the NHS? I hate to say it (because the NHS is a wonderful thing, in principle if not always in practice - another discussion entirely!) but T/PKR on the NHS does not make use of the latest/best materials. The advice given by NHS professionals is often, well, a bit "dated" as a result. So their policy is not to do ops on 'young' and/or active people. The difference in materials (and therefore robustness and longevity) if you can go private is like, well, 20th century versus 21st.



It was NHS at the SWLEOC centre of excellence.


----------



## kingrollo (11 Jan 2017)

Don't be blinded by the scans - it can be possible to have severe OA but not no pain - and a little OA but be in agony.
You need to build up the muscles around the knees.
I had OA in my hip, I declined surgery - but worked with a great physio on the NHS - it took me 18 months, but I am now back on the bike and pain free...


----------



## Alan5616 (12 Jan 2017)

PK99 said:


> A friend in his 70s needing a new knee has been told he would have to give up cycling as it would wear out the knee.
> 
> I should add that he rides long club rides 3 days a week. Ctc 50/60 miles on weds. Easy club rid on Saturday 25/30 miles, ctc day ride on Sunday 50/60/70 miles. Not all that every week as he time trials on summer Wednesdays



I firmly believe that the NHS needs to get it's act together when it comes to matters orthopaedic. So much conflicting advice. Gym work, and cycling, have helped defer my knee replacement indefinitely. According to my knee x-rays, I shouldn't be able to walk!!


----------



## dbeattie (12 Jan 2017)

Alan5616 said:


> I firmly believe that the NHS needs to get it's act together when it comes to matters orthopaedic. So much conflicting advice. Gym work, and cycling, have helped defer my knee replacement indefinitely. According to my knee x-rays, I shouldn't be able to walk!!


Agree. It's pot luck. If you're lucky you get a physiotherapist who understands strength and movement. IMO a lot of knee problems are down to issues with gait, weak feet, ankles and hips. Standard physio intervention is strengthen around the site of the pain, when root causes may lie elsewhere.


----------



## runner (16 Jan 2017)

I have just been told I have OA in my hips. I have been advised to do more cycling and forget the running ( i have been a keen runner for 35 years!) I have found that cycling is a great help as it is non weight bearing and i can cycle everyday with no adverse effects...with that in mind I am now entering sportives to give me my buzz


----------



## ColinJ (16 Jan 2017)

runner said:


> I have just been told I have OA in my hips. I have been advised to do more cycling and forget the running ( i have been a keen runner for 35 years!) I have found that cycling is a great help as it is non weight bearing and i can cycle everyday with no adverse effects...with that in mind I am now entering sportives to give me my buzz


I was never much of a runner but I did used to go for 3 or 4 mile hilly runs a couple of times a week 30-odd years ago. Then I started to get OA in my hips so I decided to just stick to cycling.

I am now 61 and my hips are not really much worse than they were in my early 30s, but they soon complain if I run for a train or bus. (Funnily enough though, I did feel a twinge or two this morning, but nothing too bad.)


----------



## runner (16 Jan 2017)

ColinJ said:


> I was never much of a runner but I did used to go for 3 or 4 mile hilly runs a couple of times a week 30-odd years ago. Then I started to get OA in my hips so I decided to just stick to cycling.
> 
> I am now 61 and my hips are not really much worse than they were in my early 30s, but they soon complain if I run for a train or bus. (Funnily enough though, I did feel a twinge or two this morning, but nothing too bad.)


I think you have convinced me Colin to stick to cycling....BTW do you use glucosamine and does it help?


----------



## Mugshot (16 Jan 2017)

Has anyone tried CBD for arthritis or rheumatism?


----------



## PK99 (16 Jan 2017)

Mugshot said:


> Has anyone tried CBD for arthritis or rheumatism?



CBD?


----------



## Mugshot (16 Jan 2017)

PK99 said:


> CBD?


Cannabidiol. It's a bit grey I suppose, although nothing like as grey as the plant it's extracted from.


----------



## runner (16 Jan 2017)

sounds like something that is smoked!


----------



## Mugshot (16 Jan 2017)

runner said:


> sounds like something that is smoked!


Well quite. CBD is extracted from the cannabis plant, however it does not contain THC which is the bit that makes you extra happy. It's being touted as a miracle cure for just about everything, the effects of cannabis smoking on pain seem to be well documented. CBD is apparently beneficial to pain relief amongst other things but does not have the less desirable properties and is available as oils, capsules, ointments as well as vapes.


----------



## ColinJ (16 Jan 2017)

runner said:


> I think you have convinced me Colin to stick to cycling....BTW do you use glucosamine and does it help?


See my earlier post HERE!


----------



## julioalmeda219 (7 Mar 2017)

Dan Morinary said:


> I've been diagnosed with Osteoarthritis in my knees, the right one is causing the most problems. Getting x ray today to find out the extent of it.
> My job is manual work and it really does not help the situation! Bloody grinding pain is getting to me now!
> Looking at a couple of old threads, I see I am not alone.
> I'm no athlete, but I love cycling and I'm concerned the effect this will have. GP states, unless problem is chronic, I'm too young for knee replacement. (I'm over 50, this has to be the only thing in the world I'm considered young for!)
> I'm really worried about work, can't afford not to, but will look for something a bit kinder on my old bones. I don't want to lose my cycling, has anyone found certain coping mechanisms or tips to help?



Did you try with a new diet? Eating fruits and veggies and less meat helps a lot.


----------



## Drago (7 Mar 2017)

Eat less meat?


----------



## screenman (8 Mar 2017)

A surgeon wanted to operate on my worn out knee 25 years ago, I declined the offer as he told me that I may not be able to kneel down, something I have to do for fixing dents. I know at some point I will need a TKR, but it will hopefully wait until I pack up working.


----------



## velovoice (8 Mar 2017)

screenman said:


> A surgeon wanted to operate on my worn out knee 25 years ago, I declined the offer as he told me that I may not be able to kneel down, something I have to do for fixing dents. I know at some point I will need a TKR, but it will hopefully wait until I pack up working.


So much has changed in the past 10 years, I suspect what you were told 25 years ago is no longer the reality. If your knees bother you, get an up-to-date assessment. Of course if you feel you can wait, then you're luckier than many.


----------



## screenman (8 Mar 2017)

velovoice said:


> So much has changed in the past 10 years, I suspect what you were told 25 years ago is no longer the reality. If your knees bother you, get an up-to-date assessment. Of course if you feel you can wait, then you're luckier than many.



I can live with the pain, for now.


----------



## vickster (8 Mar 2017)

I can't kneel as it is, unfortunately the main damage is right on the weight bearing surface, the bit that connects with the ground. I can kneel for a short time on a cushion but hard surfaces a no no 
I'll need a partial or total replacement eventually too according to the specialist. More conservative measures for now


----------

