The knee joint is the busiest joint in the human body. It has a complex structure: it is formed by the articular surfaces on the condyles of the distal end of the femur and proximal end of the tibia with lateral and medial menisci, an articular capsule, and three synovial bursae. It performs predominantly flexion-extension movements, and to a lesser extent rotational movements. In addition to the fact that the knee joint constantly bears the load from the weight of the entire body, it is also the most susceptible to injury. All these factors can cause degenerative changes, which result in the development of gonarthrosis.
What is gonarthrosis
Gonarthrosis is arthrosis (osteoarthrosis, arthrosis deformans) of the knee joint. The cause of the disease is degenerative-dystrophic changes in the cartilaginous tissue that lines the heads of the articulating bones. Due to an insufficient amount of nutrients and a decrease in the rate of regeneration, friction under load from heavy weight, previous arthritis, metabolic disorders (a variety of factors can act as a trigger), cartilage loses its elasticity and density, becomes thinner, and microcracks appear in it.
Post-traumatic complex
A leading specialist in the field of recreational gymnastics, Muslim Ramilevich Dzhamaldinov, has developed a special treatment complex for developing the knee joint after various types of injuries and damage that led to the development of arthrosis.
Exercise therapy includes the following exercises:
- like all other gymnastic complexes of Dzhabrailov, the initial stage of classes involves imitation of walking, after which the patient is asked to sit on a chair, stretch his arms first up and then forward (in front of him). Such movements are reminiscent of stretching after waking up and allow you to warm up your muscles and joints for further exercise;
- in a sitting position, the shoulders are rotated first in one direction and then in the other, after which an imitation of walking is again performed while simultaneously rubbing the knee and thigh area with the hands;
- in a sitting position, the lower limbs bend inward, after which you need to reach your heels with your hands, leaning slightly back. At the same time, it is important to remember about breathing, which should be performed synchronously with active exercises;
- sitting on a chair, legs wide apart, after which one leg is pulled to the chest, held for 5-10 seconds, after which it returns to its original position. When the left limb is bent, you need to touch the foot with your right hand, and vice versa. The movement is repeated 5–6 times, after which an imitation of walking is performed;
- starting position - sitting, knees spread as wide as possible, hands resting calmly on knees, and feet pressed firmly to the floor. In this position, bends are performed to the right and left legs, always involving the shoulder area in the deflections. After this, an imitation of walking and a light massage are performed;
- starting position - standing, arms extended upward, after which a deep bend is performed with the fingertips touching the floor. In this case, the legs must be straightened.
It must be taken into account that obtaining the most positive effect with the help of Jamaldinov’s gymnastics is possible only if the exercises are performed regularly. In addition, the success of the entire complex therapy depends on the timeliness of starting exercise therapy. Muslim Jamaldinov notes that if gymnastics is performed correctly, especially in combination with therapeutic measures, it is quite possible to achieve long-term remission, improving the patient’s general condition and giving him the opportunity to lead a normal lifestyle.
What are the stages of gonarthrosis?
Based on changes in clinical and radiological parameters, arthrosis of the knee joint is divided into 3 stages:
Stage 1 – minor changes in the cartilage and narrowing of the medial part of the joint space of the knee joint. Marginal osteophytes begin to appear along the periphery of the glenoid cavity.
Stage 2 – the joint space is noticeably and unevenly narrowed, the cartilage is loose, thinned, the bone tissue of the epiphysis is deformed and flattened at the ends, the articular surface is covered with multiple bone growths, congruence is impaired.
Stage 3 – total changes affecting the deep layers of bone tissue. Necrosis of most of the cartilage, subchondral sclerosis, cystic lesions, and usuria are observed. There may be separation of intra-articular growths.
Causes of development of arthrosis of the knee joint
Gonarthrosis can be primary, caused directly by metabolic disorders, and secondary, associated with aseptic necrosis of bone tissue, rheumatoid arthritis, etc.
The causes of primary deforming gonarthrosis are the following factors:
- obesity, as heavy weight increases the load on the joints, and they wear out faster
- age-related metabolic disorders that cause a decrease in the hydrophilicity of cartilage, slower tissue regeneration, and sclerotic processes throughout the joint apparatus
- deficiency of microelements, which leads to metabolic disorders, impairs the nutrition of cartilage, etc.
Secondary arthrosis of the knee joint develops as a consequence of any disease:
- lateral hyperpressure syndrome of the patella (can be congenital or develop after prolonged trauma, heavy loads)
- endocrine disorders
- inflammatory processes in the joints, infectious diseases affecting the musculoskeletal system
- knee injuries
- dysplasia, etc.
Rules for performing exercises
Muslim Jamaldinov’s set of exercises is called “Health Hall”. In order for exercises to be beneficial for arthrosis of the joint, you must follow the following rules:
- before starting a workout, you need to warm up your muscles;
- physical stress on damaged joints should be minimized;
- you need to perform breathing exercises;
- you need to practice on a regular basis;
- exercises are performed smoothly and slowly, no additional effort is needed;
- Sports equipment for exercise should be used strictly under medical supervision.
The order of exercises can be changed at your discretion. It is not recommended to exercise in severe forms of the disease and severe swelling. During an exacerbation, you need to perform exercises every other day, the total duration of exercises should be shorter than during remission.
Symptoms
Arthrosis is a slowly progressive disease that in itself never causes changes in blood counts (for example, ESR), an increase in body temperature or other clearly noticeable characteristic signs. It is noteworthy that the degree of pain and limitation of joint mobility does not directly depend on morphological changes. That is, one patient may have severe pain even with minor cartilage degeneration, while another may have virtually no pain even with pronounced changes, clearly visible on X-rays, MRI or CT, or ultrasound. The fact is that there are no nerve endings or blood vessels in cartilage. Therefore, symptoms appear only when changes begin in other tissues.
Signs of gonarthrosis
- joint stiffness, limited mobility
- a rough, distinct crunching sound when bending and extending the leg at the knee, sometimes when walking (caused by deformation of the articular surfaces and marginal osteophytes)
- fast fatiguability
- pain after rest (in the morning, after prolonged sitting or lying), long walking
- short-term aches in the joints (usually occurs with senile gonarthrosis), which intensifies in bad weather
- joint deformation (bone tissue thickens due to osteophytes, it seems that it is growing).
Preparing to Walk
When the muscles are warmed up and adapted to the load, you can begin standing exercises. Given the specifics of the disease, they should not be performed without support. This will make it easier to maintain balance and not overload the joint when you have to lift your foot into the air. You can and should lean your entire weight on your hands:
- Warm up. The leg on the toe first sways so that the muscles get used to the change in position. Then you need to begin circular rotational movements of the heel clockwise and counterclockwise. If the muscles get tired quickly and pain sets in, it is necessary to change legs as often as possible.
- Walking. It is necessary to completely transfer the weight to your hands and carefully begin to perform walking movements similar to the first exercise of the complex. First, they are made in place, and then you can move your feet, moving from toe to heel.
- Stretching. The leg is pulled back, placed on the toe. The knee bends slightly. The muscles are stretched due to the fact that the heel is pressed to the floor. And then she makes circular movements to relieve tension.
- Rotations. This is a continuation of the stretch. Both legs are involved at the same time. One moves forward, and the other in the opposite direction. At the same time, the pelvis twists. Then the legs are spread wide and rolls are made, when you need to lean on one leg to stretch the other. At the end of the exercise, you need to walk in place and draw circles with your heel.
When performing all exercises, one must not forget about the condition of the hands. Periodically, you need to rest your shoulders by shaking your upper limbs and torso.
Diagnostics
X-ray examination, which was previously considered the gold standard for diagnosing any pathology of the musculoskeletal system, does not provide complete information about the condition of the cartilage, especially if gonarthrosis is at an early stage. MRI is much more effective. Magnetic resonance imaging does not use X-rays, which clearly visualize bone tissue, but an electromagnetic field, which makes it possible to see any changes and pathologies of soft tissues, including cartilage.
Treatment
Slowly progressing gonarthrosis may not bother you much either at the 1st or 2nd stage, therefore one of the main problems in orthopedics and traumatology is the late diagnosis of arthrosis. Patients usually consult a doctor only when there are already significant and irreversible changes. Therefore, it is very important to contact the clinic at the first sign for consultation and examination.
In the initial stages, treatment of gonarthrosis almost always gives a positive result. True, this is a rather lengthy process, the outcome of which depends on the patient himself.
There are many methods of conservative treatment of gonarthrosis of I and II degrees:
- physiotherapy: laser therapy, UHF, magnetic therapy, UVT (shock wave therapy), etc.
- non-steroidal anti-inflammatory drugs.
- intra-articular injection of modified hyaluronic acid. Increases the hydrophilicity of cartilage, slows down the process of degeneration.
- Exercise therapy. Water gymnastics and dosed aerobic exercise strengthen the muscles of the thigh and lower leg, reduce pain, and improve joint mobility.
- intra-articular blockades. They have a pronounced analgesic effect.
- diet therapy. Used in combination to reduce weight and normalize metabolism. Fish oil and foods high in collagen are good for joints.
Conservative treatment of grade III gonarthrosis is ineffective in most cases. If the joint is already deformed, then the only way to restore it is endoprosthetics.
massage
massage
1. You must be able to do this. Without mastering the massage technique, you will not be able to do it correctly. The procedure is highly likely to not give the expected result.
2. You should reach your knee. This can be prevented by excess weight or concomitant pathologies of the spine. During the massage, the leg should be straight. If you bend it, it is much easier to reach your knee with your hands. But at the same time, the thigh muscles become tense, which limits the effectiveness of the massage.
3. Massage for knee arthrosis often begins from the back. Obviously, you won’t be able to massage your lower back yourself.
Thus, not every person will be able to perform the procedure on their own. Therefore, it is better to turn to professionals. You can get a knee and hip massage in our clinic. We employ professionals who specialize in various types of massage. The technique of exposure is selected individually, based on the characteristics of the disease and the patient’s condition. Along with massage, we use other effective treatment methods that can reduce pain and slow down the progression of the disease.