A set of exercises for the treatment of arthrosis according to Evdokimenko

Who is Pavel Evdokimenko

Pavel Valerievich Evdokimenko is a practicing rheumatologist who has been working in this field since 1984. He is an academician of the Academy of Medical and Technical Sciences of the Russian Federation, worked at the Moscow City Arthrosis Center, and is the author of specialized books and publications in medical periodicals.

Using the doctor’s method, you can get rid of diseases such as:

osteoporosis;
gonarthrosis;
coxarthrosis;
kyphosis, stoop, scoliosis;
Bekhterev's disease;
thoracic hernia;
displacement of intervertebral discs;
pathologies of the cervical spine;
gouty arthritis;
inflammation of the thigh tendons;
meniscopathy.

Dr. Evdokimenko runs his own channel on YouTube, where you can familiarize yourself with his original treatment method. Programs with his participation are also available on the Internet, where he talks about it in detail.

Features and methods of treatment

Arthrosis, according to many doctors, is completely impossible to cure. But, according to Dr. Evdokimenko, you can get rid of arthrosis of the first stage thanks to special gymnastics. However, cure is possible only with an integrated approach.

But gonarthrosis at the second stage cannot be completely cured due to the presence of bone deformations. However, thanks to special therapy, it is possible to reduce pain, make the joint more mobile and delay the operation time. Along with performing gymnastics, you need to additionally undergo maintenance therapy courses 2 times a year. But if the disease has already entered the third stage, then in most cases only surgery helps, but you can try doing gymnastics to reduce the intensity of pain.

For treatment to be successful, it must be started as early as possible and be comprehensive. Pavel Evdokimenko says that the treatment regimen should include, in addition to gymnastics, the following:

taking anti-inflammatory drugs in the presence of acute pain;
taking chondroprotectors (first and second stages), 2-3 long courses of treatment are required;
taking muscle relaxants and vasodilators as indicated;
courses of injections of hyaluronic acid (in the absence of inflammatory processes) and glucocorticoids for synovitis;
manual therapy (2-4 courses during the year), etc.

Massage for arthrosis is indicated as an adjuvant therapy. It must be performed carefully and gently, it should not cause discomfort. Pavel Valerievich also recommends alternative treatment methods - hirudotherapy, acupuncture and others, but only if they are prescribed and performed by an experienced specialist.

The most effective physiotherapeutic measures for arthrosis are laser treatment, ultrasound, therapeutic mud, cryotherapy, magnetic therapy, the use of paraffin and ozokerite. If the patient cannot perform physical exercises, then he may be prescribed electrical myostimulation, but it is not as effective as special gymnastics.

Gymnastics for knee and hip joints from Dr. Evdokimenko

Excess weight and joints

To the correspondent’s question, “Besides stress, what other causes of arthrosis could be? excess weight affect ?”

Pavel Evdokimenko answers that: yes, indeed, often the cause of arthrosis can be a factor such as excess weight - the joints of the legs, and not only them, in an overweight person they are more loaded.

Gaining excess weight is, of course, facilitated by a sedentary lifestyle and overeating.

And the chances of getting arthrosis are higher for an obese citizen than for his thin friend. But, from observational experience, not much. More often it happens that the joints become sick regardless of the presence of excess weight. However, in an obese person the disease develops faster.

Rules for performing exercises

Some patients and doctors believe that physical activity is not necessary for arthrosis, since the joints are destroyed under stress. But this is not entirely true, the main thing is to choose the right gymnastics, as Dr. Evdokimenko believes. A set of exercises for the treatment of arthrosis should be performed in compliance with the following principles:

You need to choose only those exercises that are aimed at strengthening the muscular-connective apparatus, and the joints should not be subjected to heavy load.
If the patient is poorly prepared physically, the load should be as gentle as possible. The muscles will work better even if you raise your legs while lying down and keep them in this position for at least a short time.
Exercises should be predominantly static, when you need to fix the position for a while. If the movements are more dynamic, then they are performed as smoothly as possible.
Gymnastics, stretching directions, give good results, but only if you do it slowly and do not put force on the sore joint.
With arthrosis of the hip joints, it is necessary to work out the joint and strengthen the abdominal and back muscles, so that the limbs are better supplied with blood;
If the complex includes many different exercises, then you cannot perform them all in one day; all movements can be alternated.
Each movement is performed the same number of times with each leg, applying the same force.

It may seem that in this way you can cure arthrosis without much difficulty according to Dr. Evdokimenko; gymnastics is very simple and anyone can do it. But it’s not that simple, you need to be patient, because you need to practice every day for several weeks in a row.

Patients often complain of pain that accompanies exercise. This is especially true for the first week, but with regular exercise it goes away quickly.

No. 3. What should I do if I feel severe pain while charging?

If the pain is insignificant, this is normal: at first, joints constrained by arthrosis experience unusual stress and respond to it with discomfort. You should sound the alarm if the pain is sharp and severe. You can't do any more. Such pain indicates that you have exceeded the limit of permissible physical load on the joint. Contact your physical therapy instructor or physician to adjust your program.

Never exercise with arthrosis through severe pain

Therapeutic gymnastics technique

If joint diseases have caused pathological changes, rapid movements are prohibited. Evdokimenko’s therapeutic gymnastics are based on slow static exercises aimed at strengthening and stretching the ligaments and joints.

If the patient suffers from coxarthrosis, then physical exercise should be performed taking into account the condition. Training is carried out in a sitting position or lying on your back. The basic exercises look like this:

Lying on your back, lift each leg to a height of 20 cm and hold it for 30 seconds. Repeat 10-12 times in one approach, taking into account breaks.
Lie on your stomach and stretch your arms along your body, bend one leg at the knee and lift it 15 cm and hold it for up to 40 seconds. Then you need to lower it, rest for a few seconds, and repeat the movements with the other leg.
In a similar position, the arms are extended lengthwise and the legs are straightened. They are lifted slightly, spread to the sides, and then brought together smoothly and slowly. Perform up to 10 approaches.
You need to lie on your right side and bend your leg on the same side at the knee, raise the other one 45 degrees and hold it for up to 30 seconds. Then repeat on the other side, turning on your left side.
In a lying position on the right side, the leg is raised 45 degrees, in this position it is slowly turned outward, and then to its original position. Repeat up to 10 times.
In a supine position, the legs are bent at the knees, the arms are extended along the body. The pelvis is raised, resting on the feet and shoulders, and held in this position for up to 30 seconds, repeated several times slowly.

For gonarthrosis, you need to train in a standing or sitting position. The load level rises slowly, and the training time also gradually increases. At the end of the workout, rest is recommended; it is best to lie down and take a contrast shower. The following complex is recommended:

Sit on a chair with a flat back and lift each leg in a straight position in turn. Hold each time for up to 50 seconds.
In a standing position, stand facing the chair and lean on its back. Rise up on your toes and hold for up to 5 seconds. Repeat in several passes.
In a similar position, rise on the toe of one leg, and then stand on the sole, repeat the movement for both legs several times.

At the end of the workout, a light massage is given. You can do it yourself by lightly kneading the muscles on the surface of the thigh. Thanks to a set of exercises from doctor Evdokimenko, treatment of arthrosis will be easier, regardless of location and stage.

Gymnastics for joints is indicated for patients of any age. If the knee joints are affected, then physical education can improve their functionality and relieve pain. For the results to be noticeable, the course must be completed in full. Before starting training, you should consult your doctor.

Possible contraindications

Preliminary medical consultation is also necessary so that the specialist takes into account possible contraindications and selects the most suitable physiotherapy option in a particular case. The age of the patient, the degree of joint damage, and the presence of other diseases are taken into account.

But there are situations when you can exercise in limited quantities or it is better to give up gymnastics for a while. These include:

“loose” joints and spine;
increased body temperature;
critical days for women;
presence of hernias;
after operations on the chest and abdominal cavity;
high pressure.

If the disease is at an acute stage, then any physical activity is prohibited. Before doing gymnastics, characteristic symptoms should be eliminated.

No. 8. What is better to do when you have joint pain – swimming, cycling or yoga?

Physical activity for joint pain has one goal - to strengthen the muscles around the joints and spine. A strong muscle corset will create reliable fixation and improve the position of the ligamentous apparatus, that is, it will stop the destruction of cartilage. You need to move towards this goal slowly and carefully, avoiding intense physical activity and strength exercises. At the first stage, swimming and yoga are ideal for this. Such training acts on the body as gently as possible, while actively training the muscles. The optimal duration of training for arthrosis is 1-2 hours per week.

Additional events

Dr. Evdokimenko says that arthrosis is directly related to a person’s lifestyle and how he perceives it. It often affects not only those people whose work involves physical labor, but also those who are constantly under stress and get little rest. Dissatisfaction and irritation lead to the body producing hormones that contribute to the destruction of cartilage tissue.

Nine best exercises for the treatment of gonarthrosis - arthrosis of the knee joints

The doctor recommends that at the first problems with joints you reconsider your attitude towards life. In some cases, it is necessary to seek the help of a psychotherapist. If the emotional aspect is not taken into account, the treatment will not have results.

Another important factor contributing to the successful outcome of therapy is diet. But it must be observed taking into account a number of requirements:

you need to choose the right diet, it is best to keep a special diary;
It is recommended to reconsider your eating habits, limit the consumption of salt and fatty foods;
portions should be smaller;
unhealthy foods need to be replaced with healthy alternatives;
During the day you need to organize light healthy snacks.

Diet and proper drinking regimen are also important because excess weight is a big enemy of joints. During the day you need to drink up to 2 liters of pure water without gas.

Patients with gonarthrosis should limit themselves in physical activity - do not run, do not jump, do not squat, do not carry or lift anything heavy. If your muscles are weak, you should walk slowly; when walking up the stairs, you need to lean on the railing. It is forbidden to stand for a long time, squat or sit on a chair when it is impossible to change the position of your legs for a long time. When using a cane, the following rules must be observed:

the length of the cane should be optimal so that it is comfortable to hold in your hand without bending over;
it must be equipped with a shock-absorbing tip;
You need to hold the cane in the hand that is on the opposite side of the sore leg;
when the patient steps with the affected leg, the body weight is transferred to the support.

Doctor Evdokimenko does not say that joints can be cured only through gymnastics, but he emphasizes the importance of this therapy as part of the complex treatment of arthrosis of various origins. He does not call for abandoning medications and other classical treatments. But in his opinion, special exercises can relieve pain and other discomfort, and also eliminate the need for surgical intervention.

Evdokimenko Pavel Valerievich , rheumatologist, chiropractor, psychophysiologist, Academician of the Academy of Medical Sciences of the Russian Federation. Author of many books, articles and healing methods.

He worked for many years at the Moscow City Arthrosis Center (MGAC).

He believes that the cause of all diseases is stress and negative emotions.

In a state of negativity, blood vessels narrow, which limits the supply of oxygen and nutrients to our organs.

Therapeutic gymnastics by Evdokimenko for hip joints: video exercises

And the released stress hormone destroys the cartilage tissue of the knee joint.

Currently, Evdokimenko works in the Moscow clinic “Health is the basis of everything.”

Causes of arthrosis and arthritis

To the question “What are the causes of arthrosis and does the condition of the joints, for example, be affected by the type of human activity?” The rheumatologist answers that, unfortunately, there are many reasons for the occurrence of arthrosis.

Of course, the type of activity also plays a role. Pavel Valerievich tells me that patients of different professions come to me, and in each case there is a cause-and-effect relationship between the onset of the disease.

For example, the appearance of arthrosis in athletes is often a consequence of injury. Either the joint capsule is broken, or dislocations and subluxations occur.

In general, any recent injury by any person, not just an athlete, or the consequences of an old, untreated injury is a factor contributing to the occurrence of arthrosis. It is clear that such a joint is more susceptible to further destruction.

Another cause of joint disease may be long-term, same-type load on a given joint that is unusual for a particular person. In general, arthrosis occurs more often in people who work physically. The basis of this disease is a malnutrition of the articular (epiphyseal) ends of the bones.

Nowadays, a very common “computer disease” is carpal tunnel syndrome. With this type of arthrosis, there is pain in the fingers. A person feels like his finger joints hurt. In fact, it is not they that are inflamed, but the tendons, and in addition the nerve is inflamed.

Another occupational disease is elbow bursitis. This is an inflammation of a special serous tissue near the joint capsule, which, in fact, is called the “bursa”. Often bursitis is a consequence of some kind of arthritis.

Elbow bursitis, unfortunately, accompanies the profession of draftsmen, engravers and the like. During work, such people experience friction between the protruding elbow bones and the surface of the table or floor.

Sometimes bursitis develops due to injury - a blow to the elbow or a fall on the elbow. Very often, pain in the elbow area is caused not by damage to the joint itself, but by damage to the tendons attached to its bones.

To the question “Does a sedentary lifestyle somehow affect the occurrence of arthrosis?” Dr. Evdokimenko answers that it influences indirectly. A person “sits” all week. Doesn't do physical education. Joints and blood vessels get used to inactivity. Metabolism decreases, the amount of synovial fluid produced in the joint decreases.

And on weekends a person goes to the country and there, in one or two days, he wants to embrace the immensity, fulfill all his plans for the household. For this reason, he sharply increases his physical activity.

Or he’s just inactive for a week, and for the week-end he plans active recreation, sports or extreme sports.

A joint that is not ready for a load that has sharply increased in a short period of time, and does not contain a sufficient volume of synovial fluid, in such cases begins to collapse.

To prevent this from happening, two ways can be recommended. The first is to load the musculoskeletal system with certain physical exercises for a week. You can do this every other day, but regularly.

The second is to change the type of activity every twenty to thirty minutes while doing chores. Let me give you the simplest example: paint the fence at your dacha with your right hand. After twenty minutes, take the brush in your other hand. And after an hour, change the type of activity.

Your fence can be repainted another time. But the joints will remain healthy. This path is for unprepared people.

Anyone who uses their hands regularly can paint the entire fence in one day. Take care of your joints. It’s easy to get arthrosis.

Its treatment can take a very long time. Before loading them, think about the size and duration of the load.

But the cause of most arthrosis today is stress!

Signs of illness from Dr. Evdokimenko

“The characteristic signs of arthrosis are the gradual development of the disease over several years, when at first a person experiences mild discomfort, then the condition worsens, and pain occurs in the knees when walking.

Pain when walking is a characteristic sign of the disease, especially when walking up stairs, and the pain goes away with rest!

If you have such symptoms, then most likely it is arthrosis.

Of course, this diagnosis must be confirmed with an x-ray.

And also take blood tests to make sure that you don’t have any inflammatory processes in your knee joints, that uric acid is normal, that is, to rule out gout.

If all these indicators are normal - there is no elevated C-reactive protein, ESR and normal rheumatoid uric acid factor, then we diagnose gonarthrosis and begin treatment.”

No. 10. What injections will help with arthrosis?

One of the effective but long-term treatment options for osteoarthritis is injections of chondroprotectors. The active substance acts directly on the problem area, restores cartilage, stimulates its renewal, increases the formation of collagen and mucopolysaccharides, and has a healing effect.

The second option is intra-articular injections of a synovial fluid prosthesis, for example Noltrex. The drug is injected into the joint, where it replaces the missing synovial fluid. The gel covers the damaged cartilage surfaces and pushes them apart. You no longer experience pain or discomfort while moving. The effect is noticeable after 1-2 injections and lasts for 12-18 months.

Synovial fluid prosthesis is already approaching the gold standard for the treatment of arthrosis

If you have other questions about the treatment of arthrosis, do not be afraid to ask your doctor during your routine consultation. This is the only way to get a qualified answer and correctly adjust the treatment regimen.

Evdokimenko about therapeutic exercises

“When treating knee arthrosis, you need to remember perhaps the most important thing for recovery - this is performing therapeutic physical exercises.

I always tell my patients - “you can, in general, not take any pills, just do gymnastics and you will feel better!

Without exercise, there is very little chance of healing your knee!

Therefore, a prerequisite for getting rid of such a disease is therapeutic exercises for the knee joints.”

Evdokimenko about intra-articular injections

“The most important topic is intra-articular injections. There are two main groups of injections for injection into the knee joint: hyaluronic acid preparations and glucocorticosteroid hormones, which have an anti-inflammatory effect.

What medications should be given and when?

If the knee is swollen and inflamed, it means that a lot of fluid has accumulated in it and there is no need to introduce additional lubricant in the form of hyaluronic acid!

In this case, it is necessary to introduce anti-inflammatory glucocorticosteroid hormones Kenalog, Diprospan, Hydrocortisone and relieve inflammation.

When should you use lubricants for your knee joints? Only when there is little natural lubrication left in the knee, but it is not swollen or inflamed, when there is pain from dry friction in the knees.

Precisely, in this case, hyaluronic acid preparations are needed and most effective! The choice of these funds on the market is huge, you can choose for any wallet, but they are not cheap. These are Ostenil, Sinokrom, Giastan and many others.

For grades 2 and 3 of the disease, it is usually necessary to make 3-4 injections into each knee joint. We give the injection and see the result. After 2 weeks we give the second injection and after another 2 weeks the third. I usually recommend doing the fourth only 3-4 weeks after the third.

At stage 1, it is enough to give 2-3 injections. Now there are drugs on sale that go under the “+” brand; these substances can be administered once every six months.”

Evdokimenko about chondroprotectors

“Taking chondroprotectors, I think, is the second important point in treatment.

These are drugs for the restoration of articular cartilage. There is a large assortment of them on sale, the most common are Dona, Teraflex, Artro.

The therapeutic dose that the patient should receive is 1000 milligrams of glucosamine and chondroitin sulfate per day.

There is a lot of controversy and discussion surrounding these drugs; some TV presenters on central channels say that: “...chondroprotectors are useless, that they are almost a placebo...”

Chondroprotectors are taken in courses. The standard course for arthrosis stages 1 and 2 is 3 months, then a break of 6 months and repeat the course.

For stage 3 arthrosis, these drugs, unfortunately, are no longer effective, and to enhance the results they must be taken longer, on average six months, with the same break.

The advantage of chondroprotectors is that they practically do not cause side effects.

Evdokimenko about diet

“And of course, a few words need to be said about the diet for arthrosis. Patients often ask me, “Is there any special diet that can cure this disease?”

I can say for sure that diets cannot cure the disease, but there are foods whose consumption should be reduced.

First of all, this concerns salt.

It should be consumed as little as possible, because it is an irritant to the joint and retains excess fluid in it.

And, perhaps, the most important thing is that you need to eat less of all semi-finished products, such as sausages, sausages, and it’s better to give them up altogether.

That is, do not consume foods that contain preservatives.

It is known that preservatives are a kind of irritant to the joints.

If you cannot completely give up sausages, then instead of buying these products in stores, it is better to make this dish yourself at home.

Bake a piece of meat in the oven with spices, eat it with horseradish, mustard...it’s healthier and tastier.

A few words about tomatoes. For some reason, they are often accused of allegedly contributing to the development of knee joint disease. Actually this is not true! If the tomatoes are grown in your own garden, and not some chemical ones bought in stores, you eat them calmly and with pleasure!”

In conclusion, good news from the doctor - “in most cases, arthrosis of the knee joints can either be cured if you have stage 1, or stopped and even reversed if you have stages 2 and 3.”

Author: · Published 11/20/2019 · Updated 03/19/2020

The book “Arthritis” was written in 2003, expanded and republished in 2011.

In the book “Arthritis,” Dr. Evdokimenko talks about inflammatory diseases of joints and tendons - about arthritis and periarthritis (inflammation of the tendons). You will learn what arthritis is and how it differs from arthrosis. Get the most complete information about all arthritis, their causes, possible complications and treatment methods.

After reading this book, you will be able to monitor the progress of your treatment and, together with your doctor, make meaningful decisions about certain treatment measures.

Stress and joints

Correspondent: “Are you saying that because of stress, joints “age” faster? Wow, here too all diseases are caused by nerves. What is the mechanism of the influence of stress on the condition of the joint? To this question, doctor Pavel Evdokimenko answers that when a person is nervous, he experiences a spasm of muscles and, naturally, blood vessels.

The muscles tighten the joint, begin to put pressure on it, and the pressure causes the joint cartilage to deteriorate faster. Through pinched arteries, nutrition either stops flowing to the joint completely or only reaches it in an incomplete volume. The drainage of waste and toxins through the veins becomes difficult.

In addition, against the background of a state of increased nervousness, a large amount of stress hormones is released. In particular, cortisol. This is, so to speak, a “slow stress hormone.” And it is this substance that, when released into the blood in large quantities, significantly harms the joints.

Under the influence of this hormone, in particular, spasm of the blood vessels surrounding the joint occurs. Naturally, this disrupts blood circulation, nutritional and drainage processes, which leads to the destruction of cartilage tissue.

Correspondent: “Are you saying that in this case the cause of arthrosis is a constant irritant?”

Pavel Evdokimenko: “Exactly so. It doesn’t matter where a person receives his “dose” of stress, the joints will still react to it. This can be either an unpleasant situation at work or a depressing environment at home. If there is some kind of chronic negative psychological factor, then arthrosis is easier to get.

But it is clear that if you treat only the nervous system, that is, the cause, then the joint, which in this case is the object of influence, will not recover on its own.

On the other hand, it is useless to give a patient medicine for a joint if the person is in constant nervous tension. He will take a pill. Cartilage, for example, will heal. And the patient will again release a stress hormone, which will again destroy cartilage.

Therefore, it is necessary to approach the problem comprehensively. It is necessary to influence both the cause and the result. A qualified doctor - a rheumatologist or arthrologist - will help you with this.