Expert: Dr. Victor Dolan, DC, DACBSP - 7/31/2009

Question
I am a 43 year old female who suffers from arthritis in both knees.  Recently, I began bike riding to help me loose weight. Shortly after beginning, I attempted to ride home from work which is 12 miles.  The first time I didn't experience any problems.  The second time within the same week, it attempted again.  During the second trip home I traveled all the way without taken a break.  During this travel, I began experiencing a lot of stress in my left knee and left ankle. However, I continued without stopping.  Afterward and for a month and half I continue to have a swollen knee along with aching pains.  The muscle behind the knee is swollen, my calf is sore, I am catching charlie horse from the back of my knee into the upper part of my calf and up the hamstring.  I am hearing a lot of clicking when bending and my knee is locking when I lay down at night.

Answer
Hello Delphyne,


I am sorry to hear of your knee pain, swelling, clicking, cramps.

Want me to 'cut to the chase'?  -  answer you real quick and simple (and you probably know this):
Too  Much  Too  Soon !!!

Your first 12 mile trip ( crazy long for a first trip ! ) , you at least took some breaks,,, and you got away with a pretty long trip- without prior 'break-in' training.

Your second 12 mile trip- #1) you may have been fatigued from the first trip still,
and  #2)  12 miles with breaks is pretty long,,,, 12 miles without a break = LONG trip, who are you??? Lance Armstrong ???

At 43 years old it is common and usual to have SOME arthritis in the knees.  Please notice, I said common and usual to have arthritis; I did not say it is normal or healthy.  It is NOT 'normal' to a 'healthy' body.  We do it to ourselves- - - we injure ourselves, pay no attention, hope it will go away; or we take painkillers that actually ACCELERATE arthritic degeneration!  Please read this information handout I utilize in my Staten Island Chiropractic office for my arthritis patients:





PAIN     

Pain  is a  ‘red light on the dashboard’.
 
Pain is your body telling you that something is wrong.

That RED LIGHT on the dashboard of your car-
-- do you ignore it until the car breaks down,
or do you get it checked and correct the problem?  

Pain,
pain in your body-
-- do you ignore it until your body breaks down,
or do you get it checked and correct the problem?   

Pain,  
do you cover up the pain by taking a painkiller?  
Take a painkiller,
mask the pain,
and allow a problem to progress in your body?


       NOTICE  ON  PAIN  RELIEVERS:

 
Label changes ORDERED by FDA;  the FDA announced proposed label changes for OTC over-the-counter pain relievers to include the potential for stomach bleeding and liver damage (FDA news  206- 207;  12-9-06) ;

The  American Heart Association issued a scientific statement recommending medical doctors change the way they prescribe OTC pain relievers from a first choice to an alternate of recommending non-pharmacologic treatment (AHA statement  2-26-07).

NSAID Acceleration of ARTHRITIS; an important side effect of Aspirin and other NSAIDS is that it will inhibit cartilage repair and accelerate cartilage  destruction ( Journal of Rheumatology, 1982; 9: 3- 5 ). Many times people take NSAIDS for the pain of Arthritis, not realizing these drugs may make the underlying condition worse.  These medications cover up the pain, and cause the problem to worsen.


Pain  can  often  be  the  result  of  the  Vertebral  Subluxation  Complex.

Vertebral  Subluxation           (  ‘VSC’ ,    ‘subluxation’   )
Vertebral Subluxation  is  actually  a  quite  common  condition.   Doctors of Chiropractic look for pathological conditions which may require referral to other specialties,   and also look for ‘Subluxation’. Other disciplines look for pathology, but overlook the importance of alignment and movement in the spine which affects our nervous system  (the master control system- ALL health disciplines learn this).  VSC- ‘Subluxation’ – can be the cause of many symptoms and conditions.

Only  a  Doctor of Chiropractic  will  evaluate  and  treat  for  VSC,   as  well  as  other  pathology.

The course of VSC is highly variable.   Some patients with VSC literally cannot walk, yet other patients with similar test findings may be able to run marathons or lift heavy weights.    Some patients immediately develop symptoms related to the VSC,  some patients take years to develop symptoms.  Some people suffer for only a few days with pain and symptoms, some people suffer for months.  Some people recover in days, some take months or years, depending upon severity of the condition.

A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.


The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.
       Vertebral  Subluxation   cannot   be corrected through chemicals (medicine), stretching,  yoga,  vitamins  or  physical  therapy  alone.       Subluxation- a neuro/skeletal/muscular-    mechanical-    problem  requires  a    mechanical correction-  -  -    a manipulation,         best  performed  with  the  chiropractic  adjustment.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine


++++++++++++++++++++++++++++++++++++++

I recommend you read "The Arthritis Cure"  http://www.amazon.com/Arthritis-Cure-Revised-Updated-Osteoarthritis/dp/031299063...  

Of special interest-- the drugs we take for arthritis pain actually speed the degeneration of osteoarthritis !  "..... NSAID Acceleration of ARTHRITIS; an important side effect of Aspirin and other NSAIDS is that it will inhibit cartilage repair and accelerate cartilage  destruction ( Journal of Rheumatology, 1982; 9: 3- 5 ). Many times people take NSAIDS for the pain of Arthritis, not realizing these drugs may make the underlying condition worse.  These medications cover up the pain, and cause the problem to worsen...."


"...During the second trip home I traveled all the way without taken a break. ..."- I must congratulate you on your ambitious undertaking; I must scold you on doing too much too soon.

You had previously diagnosed arthritis ? - you did too much and you aggravated your arthritis.
Now you need to treat this exacerbatory incident.  Rest, Ice, and a treatment regimen at your local physical therapist or even your doctor of chiropractic may be necessary.

"....Afterward and for a month and half I continue to have a swollen knee along with aching pains.....", I recommend physical Tx- again, at your local DC or PT.  Even though this is six weeks later this info/ regimen may help:





P.R.I.C.E. =    

P  protection.   R rest.   I  ice.   C  compression.   E  elevation.

Hurt  yourself ??  injury/ trauma/  bruise/ not even sure - - a broken bone ??

You should certainly get to the Doctor or trained health professional to be examined  if you think it  is  bad  enough.     
BUT  in  the  meantime,  some  simple  steps  may  help.   

PRICE.


The  PRICE  protocol will usually help just about any musculoskeletal injury.

P = Protection;  protect the area from further injury- stop what you are doing, can you
     pad  or bandage the area ? Tape the area? Do something to protect the area !

R = Rest;  rest the area as much as possible, if a part is damaged, give the body time to
       repair the area

I = Ice;  ice is a potent anti-inflammatory; it will slow swelling, help with pain control
     (ice is analgesic), place ice over cloth over the injured area for 5, 10 minutes, off the
     injured area for 30 minutes; then back on again

C = Compression;  to help prevent swelling compression may be helpful- for example
      if it is an ankle, wrap the ankle with an ace bandage and ice the area.  Many body
      parts may not be applicable to compression.

E = Elevation; again to fight swelling and pain, raising the injured body part above the
      heart may be helpful- ie raise an ankle or knee, you lay down, raise the injured part


PRICE  may  help :    Sprains,  Strains,  musculo-skeletal injury,  bruise,  contusion
Sometimes  a slip, trip, fall, heavy lift, athletic injury, or a motor vehicle accident can cause a bump or bruise, sprain or strain.  Sometimes also involved with the injury is a vertebral subluxation (or other joint subluxation) (subluxation is a mechanical problem- of any joint- and requires a mechanical correction).  In the spine, a sprain/strain  is a misalignment,  a ‘kink’ in the joint, a stretch of the muscles, tendons and/ or ligaments:- more properly termed a Vertebral Subluxation.   Sometimes symptoms can come immediately, sometimes days, weeks or even months later!- Well after the actual trauma !!!

         Spinal = Vertebral   Subluxation   Complex    (a.k.a.  ‘subluxation’)  ;   ( subluxation COULD be any joint )
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A  subluxation  interferes with the proper functioning of the nervous system  (the master system  which controls and coordinates all function within the body)  and may cause various other conditions, symptoms and problems.

This is a serious condition identified by its five parts:
    Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
    Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
    Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
    Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.
    Pathophysiology:
         Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.


The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.
         Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
          Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.  Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.  For good health- Treat the   Cause,  not just the Symptoms.  Sprain/ strain/ bump/ bruise?= may result in subluxation of the nearby joint.  CORRECT the subluxation !!!!



+++++++++++++++++++++++++++++++++

I have patients in their Eighties and even (literally!) in their Nineties.  These older people have little or NO ARTHRITIS is their spine (or elsewhere).  I have patients in their thirties and forties- with severe arthritis!  - why? what is the difference???
         PROPER TREATMENT.

Many people injure themselves, take painkillers, muscle relaxants, even anti-inflammatories.  This is great to kill the pain; BUT if it is a joint that is involved--- what re-aligns that joint into proper position, proper movement patterns?

If your car hits a pothole, and the front end is out of alignment- your front end and tires will wear out FASTER then it should.  If you put the BEST most expensive gas and oil, the most expensive wax on the car,,,, the front end still wears out.  If you take drugs to kill the pain,,, what re-aligns the joints.  When joints deteriorate,,, we call it OsteoArthritis.
Don't just cover up the problem, get to the cause of the problem!     Another information handout I utilize in my Staten Island Chiropractic practice:





Degenerative    Joints,  Arthritis:


DDD = Degenerative Disc Disease;  OsteoArthritis- THE most common Arthritis-  the ‘wear and tear disease’ .                         DJD = Degenerative Joint Disease; = similar/ same OsteoArthritis.
Degenerative Disc Disease  (old term =  DJD) is  actually  a  quite  common  condition.   However,  the course of the condition   is  highly variable.   Some patients with DJD literally cannot walk, yet other patients with similar X-ray/ MRI findings may be able to run marathons or lift heavy weights.   Some people suffer for only a few days with pain and symptoms, some people suffer for months. Although the course is highly variable, there are certain steps that are always helpful to follow:  Ice the area when painful-  10/ 15minutes on, 30/ 45 minutes off;  avoid certain postures and movements;  bend the knees when coughing or sneezing;  bend the knees when lifting anything;  do not extend legs straight out when sitting, laying down, lifting, or driving.   Avoiding certain movements and postures will prevent aggravation of the condition.   Practicing good postures and movement patterns will help the condition heal and be less painful.  DDD, DJD,  OsteoArthritis, -  deteriorating discs (disk)   is/ are  often caused by,  or often  concurrent with the Vertebral Subluxation Complex.  VSC is a misalignment which hastens deterioration of the joints involved.    Misalignment/  improper motion patterns  CAUSE/ HASTEN  OsteoArthritic degeneration.

         Vertebral   Subluxation   Complex    (a.k.a.  ‘subluxation’)
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A subluxation interferes with the proper functioning of joints, and can cause osteo-arthritic degeneration, Degenerative Disk Disease, degenerative joint disease, etc.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.
Subluxation  is  a  serious  condition  identified  by  its  five  parts:
    Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
    Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve  system  dysfunction  can  cause  symptoms  elsewhere  in  the  body.
    Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The  resulting  scar  tissue  changes  muscle  tone,  requiring  repeated  spinal  adjustments.
    Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation.   Inflammed  Discs can easily bulge,  herniate,  tear,  or  degenerate.   Other  soft tissues  may  also  suffer  permanent  damage.
    Pathophysiology:
         The VSC contributes to  OsteoArthritic  degeneration.  Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term  nerve  dysfunction  can  cause  other  systems  of  the  body  to  malfunction.

The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, Disk Degeneration,  or aggravate such conditions.   
          Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.     Subluxation- a neuro/skeletal/muscular-   mechanical-   problem  requires  a   mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine

+++++++++++++++++++++++++++++


You had pre-existing arthritis.  You aggravated your arthritis.  You need treatment upon the cause of your complaint:  Chiropractic and / or physical therapy, in my opinion, is more indicated then chemical drug management of the complaint.

I recommend you see your local Doctor of Chiropractic- perhaps with sports injury, orthopedic or rehab credentials  (see:  chiropractic specialties:  http://www.acatoday.org/pdf/ApprovedChiropracticSpecialtyPrograms.pdf ).

Take your anti-arthritic nutritional supplements, i.e.: glucosamine, chondroitin, MSM, SAMe,
etc.

I hope this helps.

If you need further information, do not hesitate to RE-contact me at:
http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm

Good Luck,

Dr. Victor Dolan, DC, DACBSP
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