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Arthritis: Two exercises to avoid to prevent joint pain from developing

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"The most common issues are related to damage to the soft tissue around the lining or tendons of the knee, whereas any problem with the knee bone itself is unusual."

In order to prevent knee damage from jogging, as well as wearing the correct footwear, Lee recommends to "limit your running on hard surfaces".

Lee elaborated: "Many trainers believe that 60-70 percent of running should take place instead on dirt tracks or grass.

"The most common issues are related to damage to the soft tissue around the lining or tendons of the knee, whereas any problem with the knee bone itself is unusual."

In order to prevent knee damage from jogging, as well as wearing the correct footwear, Lee recommends to "limit your running on hard surfaces".

Lee elaborated: "Many trainers believe that 60-70 percent of running should take place instead on dirt tracks or grass.

"The ground is more forgiving so there is less wear and tear on the joints."

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Why does knee pain get worse in the winter?

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If you have already been diagnosed with arthritis in the knee, you will be advised that cycling, swimming and walking through water is the best form of exercise to alleviate painful symptoms.

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Experts from the American Academy of Orthopaedic Surgeons pointed out that arthritis symptoms include: pain, swelling and stiffness.

Known to be "particularly common" in the knee joint, the condition can cause difficulty with everyday life, such as climbing stairs.

"It is a major cause of lost work time and a serious disability for many people," the experts stated.

Osteoarthritis in the knee involves the cartilage gradually wear away, becoming frayed and rough.

Books

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Sports Muscle Injuries and Actovegin

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ACi Ten Years on

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Magic of Fat Cells

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Biological Recovery Plan

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The Hip Replacement Guide

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Is Running Bad For Your Knees? We Asked A Top Expert

The short answer is no, but it certainly pays to be careful when running regularly

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There are a lot of preconceptions about running and one of the most common is that it’s bad for your knees. As with much received wisdom, there’s some truth to it – running is a high-impact sport and people can hurt their knees doing it. One of the most common running injuries is called runner’s knee, after all.

However, it’s not true to simply say that running is bad for your knees. We know that because it was the first question we asked professor Paul Lee, medical director at MSK Doctors and an orthopaedic surgeon who specialises in knee and hip conditions.

Paul Lee

Professor Paul Lee is a double board-certified orthopaedic surgeon who specialises in knee and hip conditions, and sports medicine. Lee is a medical director at MSK Doctors(opens in new tab) on Harley Street, has over 50 peer-reviewed publications and has written textbooks, as well as having treated Premier League footballers for sports injuries.

What are some common knee injuries that runners suffer?

Common injuries around the knees are anterior knee pain and shin splints. Anterior knee pain, which is suffered by a lot of runners, comes from putting a lot of stress on the front part of the knee. Between the kneecap and the thigh bone itself there are a lot of complicated mechanisms. It’s very difficult to diagnose what exactly is the problem. If you have this sort of injury, my first advice is change your trainers, rest for a few days, and then go again and test it out. If it continues for more than a month even though you have rested and changed your trainers, I suggest seeking professional help. Go straight for an MRI scan – a standard X-ray won't really help. 

How can you prevent knee pain?

Doing core exercises are really important, don’t skip them. Warming up is important. Stretching – don’t do it at the beginning [of a run], do it at the end; it really does make a difference. Stretching the iliotibial band around the knee will really help to reduce the transport friction syndrome on this tissue. 

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If done correctly, does running help knee health?

Running generally is good for you. I am a specialist knee surgeon, but at the end of the day life does not just revolve around your knees. The biggest benefit of running is to your cardiovascular fitness, but it does stress your joints – if you overdo it, it will hurt your knees, you will damage the cartilage and you can cause irreversible damage. But at the same time, if you do it in moderation and you do it appropriately and safely, it will build your muscles. By building the muscle it reduces the load around your knee.

There are two very interesting studies that I talk to my patients about. One is where patients had an MRI scan before a marathon, and then 24 hours after and six weeks after. They looked at any lesion within the bone, within the cartilage, within the meniscus. Even if you are a well-trained athlete, after a marathon you will still have bone bruising and meniscus bruising around your joint. The good news is with appropriate rest at six weeks, most of this bruising will go away. I cannot stress enough [the importance of] taking appropriate time to rest.

The other study shows that doing long-distance running repetitively does not thin your cartilage out. What it actually does is thicken your cartilage slightly. Again, the big “but” there is you have to make sure there is enough rest. In the same study, they say that if people don’t have enough rest, it does cause cartilage damage and create cartilage lesions, and make people have arthritis sooner. 

The answer to “is running good for your knees?” is yes, if you have appropriate rest in between.

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4 reasons you have hip pain when walking

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Among the reasons why walking has become one of our favourite activities is that it’s a gentle, low-impact activity. A stroll is a great antidote to our high-intensity workouts, allowing us to be mindful and take things slow while still reaping the benefits of moving our bodies.

But that doesn’t mean walking is easy. Long hikes can leave us with muscle soreness as bad as a tough strength training session, and we’re often hampered by aches and pains while out on our walking route.

You’re walking too far

If you’ve gone from 30 minute strolls around your neighbourhood to suddenly taking on a half marathon walk, you should probably expect your body to feel a little uncomfortable. “People can experience pain if they have had a sudden increase in walking duration,” says Yasmin Milne, a specialist musculoskeletal physiotherapist at Pure Sports Medicine. “It’s because the muscles and joints are pushed beyond the capacity of what they can tolerate, and there’s too much load put on the area.”

 

The obvious way to get around this is to increase your mileage slowly, just like you would with running. Walking may be lower intensity, but long distances are tough on the body regardless of the speed or impact. “Ensure you’re taking adequate rest and recovery between walks and try not to increase your overall weekly load – in terms of distance or time – by more than 10% each week for injury prevention,” adds Milne. 

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Joint or muscle problems

In runners, weak glutes have long been linked with hip pain. In a 2005 paper, researchers tested hip strength in all six directions of motion in runners with hip injuries and runners with no injuries. Those who were injured were found to have noticeably weaker hip flexors and hip abductors. 

As all of the glute muscles are used when striding, strengthening them could help make you a better walker too. Remember, just because the impact is less, it doesn’t mean the body doesn’t need to be strong.

The authors of a 2019 paper into hip pain wrote that “the gluteus maximus functions in conjunction with the other gluteal muscles (gluteus medius and gluteus minimus) to stabilise the hip by counteracting gravity’s hip adduction torque and maintain proper leg alignment”. That means that they stop the legs from falling inwards, as well as producing the “large amounts of force and power to contribute to hip extension” we need when walking. 

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'Leisure sickness': uncovering the reason why we all get ill on holiday

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Weird and unexpected ailments are hallmarks of a trip away – so what can you do to prevent them from ruining your all-important break?

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Mr Alun Yewlett and Professor Paul Lee, of MSK Doctors, have opened a new clinic in Sleaford. It houses the only open MRI scanner in the county.

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A Lincolnshire clinic is hoping to help take the pressure off the NHS through the use of the county's only open MRI scanner.

Staff at the newly opened Sleaford branch of MSK Doctors hope their host of modern equipment, sourced from across the world, will help to alleviate the strain on the NHS.

Mr Yewlett and Professor Lee stand in the sports assessment room. Now MSK House, the building used to be a driving range.

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The clinic also makes use of equipment that tests patients' balance, which is typically reserved for high-level athletes. Professor Lee explained: "It is usually used by elite sportspeople - they have one in West Ham and one in Chelsea.

"It looks at how quickly people can balance from one side to the other side.

“We’ll ask people to jump up onto it and jump off, and then you can see which leg they put more force on, and from there we can assess if there any issues in the joints.

"We are treating very different people will this equipment. Sportspeople are normally between 16 and 25 years old, and the focus is on 0.2 milliseconds of movement.

"But with someone who needs a joint replacement, the age group is typically between 60 and 90.

"We're not looking at 0.2 milliseconds, we're looking at what they can do in five seconds - if they can stand, that sort of thing.

"It's the same equipment but on a different scale.

"There is no other facility like this, outside of Harley Street in London."

Mr Yewlett and Professor Lee stand in the sports assessment room. Now MSK House, the building used to be a driving range.

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The team chose Sleaford as the location for their second clinic as they found it was easy for everyone to get to from across Lincolnshire. The professor said: "Sleaford is a growing town - there are many, many houses coming along.

"But the main reason is that Sleaford is bang in the middle of Lincolnshire.

"It doesn't take that long for people from LincolnGrantham, or Boston, to get to it.

"Regardless, our patients are going to have to drive. If the clinic was in Lincoln centre, people would then be asked to walk when they maybe couldn't. "It will also allow people to stay in Lincolnshire for their treatment, and the money will get recycled in Lincolnshire rather than in Nottingham or London."

The clinic is on London Road, Sleaford. Left to right: Mr Yewlett, Professor Lee, clincial assistant Daisy Price and practice manager Bethan Lee. 

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Portable ultrasound helps MSK Doctors offer one-stop treatment to patients

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Esaote’s MyLab Omega has been installed at The Keep Clinic, Grantham, to help diagnose the cause of shoulder pain as well as to guide injections. MSK Doctors consultant orthopaedic surgeon Professor Paul Lee is pictured with the MyLab Omega portable ultrasound system. He said: “MSK Doctors specialises in biological and minimally invasive treatments for sports injuries and arthritis. The MyLab Omega ultrasound machine has extended our ability to see beyond our eyes. This allows us to offer one-stop diagnostic and treatment solutions to our patients. This new ultrasound service makes many regenerative procedures possible without the need of a hospital. The MyLab Omega is a high quality machine that is logical and easy to use, the image quality is great and it is very portable.”

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MSK Doctors

MSK Doctors adds MRI for real-time assessment

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MSK Doctors has acquired Esaote’s dedicated MRI S-scan system. The company has two clinics in Lincolnshire – The Keep in Grantham and The MSK House in Sleaford.

Professor Paul Lee said: “Esaote’s dedicated MRI scanner is vital for us as it is our eyes and we need to be able to clearly see patient pathology and degradation. We chose the S-scan as it is a dedicated MSK scanner, well suited to a dedicated MSK clinic. We were also very impressed as they are endorsed by FIMS, the International Federation of Sports Medicine.

“The scanner appealed to us due to the open bore for claustrophobic patients, the good standard of imaging and the cost-effective nature of the power requirements. Another big benefit are the dynamic true motion sequences that are available; these allow us to assess anatomy in real time, which is hugely beneficial to patient diagnosis.”

MRI system, with simple patient workflow that cost-effectively delivers image quality. It has an open design and real-time image display on the gantry that facilitate easy patient positioning.