Why Does Weight Loss Help Arthritic Knees?

For every step you take while walking, 3 pounds of force is applied on your knee joint. So for example, if you weigh 100 pounds, when you walk, every step places 300 pounds of force on your knee joint.

When you ride a bicycle you apply 3 pounds of force on your knee joint. Running places 10 pounds of force for every pound that you weigh on your knee joint. So that 100 pound person actually puts 1,000 pounds of force with every step they take while running.

If you are a runner and you have arthritic knees you should consider cross training for some of your run days. Running will just accelerate the arthritic process because of the amount of force being applied to the knee joint that already is unhealthy.

If you have arthritic knees and you are overweight, it will definitely help to lose weight. I get asked all the time from my patients, “How I am supposed to lose weight if I can’t exercise.”

Science has proven that most weight loss occurs through reduction of caloric intake and not through exercise.

I’d like to give the example if you can run an eight minute mile, which is pretty quick, you only burn about 87 calories. That is about half a piece of bread. So if you restrict your caloric intake, you will reduce your total calories quicker than with exercise. You would have to run about 4 miles, at an eight minute pace, to burn enough calories to eat a piece of chocolate cake. If you don’t eat the chocolate cake you are ahead by 4 miles so to speak without ever even going to the gym.

I like the saying that you lose weight in the kitchen and get fit in the gym. Daily exercise is extremely important. However, exercise is not the quickest way to achieve weight loss. It is important if you have arthritic knees to choose exercise that gives you a good cardio workout, keeps your muscles strong but does not put excessive amount of force on your knee joints.

So for every pound you can lose, you are helping to save your knee joints.

4 Cortisone Injection Myths

1. Cortisone causes knee osteoarthritis.

This is not true. The reason you’re doctor is recommending a cortisone injection is because your knee is arthritic.

2. A cortisone injection into a knee or shoulder joint will make me fat.

This is also not the case. There is a slight systemic affect when you were given a cortisone injection into a knee or other joint. It may raise your appetite for 1 to 2 days after the injection. You need to consume an excess of 3,500 calories over your normal amount of what you eat per day to gain a pound of weight. A potential slight increase in appetite over one to two days will not cause you to gain weight.

3. Cortisone will deteriorate my bones.

Cortisone injections given into a joint will not deteriorate your bones. If you take oral prednisone (which is a pill form of cortisone) for more than three months in a row, the prednisone can cause osteopenia. Osteopenia is a condition when bones lose their strength. However, a cortisone injection into a joint will not cause osteopenia.

4. You can only get three or four cortisone injections in your lifetime.

You can get cortisone injections every three months in a joint. The rate limiting factor is the fact that cortisone stops being effective if given in intervals closer than three months. There is not an absolute number of cortisone injections you can get during your lifetime. Eventually as the arthritis worsens the cortisone becomes less effective.

Ortho Bone Slang 

– Heel bone / calcaneus
– Collar bone / clavicle
– Shin bone / tibia
– Knee cap / patella
– Funny bone / ulna
– Back bone/ lumbar vertebrae body
– Sit bones / ischial tuberosity
– Thigh / femur
– Knuckles / metacarpal phalange joints
– Breast bone / sternum
– Ankle / tibial talar joint
– Hip joint / acetabulum
– Tail bone / coccyx

Dr. Grossfeld Opens Kentucky’s First F45 Fitness Center

F45, the Australian-born hardcore fitness trend that has become a global phenomenon, is about to explode in Louisville. Seven local investors, led by Dr. Stacie Grossfeld, owner of “Orthopedic Specialists,” have purchased the rights to open six F45 locations — the very first in Kentucky. Three of the boutique fitness studios are slated to open this year in Louisville (March, May, July) and three more in the future. The fastest-growing fitness franchise in the world started six years ago in Australia, and there are approximately 1,400 F45 locations worldwide, with only 200 currently open in the United States and another 200 U.S. locations in the planning stages. Louisville fitness fiends are about to get in on the ground floor!

Redline LLC is the newly-formed local franchise group bringing the new boutique fitness sensation — which is said to be a cross between Orange Theory and Crossfit —to the Derby City. For Dr. Grossfeld, a lifelong athlete who began her competitive career as a teenager in both cross-country skiing and cycling “(USCF)”and is currently a competitive tennis player, fitness has always been a top priority and this new business venture is a perfect compliment to the work she does with her patients.

“As an orthopedic surgeon, I treat a lot of injuries and arthritis. My goal is to get them back to being active and having an outlet or gym to promote a healthy lifestyle just kind of completes the circle. It’s a natural coupling that is in line with my whole personal and professional life,” explained Dr. Grossfeld.

Why F45?

F45 – which stands for functional (fitness) in 45 minutes —incorporates 2019’s top fitness trends into a revolutionary regimen that merges high-intensity interval training (HIIT), circuit training, and functional fitness training into a high-energy group training experience complete with wearable heart rate technology to track performance. The 35-person classes (as opposed to 90 in some boot camp classes) use a combination of F45TV’s and on-floor trainers to make sure participants use proper technique to get the most effective fat-burning, muscle-building workouts. There are 31 different workouts, with more than 3,000 different exercises, which means there will be a new workout every day.

“This is a workout no one else in Louisville is offering, and we are definitely a town that embraces boutique fitness,” said Dr. Grossfeld.

The Boutique Experience 

The specialized and customized training that boutique studios offer continues to gain in popularity (Cyclebar, Barre 3, yoga), especially with millennials who prefer the more intimate pay-as-you-go model, as opposed to long-term memberships at big box gyms. At $150-$160 a month, the F45 price point is in line with other boutique fitness offerings in the area. According to the 2017 IHRSA Health Club Consumer report, more than 18 million Americans belonged to a fitness studio (“boutique”), representing more than 40 percent of those who visit health clubs. Those members are:

  • An average age of 30, nearly a decade younger than traditional clubs
  • More diverse including growing Asian, Hispanic, and African-American users
  • Twenty-two percent are multi-club users

The first 3,000 square-foot location is scheduled to open in late March in Middletown. The second is slated for a May opening in St. Matthews and a third opening in Crestwood in July. Each location will create 9 to 11 jobs and several of the investors will be owner/operators.

About F45

Born in Australia, F45 Training is a team-based, functional training facility that places a huge emphasis on the ‘three key factors’ of motivation, innovation, and results. Merging three separate leading-edge fitness training styles into one consummate and compelling group training experience for its members. F45 Training combines elements of High-Intensity Interval Training (HIIT), Circuit Training, and Functional Training. The fusion of these three training concepts has led to the development of 31 different, 45-minute workout experiences, with more in development by our F45 Athletics Department, meaning you’ll never do the same workout twice. This combination of interval, cardiovascular and strength training has been proven to be the most effective workout method for burning fat and building lean muscle. The variation of our workout programming keeps our members challenged, eager to grow, and ready to have fun. For more information visit us online www.f45training.com.

Can you be double jointed?

Nope! People that are flexible are not double jointed. They do not actually have two joints instead of one. What “stretchy” people do have is ligaments and capsules that surround their joints that have a greater degree of laxity than those of average people. Ligamentous laxity is key in certain athletes such as dancers, butterfly swimmers and gymnastics. It can be a double edge sword in the sense that these athletes are more prone to joint dislocations and ligament tears. There is a condition called Ehlers–Danlos syndromes. With this diagnosis, patient’s joints are so lax that they have chronic dislocations and pain. It can be a disabling condition. Unless you are Elasto Woman, than you will super powers…

Orthopaedic Surgery

Orthopaedic surgery is all about drilling, sewing, crocheting, and tying knots. The image above is me tying down a suture outside of the shoulder. I am using a tool called a knot pusher, which really looks like a crochet hook. I then push the knot into the shoulder joint to tie down the rotator cuff to the humerus.

 

Understanding the Wrist

The wrist is a super complicated part of your body. There are eight little bones that make up the wrist joint.

  1. Scaphoid
  2. Trapezium
  3. Trapezoid
  4. Capitate
  5. Hamate
  6. Pisiform
  7. Triquetrum
  8. Lunate

Growing Pains: What are they?

The medical term for growing pains in the knee is called Osgood-Schlatter Disease. Osgood-Schlatter Disease occurs in kids when they go through rapid vertical growth phases, typically sometime between 11 and 16 years of age. During this growth phase the bones grow faster than the tendons. The tendons tug on the growth plates were they are attached to the bone.

The most common site for growing pains is the front part of the knee. There is a growth plate in the front of your knee. If your shin bone grows very quickly where the tendon attaches to the growth plate or bone, the tendon can pull and elevated the growth plate off the major shaft of the tibia or shin bone. This will bother kids when they jump or run. The pain may occur until the growth plate completely closes which is typically age 14 for girls and age 16 in boys.

The treatment is supportive. Supportive means it’s OK to play through the pain. We recommend ice, anti-inflammatory medications as needed, and sometimes even a patellar tendon strap can help. Once the growth plate has closed the growing pains go away.

Image below is an x-ray of a patient with Osgood-Schlatter Disease. The red arrow points to the growth plate that is elevated off of the shaft of the bone. Typically the kids will complain of pain right in that area. Sometimes you may actually see some swelling from the localized inflammation.

The Biceps Muscle

Your biceps muscle turns into a thin tendon that attaches to your forearm. Rarely can the tendon tear off the bone, where it attaches in the forearm. When that happens the biceps muscle looks very flat and can migrate closer to your shoulder because the bicep muscles are no longer anchored at the end distally. The image with the blue arrow reveals how the patient for the biceps muscle has moved towards the shoulder and you can see some bruising where the tendon ruptured.

That image with the green circle and arrow is the end of the torn biceps tendon. The green arrow shows where the tendon should be attached in the forearm.

The purple arrow shows the tendon after I have placed sutures around it. I have already secured a metal suture anchor that is attached to the bone where the tendon is going to be attached. I’m now placing the sutures around the tendon and will pull the biceps tendon back into the form and attach it down to the bone in the forearm .

Five Ways to Prevent Tearing Your ACL While Downhill Alpine Skiing 

1. Warm up properly.

If you are a black diamond skier, warm up on some blue runs. If you were a blue level skier, warm up on some green runs.

2. Be aware of your surroundings.

While nothing is better than skiing with your air pods in your ears listening to your favorite Alpine ski playlist, listening to your surroundings is very important. When you’re on the chairlift for example, and the lady sitting next to you is nervously asking your husband how to get off the chairlift…that is a conversation you want to hear. Because when you’re getting off the chairlift, you want to make sure you are no where near her as you exit.

3. Make sure your equipment is properly fitted.

Check that your bindings are not too tight for your ski boots based on your ski ability. If you wipe out, you want to make sure your skis pop off your boots. A ski that does not detach can catch in the snow and tear your ACL.

4. Listen to your body.

When your legs are tired, you’re done for the day. I know everybody wants 10,000 vertical feet of skiing before 10 AM and 30,000 vertical feet of skiing before 3 PM, but if at 2 o’clock your legs are tired, end your day. It’s very important that you’re not skiing with tired legs.

5. Make sure you’ve worked on strengthening your hamstrings in the gym.

Your hamstrings protect your ACL. So hit the hamstring curl machine prior to heading out west or jumping on that chairlift. Also, when you’re riding a bike, make sure you are clipping into your petals and pulling back during the up stroke of your pedal stroke on the bike because that will strengthen your hamstrings.

The top image is a normal ACL(a happy skier’s knee) and the bottom image  is a torn ACL (a sad skier’s knee).