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.

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.

– 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

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.

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

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.

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 .