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Scott Webb: Sore knees are a real pain as. Us know, but there are things that we can do to prevent ending up with Sored Knee later in life. Joining me today to help us prevent knee pain as we age is Dr. Brenton Bohlig. He's a board certified sports medicine physician with Genesis Orthopedic Sports Medicine. This is Sounds of Good Health with Genesis brought to you by Genesis Healthcare System. I'm Scott Webb. Dr. Bohlig, thanks so much for your time today. I was mentioning to you that I'm 54 and my knees hurt, so some free medical advice for me and for all the listeners out there, to get into the conversation here, what can someone do to prevent having knee problems as they get older? I'm sure a lot of this is just wear and tear behavior, lifestyle, family history, genetics, all the above. But is there anything that we can do to kinda prevent our knees from aching the way mine do?

Dr. Brenton Bohlig: There's absolutely a ton of things you can do to help prevent. Injuries for the knee. It's a tough joint to treat or to diagnose things because there's so many structures around including the bone, the cartilage, ligaments, tendon, it's complicated. And even if you try to do a bunch of things to prevent injury, accidents can happen. It's a dynamic joint. It goes in a lot of different directions. It's can be easy to injure. So even if you do some of these things to prevent, it may not avoid an injury, but what we often say is if you can be in a strong condition before an injury, you usually can recover and have a better outcome.

So, along the lines of prevention, you've got stretching. You want to keep those muscles above and below the knee joint strong so they can support kind of like a scaffolding to that bony structure underneath, , good exercise, we often say low impact. So you don't wanna put a lot of. Jumping or heavy pressure through that knee joint. So it's walking or biking or swimming, those types of things. I suggest usually to walk even 30 minutes a day, a few days a week is really great for knee strengthening and prevention of further injuries down the line.

Additionally you can add weight training, to the muscles around the knee joint, whether it's involving the hip thigh, lower leg, all those things can be helpful. But proper technique is often key there. So, sometimes Good place to go, simple online videos or looking up exercises for some direction. Of course, we can always prescribe physical therapy or just working with like a trainer at a gym or something And then one other thing that usually helps to prevent knee injuries is because it is a weight bearing joint.

Maintaining a healthy weight, excess weight through the knee joint can put more stress and lead to more, I guess detrimental effects to the cartilage that line that bone and can lead to arthritis. Specifically osteoarthritis or breakdown of the cartilage at an earlier age than we would expect. One tip or thing out of the kind of fact I like to share when we talk about weight loss is every pound you can lose or drop, you're actually taking three to six pounds of pressure off that knee joint. So if you drop 10 pounds, it'd be like taking at least 30 pounds off the knee with every single step. So that's just something to think about there.

Scott Webb: Yeah, for sure. And you mentioned osteoarthritis, so wondering when people are in the office and they get a patient history and you do an examination, how do you differentiate between just the normal wear and tear of being a human and walking around and doing stuff their whole lives, versus maybe some sort of acute injury? Like how do you diagnose basically, and then sort of guide folks in the right direction?

Dr. Brenton Bohlig: Often involving the knee I mean, we'll always start with x-rays. X-rays are really key to help diagnose osteoarthritis, because you can have the symptoms of what you're describing, whether it's pain with movement, maybe some like that clicking or popping that's painful or swelling. Any of that can happen with multiple types of injuries. In terms of bone, looking at x-ray is helpful to see the joint spacing, and if there's loss of cartilage, those bones will look closer together on an x-ray, maybe the alignments off, maybe there's some bone spurs that have developed because of increased stress or wear and tear.

Swelling can sometimes show up on that x-ray. Otherwise that's just a good physical exam. We'll show that as well or be able to detect that. I mean, but yeah, we often would, in terms of osteoarthritis, x-ray, good physical exam and then just listening to you in your history and kind of what symptoms you're having and compiling that all together to come up with the diagnosis. Osteoarthritis is very common, but then other knee injuries can involve surrounding ligaments, tendons, or the cartilage or the meniscus layer in between the knee joint, which is like our shock absorber.

Scott Webb: Yeah. and as you. The knees they're complicated. There's a lot of moving parts. But doctor, when I walk the aisle at the store trying to figure out maybe some vitamins or supplements or things I could take to just sort of slow down the aging process or make my knees feel better, my head starts to spin a little bit. But I'm wondering like, are there some vitamins in supplements, things we can do to keep the knees healthy, repair minor damage? Is there any sort of magical pills out there?

Dr. Brenton Bohlig: Well, maybe not a magical pill, but I think there are some things that could help. So I get this question a lot and it's hard to know a lot about everything that's out there because there's so many different supplements that will advertise about osteoarthritis or being anti-inflammatory. Or maybe they'll support your cartilage regrowth. The problem with this is vitamins and supplements are not regulated by the Food and Drug Administration, the FDA, so they don't go through really much testing or rigorous testing that like prescription medications might, so the claims can kind of be out there and maybe not backed by research.

So, it's just like advertising with any other sort of product. It's like they're trying to sell it. So there are a few. websites that I use or I recommend people use to look up. So if there's a supplement in question, they can go there. And there's some independent companies that do research to help provide some scientific backing to these products. And one website is called Labdoor, just one word. So L A B D O O R.com. And they rate supplements that you'll see in the pharmacy, grocery store, wherever. They'll give it a letter grade, so like anywhere from A plus down to F and saying this is accurate on the bottle is actually what's in there.

And the claims might be somewhat accurate. So that's a really nice website. A more scientific one is called examine.com and they'll provide links to like research articles about whatever you're looking for. For example, I actually looked up curcumin or turmeric is a common supplement that you'll see is for knee, joint or any really joint pain because it's anti-inflammatory and antioxidant. And they'll provide articles showing that there's actually been benefit with patients who have osteoarthritis. So the knee that if you take curcumin around 1500 milligrams a day for about four weeks, and they compared it to Ibuprofen, 1200 milligrams a day for the same timeline.

And they said it was about equal, so in terms of relief benefit from knee pain. That's one I really like to maybe suggest is curcumin or turmeric. You do have to take it for a few weeks to feel relief, but the studies are showing that it's about equal to anti-inflammatories that. Some people can't take, maybe they have kidney issues, heart problems, or other medications that don't let them take that. And this can be relatively equivalent with less maybe adverse effects that the other medications might. I will preface that everybody's a little different in terms of meds they're taking and there could be drug interactions.

So we do say, Hey, talk to your primary care provider or specialist. These before starting them. If you do take a number of other medications, because they can interact. One other one I'll mention is glucosamine Condroitin. That's a pretty popular one you'll see for like joint health, and it contains elements that kind of replicate the connective tissue or cartilage in the joint. That one is pretty heavily advertised and you see it out there, but the research isn't as good with that. I mean, I'm not saying you can't get benefit, but it's just showing maybe compared to others that it's not as helpful.

And therefore, like the American Academy of Orthopedic Surgeons, I think in a 2015 statement they said they cannot recommend it. So there's not enough evidence to say, oh, go ahead, use this. It's great. It might help, but we can't really say an official recommendation.

Scott Webb: As you were saying, they may not be magic, but , maybe some benefits for some folks, avoid some of the interactions they may have with some other medications. And when in doubt, of course, speak with your provider, they would know best hopefully. When should we reach out? When is the pain or, our lives suffering too much or so much that it's really time, we just have to speak up. We have to reach out, we need to seek medical attention?

Dr. Brenton Bohlig: I do like to point out some of the more kind of red flags or things that we say, okay, if this is happening, yeah, maybe you should get checked out and hey, who knows? Maybe it's fine, but at least you maybe feel more comfortable about doing so. I mean, we all injure our knees at some point. Often it's short term, maybe it's like a sprain, a ligament or a strain of the muscle or tendon, and you do the rest, bracing, compression, ice, all of that stuff over the counter medications. And within a few days, or even a couple weeks, it feels better.

But if you do that stuff and there's some of these other things that are still going on and maybe it's still painful, then that is a good time to seek some, whether it's your primary care provider or a specialist, just some medical attention. And on that list of kind of those red flags, I would say is if you have difficulty with range of motion of the knee, so like getting it fully straight or bending, especially with any pain involved, that's one of those things I would seek some attention. If it feels like it locks up or catches like you can't get it straight or can't bend it back.

Pain involved with that as well is often a sign of, maybe there's a, not just arthritis, but there might be injury to like the meniscus or other cartilage lining in the joint. When you're walking or weightbearing if there's sharp pain or it feels like the knee's gonna give out, often if you have persistent swelling or tightness in the knee joint, that could limit the range of motion. That's something that we might need to address. And then twisting or pivoting with sharp pain, those can also be related.

Those type of symptoms can also be related to like a minuscule injury, which is that shock absorber kind of layer of cartilage in the knee joint. So I would say if you have trouble with range of motion, feel like it locks or catches and it feels like your knee's gonna give out or there's persistent swelling. That's kind of a short list of red flags we'd say, all right, we should look at this and get x-rays, , physical exam, maybe even an MRI if we need more detail.

Scott Webb: Yeah. The red flags might be an indication that it might be just more than just wear and tear. It might be more than osteoarthritis. Like something really needs to be looked at and something may need to be done, more so than supplements or whatever it might be. So, Doctor, thanks so much. This has been really helpful. Thank you for your time, and you stay well.

Dr. Brenton Bohlig: All right. Thank you.

Scott Webb: And for more information, go to genesishcs.org/orthopedic. And thanks for listening to Sounds of Good Health with Genesis, brought to you by Genesis Healthcare System. If you found this podcast to be helpful, please be sure to tell a friend and subscribe, rate and review this podcast. And check out the entire podcast library for additional topics of interest. I'm Scott Webb. Stay well.