What I Wish Everyone Would Know About Arthritis!
- chelsie462
- Apr 17
- 10 min read
This article is a transcribed, edited summary of a video Bob and Brad recorded in June of 2024. For the original video, go to https://youtu.be/-s6DCIFb4Qs
Brad: Today, we're going to go over one common thing we wish everybody knew about arthritis.
Mike: So first we're going to discuss some surprising facts about MRIs that many people do not know. And then we're going to talk about how to actually decrease arthritic pain while walking.
Brad: So how do MRIs and arthritis work together?
Mike: We're going to get into it.
Brad: There you go. It's going to be very interesting and helpful.
Mike: So when it comes to MRIs, a lot of people put everything into one bag when it comes to the results of those, and they don't go off of things like how you're actually feeling with your arthritic pain.
Brad: That's exactly right. Now I thought, just coming out of therapy school, that the MRI was the gold standard. You're going to find out exactly what's wrong, but it is not true, and doctors realize this. So don't think the MRI is going to show you exactly what's wrong with you. For example, you could have a herniated disc and not have any symptoms.
Mike: You could also have arthritis in both knees, but maybe your left knee hurts and your right knee doesn't. We've had patients come and say, "Oh, my good knee actually looks worse, they said on an MRI." So it's not always good to put everything into the imagery when it comes to your pain. So MRIs are often used to get images of a joint, whether it's the shoulder, hip, knee, or back, and oftentimes they show muscles, tendons, and ligaments, which is good for maybe saying something like a rotator cuff tear, but they're not always the best for arthritis. It will show some symptoms, but oftentimes X-rays are used for that.
Brad: Right. X-rays are much cheaper than MRIs, and they do a good job of showing arthritis, particularly bone-on-bone. So please don't get that wrong in how we presented that. The whole point is that MRIs, CAT scans, and X-rays are all tools to look at information from the body, but it does not conclude anything. You have to have a doctor or the radiologist evaluate it and then take that information and combine it with your symptoms to come up with a conclusion. That might be a little confusing for some people. So the bottom line is, if your doctor says we're not going to do an MRI, we're not going to do a scan, you need to do therapy first because your hip or your knee joint is a problem, whatever it could be. I agree with that because there are times therapy can actually change the mechanics, reduce or eliminate the pain, and you don't have to go through an expensive scan, and it's a really good method to work with. Some people are concerned about that, but it's good.
Mike: So when it comes to arthritis, some joints may have arthritis in them, but sometimes the pain is from those tendons, ligaments, and tight muscles. So we want to stretch those out and get them coordinating and functioning properly to decrease your pain. Because we've seen patients before, get something like a hip replacement, it goes okay for a few years, and then they start having pain again, and they're confused because they don't have a hip joint anymore. So we need to look at those muscles, tendons, ligaments, and how to actually walk correctly.
Brad: Alright, now we're going to use an example on the knee, our arthritic pain, pain with walking, and how to correct this without any surgery. Just a matter of changing your body mechanics and some stretching so that the stress on the joint eliminates the pain, and success is achieved.
Mike: And this can also relate to the hip joint as well as and even the ankle, I guess, if you have an injury there.
Brad: Alright, we don't want to get it too confusing. Let's go for an example of the knee joint. The person comes in with knee pain. Every time they walk, they put weight through that knee, and it's uncomfortable. And we're going to talk about a specific change in your walking pattern or gait to help crack that, and one stretch. Okay. What we're going to talk about is a method called walking with a soft knee. This can really change the mechanics of the knee, and Mike is going to explain and demonstrate the technique.
Mike: So most people nowadays walk with a heel strike pattern, their foot out in front of them like this.
Mike: This can put stress on the ankle, knee, and hip joint, and even the back. So we want to decrease the amount of stress every time we walk through those joints. So to do that, what you can try to do is land with a bent knee. Notice my knee is bent, my foot is more flat. Some people will either try to do a flat foot, some people will try to walk on their forefoot. This may seem odd, especially when you're first beginning this, so we suggest just doing it in your house, short distances, maybe in socks or slippers. Oftentimes, modern-day shoes can make this a little more challenging as well, but it's important to walk with a nice soft knee. When you do that, you put more of the stress into your muscles versus your joints where they're supposed to be.
Mike: Now, some people may not be engaging the right muscles or even have tight muscles. So we're going to go into an exercise and stretch you can do focused around the hip region.
Brad: Can you demonstrate the incorrect versus the correct?
Mike: So incorrect is with the foot way out in front of you, heel striking like this. I'm putting a lot of impact and jarring forces through it. I'm going to take a shorter step like this, land with more of a flat foot, maybe forefoot walking, you're going to be taking more steps per minute than average, and it'll feel a little different, but it's going to be a lot less stress on your joints.
Brad: As a matter of fact, we have one person that we actually did on video about a year or two ago, and she had pain, and she started this soft knee walking, and her face just changed. Oh, the pain is so much better, but it is, it takes time to acquire a habit of walking this way. Now, this whole concept of walking to soft knees, and we're now we're going to talk about engaging your glutes, is from a therapist who has extremely good luck with this and actually has a whole system. His name is Rick Olderman, and he's got some wonderful books that he's written for therapists as well as the lay person. Now, when you walk with the soft knee, the next thing we want to address is the glute muscles so that they're engaging properly, which also takes stress off both the hip and the knee joint.
Mike: So when you're walking, your glute actually works on the extension, your butt muscle kicks back. So in the walking phase, you're walking here, loading it, kicking back like this. If I'm walking with the heel strike again, my glute is not engaged, might kick in a little bit here, but then I'm swinging through again.
Mike: So just focusing on landing with the flat or on your forefoot can really emphasize that. To do this, again, we probably suggest doing this at home. You're going to place your hands on your buttocks and walk around. Walk around how you normally would, and see how much engagement you can feel. Then, to try even more engagement, try to walk on your tippy toes if possible. You should feel your glutes engaging much more with this style of walking. Obviously, most people don't want to walk around on their tiptoes all day. So eventually, try to flatten it out and walk a little more normally.
Brad: Now we realize this is pretty weird to walk around with your hands on your buttocks, but you're just going to get in and actually feel the glute is one of the largest muscles in the body, and you'll feel that muscle engage. And once you get that connection between your brain and the glutes by feeling it with your hand, that's biofeedback, it can really assist in making those muscles work the way they're supposed to, to take the stress off the joints and through the muscle tissue.
Mike: Now, if you're still struggling to feel that glute engage when you're walking, you're feeling tight, say in the front of the hip muscles. We need to stretch out some of these muscles, specifically your rectus femoris or even hip flexors. So we're going to show you how to do that next,
Brad: Right. So that muscle connects from the hip all the way down and crosses both the hip joint and the knee joint. And when that gets tight, it can actually affect both joints, in this case, the knee.
Mike: So we're going to start by stretching the hip flexor muscles as well as the rectus femoris, which is technically a quad muscle. In order to do this, I'm going to be in a kneeling position. At home, oftentimes when I do this, I have something I can hold onto for support. It's just easier for me to get into it this way. My back foot is going to be a little elevated. Once I'm here, if you're really tight, you may be way forward like this, and this, you're feeling a big stretch. The goal is to eventually go straight and maybe even back into it a little bit, really stretching that rectus femoris. The height of the chair may vary. At home, I use a couch, it's taller like this. You're going to feel a little more aggressive stretch the higher the surface you're stretching on, and again, the further you go back. I just go to where I feel the stretch. I sit there 15 to 30 seconds, just kind of breathe through it, and then I just make sure and switch and do both sides.
Brad: So I do want to address, he has a cushion that his knee is on. You know, if you don't have a cushion, you probably may not, simply use a pillow or two, something that cushions that knee, because it will not be comfortable. And it is nice when you do this on a piece of furniture that has some cushion as well, so it's a little more comfortable for your foot to lean against. This is something that, if you haven't done before, it's a little challenging for some people to get into this position. You may want to have a chair or just hold onto a stick of some sort so you have good stability and stretch away, and don't do it too aggressively the first time.
Mike: I personally feel it's more comfortable with a shoe or slipper on versus barefoot because you're going to extend your toes a little more, and it's a little more aggressive of a stretch.
Brad: Sure. We realize that that stretch may be difficult and maybe something you do not want to do, and that's fine. We're going to show you an option that will do the stretch quite reasonably well and give you good stability so you feel safe.
Mike: So you can do this on a stair with some railings. You can start on the first step if you want to work up on steps; you certainly can, depending upon your flexibility. Now we're going to be stretching the back leg. Once you're here, make sure your back leg is far enough back, and you feel a stretch. And then just lean forward.
Mike: Make sure to have a tall spine. Don't round forward. As soon as I lean forward, I start feeling a stretch. Just go with what range you feel the stretch. If you feel it here, that's fine. If you feel nothing and you want to work on it, you can go higher up on the step and really lean into it. This really stretches my hip flexor personally, but I don't have any arthritic pain, so I can get in here. But you can sit here for 15, 30 seconds. You can do oscillations, maybe go forward and then backward. It's just a good way to work on stretching that hip flexor. Again, switch sides. Make sure to work both sides. You may notice a difference. Spend a little extra time on the tighter side.
Brad: There you go. And obviously we didn't mention this, but you really need to have a pair of shorts or some pants that stretch and you really have some give, otherwise it will not be effective.
Mike: So when it comes to arthritis, it is important to get a proper diagnosis, whether they have to use MRIs or X-rays, that's up to your physician and you. But it is also important to work on your flexibility, mobility, and walking patterns when it comes to exercising and becoming pain-free.
Brad: So where can they get this information? Well, they can go to a therapist.
Mike: Yes, or you could check out more videos that we have. We have one specifically here for hand arthritis, some exercises.
Mike: I think Bob's in that video. They'll probably be happy.
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