Dr. J. Michael Bennett is a Board Certified Orthopedic Surgeon and Fellowship Trained Sports Medicine Doctor serving patients from Greater Houston through offices in Sugar Land and Houston, TX. If you’ve experienced a knee injury and would like an appointment, please call 281-633-8600.
This is the seventh part of the transcript of a radio show hosted by Dr. Bennett on 1560 The Game. With Dr. Bennett was Bob Lewis of 1560 and Dr. Stephen Simonich of Katy Orthopedics in Katy, TX.
Click here to go to the first portion of the show and here to link to the previous portion of the transcript.
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| Physical Therapy – Image via Wikipedia |
DR. STEPHEN SIMONICH – When we talk about knee arthritis treatments, one analogy that might help someone is to picture a cobblestone road and the dirt underneath it. We just can’t replace all of that, but if you have a pothole in the middle of a nicely smooth street that’s got a little hole in it, that can cause symptoms and there are some things that we can do now to replace the pothole without replacing the road. Replacing the road is getting a total knee replacement but replacing the pothole we can do with either some of your own cartilage or from a cadaver like we talked about with the ACLs, there’s some different types it’s actually a bone structure, so that’s something that if you want to ask your doctor, “Hey I heard this radio show and do I have a broken down street or do I have a pothole?” then they’ll tell you because we can do an MRI or an X-ray.
DR. J. MICHAEL BENNETT – Yeah exactly, that’s exactly right. I think it also depends on the lesion itself. If it is a small area of knee arthritis like a pothole – I like that analogy, I’m going to steal that from you, Steve – we can do plugs and can actually plug that pothole up with some cartilage from the knee or you can actually send off some cells and have them come back and implant those cells as well. It’s called autologous contrasight implantation, there’s also microfracture where we drill some holes in there that actually stimulate something that’s like cartilage to fill it up, so there are some options there. I’m not trying to say that if you have anything like that you go towards a replacement, there are different grades of injuries and different grades of arthritis and you have different options. So it’s definitely something you want to discuss with your orthopedic surgeon.
So going back to physical therapy, and this actually goes back to the caller we had previously with the anterior knee pain, in regards to therapy I can’t emphasize how important therapy is. I bring this up in all of my clinics with my patients and everybody kind of rolls their eyes and is like, “therapy, oh, I hate physical therapy, I don’t have time to do it,” well honestly, and then they go “well can I do it on my own at home?” I’m kind of hesitant, but if they’re adamant sometimes I’ll allow it, but I guarantee you that six weeks later they’ll come back and be like, “I don’t have the results. Why am I not getting better?” And I look at their quads and I look at their strength and they’re at the same place that they were six weeks prior.
So now I tell them, look, save you six weeks of grief, just go see a physical therapist or go see whoever you’re comfortable with – any of the chiropractors can do this as well – follow this protocol and you can really start working on the quads and you can start working on the hamstrings, getting some stretching going, and actually stabilize the knee. Because if you have a weak knee it’s like having a car that the shocks just haven’t been upgraded and you’re going to wear out your tires and the car’s just going to fall apart. You’ve got to build those shocks up and stabilize that car and you’re going to have to stabilize that knee, you’ve got to build those muscles up.
SIMONICH – We get this question a lot because people don’t want to go to physical therapy, but studies have shown it’s human nature that if we are held accountable to someone we are going to do it more, we know from studies that people will go to therapy and will do the therapy if they’re with a therapist more than they will on their own. What I encourage people to do is to go at least once or twice and get a good home program; they have to spend a couple of hours with somebody, they usually end up liking the therapist and keep going as opposed to doing it at home.
What you’re talking about earlier off the air with the previous caller about the patella femoral pain is another analogy that I like to use is it’s like a cycle, basically if your knee if painful it gets weaker because you don’t use it, and it then promotes more pain which promotes more weakness and you’ve got to get out of that cycle and the way to shoot out of that cycle without any surgery – and nobody wants surgery – is to do physical therapy, and you’ll kind of get right out of that circle onto a nice straight line where you’re back to doing the things you want to do and I think it’s very beneficial, we can’t state it enough. Even after surgery, some of the surgeries Jay and I do, you’ll hear us say that the post-operative physical therapy is as important as the surgical procedures that we do to the success of your outcome.
BENNETT – Just like everything I mentioned before, do your due diligence when you’re picking a physical therapy facility; talk to the therapist and make sure you guys are on the same page. They really do need to spend one on one time with you. I mean I’m not a big fan of the sticking you in the corner with some bands and telling you to, “hey, do 20 of these and I’m going to check on you in five or 10 minutes.” I like one on one time, going through the exercises with you, making sure you are doing them safely, because the last thing you want to do is to get another injury because you’re doing something wrong. You want to make sure you’re doing the exercises safely and you want to make sure you are following the protocols. There are a lot of programs out there that do a great job in regards to preventing injuries, how to land appropriately, how to jump appropriately, and getting the fast twitch muscle fibers to fire quickly. So when your doctor recommends therapy, don’t roll your eyes. It’s really in your best interest.
SIMONICH – I’d say again, we can’t stress it enough, Houston is a very active city, we have a lot of runners, a lot of endurance athletes, we clearly have one of the best youth programs – sports programs – probably in the country, and I’ve lived in a few different areas in the country and it really can’t be beat. And because of that, kids from young teenagers on up to people running marathons into their eighties are going to get some injury along the way but they don’t often all need surgery, I mean a lot of what we see in our orthopedic clinics is non-surgical patients.
Click here to link to the next portion of the transcript discussing supplements.
If you’ve experienced a knee injury or knee pain and would like an appointment with Dr. Bennett, please call 281-633-8600.
