如果你聽說最近有人做了膝關(guān)節(jié)或髖關(guān)節(jié)置換手術(shù),這種情況肯定不在少數(shù)。
這是因為,根據(jù)美國風濕病學(xué)會(American College of Rheumatology)的統(tǒng)計,美國每年進行79萬次全膝關(guān)節(jié)置換手術(shù)和54.4萬次髖關(guān)節(jié)置換手術(shù)。而且隨著嬰兒潮一代老去,這個數(shù)字預(yù)計會持續(xù)攀升。
這些數(shù)字意味著什么?尋求全膝關(guān)節(jié)或髖關(guān)節(jié)置換的患者,通常會經(jīng)歷嚴重的關(guān)節(jié)炎、骨折或損傷、牛皮癬或類風濕性關(guān)節(jié)炎等炎癥,導(dǎo)致關(guān)節(jié)痛、僵硬或水腫,無法使用藥物進行治療,或者因為職業(yè)或運動需求出現(xiàn)了磨損。也有人發(fā)現(xiàn),關(guān)節(jié)痛意味著他們無法從事遠足、滑雪、游泳、網(wǎng)球或匹克球等運動。
接受全膝關(guān)節(jié)或髖關(guān)節(jié)置換術(shù)后需要經(jīng)過近一年時間才能完全康復(fù),許多患者在兩三個月內(nèi)恢復(fù)正常活動。患者需要在幾周內(nèi)居家修養(yǎng),然后接受每周兩至三次醫(yī)院物理療法治療,之后才能開始按照醫(yī)囑居家鍛煉。
好消息是,我們可以采取一些措施,幫助預(yù)防膝關(guān)節(jié)和髖關(guān)節(jié)出現(xiàn)問題,甚至可以避免手術(shù)。
1. 保持健康體重
經(jīng)過專業(yè)認證的骨科外科醫(yī)生、加州奧蘭治縣豪格骨科中心(Hoag Orthopedic Institute)的執(zhí)行醫(yī)療總監(jiān)艾倫·拜爾博士表示,他在周播的骨科相關(guān)廣播節(jié)目《戰(zhàn)壕里的醫(yī)生》(Doctor in the Dugout)中最常聽到的問題是,體重及其對膝關(guān)節(jié)和髖關(guān)節(jié)的影響。
他表示:“體重與膝關(guān)節(jié)和髖關(guān)節(jié)健康直接相關(guān)。隨著年齡增長,保持合理體重是保證關(guān)節(jié)健康最有效的方法之一。例如,體重每增加一磅,意味著你的膝關(guān)節(jié)要多承受三磅的壓力。”
如果你患有髖關(guān)節(jié)或膝關(guān)節(jié)疼痛,且與外傷或疾病無關(guān),那么減肥可以幫助緩解當前的不適。
他說道:“在患者接受髖關(guān)節(jié)或膝關(guān)節(jié)置換手術(shù)之前,他們的骨科外科醫(yī)生可能會告訴他們減肥,以幫助康復(fù)。這是一個數(shù)學(xué)問題。你的體重越大,每走一步關(guān)節(jié)都要承受更大壓力。”
2. 養(yǎng)成力量訓(xùn)練的習慣
希望膝關(guān)節(jié)和髖關(guān)節(jié)保持強壯和功能良好?
針對支撐關(guān)節(jié)的關(guān)鍵腿部肌肉,從事負重訓(xùn)練。例如,如果膝關(guān)節(jié)周圍的肌肉足夠強壯,如股四頭肌、臀大肌、股后肌群和腹肌等,就能減輕髖關(guān)節(jié)支撐體重所承受的壓力。同樣,通過鍛煉股四頭肌,可以減少膝關(guān)節(jié)吸收的沖擊。
Lifted Method的創(chuàng)始人霍利·雷林格表示:“專注于能夠增強臀大肌、股后肌群和股四頭肌的體育運動。最好的方式是使用器械和/或舉重器材。深蹲、硬舉和弓步蹲等啞鈴訓(xùn)練,都能鍛煉這些肌群。如果能去健身房,可以使用腿部推蹬機、腿部伸展機和腿部彎舉機等器械。如果無法去健身房,臀橋和靠墻深蹲、自重深蹲和單足登臺階(即登上高于膝蓋的表面)等動作,都是很好的入門鍛煉方式。”
此外,經(jīng)常從事拉伸和靈活性運動,如瑜伽或普拉提等,可以作為輔助練習。這兩種運動可以幫助增加膝關(guān)節(jié)與髖關(guān)節(jié)周圍的肌肉和韌帶的活動范圍,避免與肌肉緊張有關(guān)的損傷。
3. 通過飲食保證關(guān)節(jié)健康
有研究發(fā)現(xiàn),地中海飲食可以幫助骨關(guān)節(jié)炎患者減少炎癥,還有助于控制體重和骨折風險。
地中海飲食主要包括新鮮水果蔬菜、全谷物和富含健康脂肪的植物性食品,如堅果、種子和豆類等。這類飲食使用橄欖油,而不是植物油和動物脂肪。此外,還建議使用富含歐米伽-3脂肪酸的魚類,如三文魚、沙丁魚、金槍魚、鯡魚和鯖魚等。含精制糖食物、高脂肪酸奶和紅肉等容易引發(fā)炎癥的食物,應(yīng)該限制為每周一次。
拜爾表示:“為保證骨骼強健,還應(yīng)該食用更多含鈣食物。”其中包括低脂酸奶和乳酪,脂肪含量1%或更低的牛奶、以及綠甘藍、芥蘭、羽衣甘藍和白菜等綠葉蔬菜等。
4. 保持恰當?shù)淖藙?/strong>
我們小時候經(jīng)常被告誡要站直。事實證明,這個建議能夠保持膝關(guān)節(jié)和髖關(guān)節(jié)健康。
拜爾表示:“姿勢在人體關(guān)節(jié)中發(fā)揮著重要作用。從脊柱到髖關(guān)節(jié)、膝關(guān)節(jié)和腕關(guān)節(jié),姿勢的影響可能長期累積,引發(fā)關(guān)節(jié)疼痛。雖然姿勢的影響可能與長期髖關(guān)節(jié)和膝關(guān)節(jié)疼痛有關(guān),但其主要影響是加劇關(guān)節(jié)存在的基本問題。糟糕的姿勢習慣會讓疼痛加劇。”
他建議許多患者注意自己的姿勢,尤其是久坐的患者;要選合適的鞋子,而且要使用人體工學(xué)設(shè)計的工作站。
他還建議患者警惕所謂的“科技頸“,即因大量玩游戲或使用手機導(dǎo)致的脖子和上背部疼痛。
拜爾說道:“需要根據(jù)身體狀況糾正任何姿勢問題。如果久坐者發(fā)現(xiàn)髖關(guān)節(jié)或膝關(guān)節(jié)疼痛增多,一定要站起來活動。在飛機上也一樣,你可能長時間保持一個姿勢。你可以向骨科醫(yī)生尋求姿勢方面的建議,了解如何減少關(guān)節(jié)疼痛和長期風險,以及這些關(guān)節(jié)存在的基本問題是否可能是導(dǎo)致不適的直接原因。”(財富中文網(wǎng))
譯者:劉進龍
審校:汪皓
如果你聽說最近有人做了膝關(guān)節(jié)或髖關(guān)節(jié)置換手術(shù),這種情況肯定不在少數(shù)。
這是因為,根據(jù)美國風濕病學(xué)會(American College of Rheumatology)的統(tǒng)計,美國每年進行79萬次全膝關(guān)節(jié)置換手術(shù)和54.4萬次髖關(guān)節(jié)置換手術(shù)。而且隨著嬰兒潮一代老去,這個數(shù)字預(yù)計會持續(xù)攀升。
這些數(shù)字意味著什么?尋求全膝關(guān)節(jié)或髖關(guān)節(jié)置換的患者,通常會經(jīng)歷嚴重的關(guān)節(jié)炎、骨折或損傷、牛皮癬或類風濕性關(guān)節(jié)炎等炎癥,導(dǎo)致關(guān)節(jié)痛、僵硬或水腫,無法使用藥物進行治療,或者因為職業(yè)或運動需求出現(xiàn)了磨損。也有人發(fā)現(xiàn),關(guān)節(jié)痛意味著他們無法從事遠足、滑雪、游泳、網(wǎng)球或匹克球等運動。
接受全膝關(guān)節(jié)或髖關(guān)節(jié)置換術(shù)后需要經(jīng)過近一年時間才能完全康復(fù),許多患者在兩三個月內(nèi)恢復(fù)正常活動。患者需要在幾周內(nèi)居家修養(yǎng),然后接受每周兩至三次醫(yī)院物理療法治療,之后才能開始按照醫(yī)囑居家鍛煉。
好消息是,我們可以采取一些措施,幫助預(yù)防膝關(guān)節(jié)和髖關(guān)節(jié)出現(xiàn)問題,甚至可以避免手術(shù)。
1. 保持健康體重
經(jīng)過專業(yè)認證的骨科外科醫(yī)生、加州奧蘭治縣豪格骨科中心(Hoag Orthopedic Institute)的執(zhí)行醫(yī)療總監(jiān)艾倫·拜爾博士表示,他在周播的骨科相關(guān)廣播節(jié)目《戰(zhàn)壕里的醫(yī)生》(Doctor in the Dugout)中最常聽到的問題是,體重及其對膝關(guān)節(jié)和髖關(guān)節(jié)的影響。
他表示:“體重與膝關(guān)節(jié)和髖關(guān)節(jié)健康直接相關(guān)。隨著年齡增長,保持合理體重是保證關(guān)節(jié)健康最有效的方法之一。例如,體重每增加一磅,意味著你的膝關(guān)節(jié)要多承受三磅的壓力。”
如果你患有髖關(guān)節(jié)或膝關(guān)節(jié)疼痛,且與外傷或疾病無關(guān),那么減肥可以幫助緩解當前的不適。
他說道:“在患者接受髖關(guān)節(jié)或膝關(guān)節(jié)置換手術(shù)之前,他們的骨科外科醫(yī)生可能會告訴他們減肥,以幫助康復(fù)。這是一個數(shù)學(xué)問題。你的體重越大,每走一步關(guān)節(jié)都要承受更大壓力。”
2. 養(yǎng)成力量訓(xùn)練的習慣
希望膝關(guān)節(jié)和髖關(guān)節(jié)保持強壯和功能良好?
針對支撐關(guān)節(jié)的關(guān)鍵腿部肌肉,從事負重訓(xùn)練。例如,如果膝關(guān)節(jié)周圍的肌肉足夠強壯,如股四頭肌、臀大肌、股后肌群和腹肌等,就能減輕髖關(guān)節(jié)支撐體重所承受的壓力。同樣,通過鍛煉股四頭肌,可以減少膝關(guān)節(jié)吸收的沖擊。
Lifted Method的創(chuàng)始人霍利·雷林格表示:“專注于能夠增強臀大肌、股后肌群和股四頭肌的體育運動。最好的方式是使用器械和/或舉重器材。深蹲、硬舉和弓步蹲等啞鈴訓(xùn)練,都能鍛煉這些肌群。如果能去健身房,可以使用腿部推蹬機、腿部伸展機和腿部彎舉機等器械。如果無法去健身房,臀橋和靠墻深蹲、自重深蹲和單足登臺階(即登上高于膝蓋的表面)等動作,都是很好的入門鍛煉方式。”
此外,經(jīng)常從事拉伸和靈活性運動,如瑜伽或普拉提等,可以作為輔助練習。這兩種運動可以幫助增加膝關(guān)節(jié)與髖關(guān)節(jié)周圍的肌肉和韌帶的活動范圍,避免與肌肉緊張有關(guān)的損傷。
3. 通過飲食保證關(guān)節(jié)健康
有研究發(fā)現(xiàn),地中海飲食可以幫助骨關(guān)節(jié)炎患者減少炎癥,還有助于控制體重和骨折風險。
地中海飲食主要包括新鮮水果蔬菜、全谷物和富含健康脂肪的植物性食品,如堅果、種子和豆類等。這類飲食使用橄欖油,而不是植物油和動物脂肪。此外,還建議使用富含歐米伽-3脂肪酸的魚類,如三文魚、沙丁魚、金槍魚、鯡魚和鯖魚等。含精制糖食物、高脂肪酸奶和紅肉等容易引發(fā)炎癥的食物,應(yīng)該限制為每周一次。
拜爾表示:“為保證骨骼強健,還應(yīng)該食用更多含鈣食物。”其中包括低脂酸奶和乳酪,脂肪含量1%或更低的牛奶、以及綠甘藍、芥蘭、羽衣甘藍和白菜等綠葉蔬菜等。
4. 保持恰當?shù)淖藙?/p>
我們小時候經(jīng)常被告誡要站直。事實證明,這個建議能夠保持膝關(guān)節(jié)和髖關(guān)節(jié)健康。
拜爾表示:“姿勢在人體關(guān)節(jié)中發(fā)揮著重要作用。從脊柱到髖關(guān)節(jié)、膝關(guān)節(jié)和腕關(guān)節(jié),姿勢的影響可能長期累積,引發(fā)關(guān)節(jié)疼痛。雖然姿勢的影響可能與長期髖關(guān)節(jié)和膝關(guān)節(jié)疼痛有關(guān),但其主要影響是加劇關(guān)節(jié)存在的基本問題。糟糕的姿勢習慣會讓疼痛加劇。”
他建議許多患者注意自己的姿勢,尤其是久坐的患者;要選合適的鞋子,而且要使用人體工學(xué)設(shè)計的工作站。
他還建議患者警惕所謂的“科技頸“,即因大量玩游戲或使用手機導(dǎo)致的脖子和上背部疼痛。
拜爾說道:“需要根據(jù)身體狀況糾正任何姿勢問題。如果久坐者發(fā)現(xiàn)髖關(guān)節(jié)或膝關(guān)節(jié)疼痛增多,一定要站起來活動。在飛機上也一樣,你可能長時間保持一個姿勢。你可以向骨科醫(yī)生尋求姿勢方面的建議,了解如何減少關(guān)節(jié)疼痛和長期風險,以及這些關(guān)節(jié)存在的基本問題是否可能是導(dǎo)致不適的直接原因。”(財富中文網(wǎng))
譯者:劉進龍
審校:汪皓
If you know someone that has had a knee or hip replacement recently, you’re probably not alone.
That’s because about 790,000 total knee replacements and 544,000 hip replacements are performed every year in the U.S., according to the American College of Rheumatology. And that number is expected to rise as the baby boomer population ages.
What’s behind these numbers? Patients seeking a total joint replacement of the knee or hip often experience severe arthritis, bone fractures or injuries, inflammatory conditions such as psoriatic or rheumatoid arthritis that result in joint pain, stiffness, or swelling and can no longer be treated with medication, or wear and tear due to occupational or athletic demands. Others find their joint pain means they can no longer enjoy certain activities like hiking, skiing, swimming, or playing tennis or pickleball.
It takes about a year to fully recover from a total knee or hip replacement surgery, with many patients resuming normal activities within two to three months. Patients will be required to rest at home for several weeks, then maintain a two-to-three-times-a-week in-office physical therapy regimen before continuing the exercises they are prescribed at home.
The good news is that there are steps you can take to help prevent knee and hip problems and potentially avoid surgery.
1. Maintain a healthy weight
Dr. Alan Beyer, board-certified orthopedic surgeon, and executive medical director at Hoag Orthopedic Institute in Orange County, Calif., says concern about weight and its effects on the hip and knee joints is the most common question he gets on his weekly orthopedic-based radio show, Doctor in the Dugout.
“Weight is directly related to your hip and knee joint health,” he says. “Keeping your ideal weight as you age is one of the best things you can do for your body’s joints. For every pound you add to your body, that one pound translates into three more pounds of pressure on your knee joints, for example.”
If you have hip or knee pain that’s unrelated to an injury or disease, losing weight can help ease your current discomfort.
“Before a patient is a candidate for a hip or knee replacement, they may be advised by their orthopedic surgeon to lose some weight to help in recovery and rehabilitation,” he says. “It’s math. The more you weigh, the more strain on your joints with every step.”
2. Make strength training a habit
Want to keep your knees and hips strong and functioning well?
Befriend weight-bearing exercises that target leg muscles crucial to supporting these joints. Your hips, for example, will have to do less work to support your body weight if the muscles surrounding them—the quadriceps, gluteals, hamstrings, and abdominal muscles—are strong. Similarly, you can reduce the shock your knee absorbs by strengthening your quadriceps muscle.
“Focus on exercises that strengthen the glutes, hamstrings, and quads,” says Holly Rilinger, founder of the Lifted Method. “The best way to do this is to use machines and/or free weights. Squats, deadlifts, and lunges are dumbbell exercises that target these muscle groups. If you have access to a gym, use machines like the leg press, leg extension, and leg curl. If you don’t have access to either, then glute bridges and wall sits, bodyweight squats, and steps ups, which are stepping up onto a surface that is higher than knee level, are a great place to start.”
Complement these exercises with regular stretching and flexibility movements such as yoga or Pilates. Both can help increase the range of motion in the muscles and ligaments around the knees and hips, and protect against injuries associated with tight muscles.
3. Eat for joint health
Some studies have found that adopting a Mediterranean diet can reduce inflammation in those who suffer from osteoarthritis, as well as help control weight and bone fracture risk.
Key components of the Mediterranean diet include fresh fruits and vegetables; whole grains; and plant-based foods rich in healthy fats such as nuts, seeds, and legumes. Olive oil is used instead of vegetable oil and animal fats. Fish rich in omega-3 fatty acids including salmon, sardines, tuna, herring, and mackerel are also recommended. Inflammatory foods that contain refined sugar, high-fat dairy, and red meat should be limited to one serving a week.
“More calcium-based foods should be included in your diet to ensure strong bones,” says Beyer. These include low-fat yogurt and cottage cheese, 1% or less milk, and green, leafy vegetables such as collard greens, broccoli rabe, kale, and bok choy.
4. Maintain proper posture
When you were young you were often told to stand up straight. Turns out that advice was keeping your knees and hips healthy.
“Posture plays a role in all our body’s joints,” says Beyer. “From the spine to our hips, knees, and wrists, posture’s effects may accumulate over a long period and cause us pain. While posture’s effects may be relevant to long-term hip and knee pain, the effect is mostly exacerbation of the underlying health of a joint. Bad posture habits can make the pain worse.”
He advises many of his patients to be aware of their posture, especially when they are sitting for long periods of time; to wear proper footwear; and to use ergonomically designed workstations.
He also urges his patients to be aware of so-called “tech neck,” or neck and upper-back pain that results from too much gaming or mobile phone use.
“To correct any posture issue, listen to your own body,” says Beyer. “If you sit for long periods and you notice more hip or knee pain, make sure you get up and move around. Same as on a plane, where you might be in one position too long. You can talk to an orthopedist about your posture for tips on how to limit your pain and lessen long-term risk to those joints, and see if there is an underlying issue with those joints that may be more of a direct cause to your discomfort.”