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如果你听说最近有人做了膝关节或髋关节置换手术,这种情况肯定不在少数。
这是因为,根据美国风湿病学会(American College of Rheumatology)的统计,美国每年进行79万次全膝关节置换手术和54.4万次髋关节置换手术。而且随着婴儿潮一代老去,这个数字预计会持续攀升。
这些数字意味着什么?寻求全膝关节或髋关节置换的患者,通常会经历严重的关节炎、骨折或损伤、牛皮癣或类风湿性关节炎等炎症,导致关节痛、僵硬或水肿,无法使用药物进行治疗,或者因为职业或运动需求出现了磨损。也有人发现,关节痛意味着他们无法从事远足、滑雪、游泳、网球或匹克球等运动。
接受全膝关节或髋关节置换术后需要经过近一年时间才能完全康复,许多患者在两三个月内恢复正常活动。患者需要在几周内居家修养,然后接受每周两至三次医院物理疗法治疗,之后才能开始按照医嘱居家锻炼。
好消息是,我们可以采取一些措施,帮助预防膝关节和髋关节出现问题,甚至可以避免手术。
1. 保持健康体重
经过专业认证的骨科外科医生、加州奥兰治县豪格骨科中心(Hoag Orthopedic Institute)的执行医疗总监艾伦·拜尔博士表示,他在周播的骨科相关广播节目《战壕里的医生》(Doctor in the Dugout)中最常听到的问题是,体重及其对膝关节和髋关节的影响。
他表示:“体重与膝关节和髋关节健康直接相关。随着年龄增长,保持合理体重是保证关节健康最有效的方法之一。例如,体重每增加一磅,意味着你的膝关节要多承受三磅的压力。”
如果你患有髋关节或膝关节疼痛,且与外伤或疾病无关,那么减肥可以帮助缓解当前的不适。
他说道:“在患者接受髋关节或膝关节置换手术之前,他们的骨科外科医生可能会告诉他们减肥,以帮助康复。这是一个数学问题。你的体重越大,每走一步关节都要承受更大压力。”
2. 养成力量训练的习惯
希望膝关节和髋关节保持强壮和功能良好?
针对支撑关节的关键腿部肌肉,从事负重训练。例如,如果膝关节周围的肌肉足够强壮,如股四头肌、臀大肌、股后肌群和腹肌等,就能减轻髋关节支撑体重所承受的压力。同样,通过锻炼股四头肌,可以减少膝关节吸收的冲击。
Lifted Method的创始人霍利·雷林格表示:“专注于能够增强臀大肌、股后肌群和股四头肌的体育运动。最好的方式是使用器械和/或举重器材。深蹲、硬举和弓步蹲等哑铃训练,都能锻炼这些肌群。如果能去健身房,可以使用腿部推蹬机、腿部伸展机和腿部弯举机等器械。如果无法去健身房,臀桥和靠墙深蹲、自重深蹲和单足登台阶(即登上高于膝盖的表面)等动作,都是很好的入门锻炼方式。”
此外,经常从事拉伸和灵活性运动,如瑜伽或普拉提等,可以作为辅助练习。这两种运动可以帮助增加膝关节与髋关节周围的肌肉和韧带的活动范围,避免与肌肉紧张有关的损伤。
3. 通过饮食保证关节健康
有研究发现,地中海饮食可以帮助骨关节炎患者减少炎症,还有助于控制体重和骨折风险。
地中海饮食主要包括新鲜水果蔬菜、全谷物和富含健康脂肪的植物性食品,如坚果、种子和豆类等。这类饮食使用橄榄油,而不是植物油和动物脂肪。此外,还建议使用富含欧米伽-3脂肪酸的鱼类,如三文鱼、沙丁鱼、金枪鱼、鲱鱼和鲭鱼等。含精制糖食物、高脂肪酸奶和红肉等容易引发炎症的食物,应该限制为每周一次。
拜尔表示:“为保证骨骼强健,还应该食用更多含钙食物。”其中包括低脂酸奶和乳酪,脂肪含量1%或更低的牛奶、以及绿甘蓝、芥兰、羽衣甘蓝和白菜等绿叶蔬菜等。
4. 保持恰当的姿势
我们小时候经常被告诫要站直。事实证明,这个建议能够保持膝关节和髋关节健康。
拜尔表示:“姿势在人体关节中发挥着重要作用。从脊柱到髋关节、膝关节和腕关节,姿势的影响可能长期累积,引发关节疼痛。虽然姿势的影响可能与长期髋关节和膝关节疼痛有关,但其主要影响是加剧关节存在的基本问题。糟糕的姿势习惯会让疼痛加剧。”
他建议许多患者注意自己的姿势,尤其是久坐的患者;要选合适的鞋子,而且要使用人体工学设计的工作站。
他还建议患者警惕所谓的“科技颈“,即因大量玩游戏或使用手机导致的脖子和上背部疼痛。
拜尔说道:“需要根据身体状况纠正任何姿势问题。如果久坐者发现髋关节或膝关节疼痛增多,一定要站起来活动。在飞机上也一样,你可能长时间保持一个姿势。你可以向骨科医生寻求姿势方面的建议,了解如何减少关节疼痛和长期风险,以及这些关节存在的基本问题是否可能是导致不适的直接原因。”(财富中文网)
译者:刘进龙
审校:汪皓
如果你听说最近有人做了膝关节或髋关节置换手术,这种情况肯定不在少数。
这是因为,根据美国风湿病学会(American College of Rheumatology)的统计,美国每年进行79万次全膝关节置换手术和54.4万次髋关节置换手术。而且随着婴儿潮一代老去,这个数字预计会持续攀升。
这些数字意味着什么?寻求全膝关节或髋关节置换的患者,通常会经历严重的关节炎、骨折或损伤、牛皮癣或类风湿性关节炎等炎症,导致关节痛、僵硬或水肿,无法使用药物进行治疗,或者因为职业或运动需求出现了磨损。也有人发现,关节痛意味着他们无法从事远足、滑雪、游泳、网球或匹克球等运动。
接受全膝关节或髋关节置换术后需要经过近一年时间才能完全康复,许多患者在两三个月内恢复正常活动。患者需要在几周内居家修养,然后接受每周两至三次医院物理疗法治疗,之后才能开始按照医嘱居家锻炼。
好消息是,我们可以采取一些措施,帮助预防膝关节和髋关节出现问题,甚至可以避免手术。
1. 保持健康体重
经过专业认证的骨科外科医生、加州奥兰治县豪格骨科中心(Hoag Orthopedic Institute)的执行医疗总监艾伦·拜尔博士表示,他在周播的骨科相关广播节目《战壕里的医生》(Doctor in the Dugout)中最常听到的问题是,体重及其对膝关节和髋关节的影响。
他表示:“体重与膝关节和髋关节健康直接相关。随着年龄增长,保持合理体重是保证关节健康最有效的方法之一。例如,体重每增加一磅,意味着你的膝关节要多承受三磅的压力。”
如果你患有髋关节或膝关节疼痛,且与外伤或疾病无关,那么减肥可以帮助缓解当前的不适。
他说道:“在患者接受髋关节或膝关节置换手术之前,他们的骨科外科医生可能会告诉他们减肥,以帮助康复。这是一个数学问题。你的体重越大,每走一步关节都要承受更大压力。”
2. 养成力量训练的习惯
希望膝关节和髋关节保持强壮和功能良好?
针对支撑关节的关键腿部肌肉,从事负重训练。例如,如果膝关节周围的肌肉足够强壮,如股四头肌、臀大肌、股后肌群和腹肌等,就能减轻髋关节支撑体重所承受的压力。同样,通过锻炼股四头肌,可以减少膝关节吸收的冲击。
Lifted Method的创始人霍利·雷林格表示:“专注于能够增强臀大肌、股后肌群和股四头肌的体育运动。最好的方式是使用器械和/或举重器材。深蹲、硬举和弓步蹲等哑铃训练,都能锻炼这些肌群。如果能去健身房,可以使用腿部推蹬机、腿部伸展机和腿部弯举机等器械。如果无法去健身房,臀桥和靠墙深蹲、自重深蹲和单足登台阶(即登上高于膝盖的表面)等动作,都是很好的入门锻炼方式。”
此外,经常从事拉伸和灵活性运动,如瑜伽或普拉提等,可以作为辅助练习。这两种运动可以帮助增加膝关节与髋关节周围的肌肉和韧带的活动范围,避免与肌肉紧张有关的损伤。
3. 通过饮食保证关节健康
有研究发现,地中海饮食可以帮助骨关节炎患者减少炎症,还有助于控制体重和骨折风险。
地中海饮食主要包括新鲜水果蔬菜、全谷物和富含健康脂肪的植物性食品,如坚果、种子和豆类等。这类饮食使用橄榄油,而不是植物油和动物脂肪。此外,还建议使用富含欧米伽-3脂肪酸的鱼类,如三文鱼、沙丁鱼、金枪鱼、鲱鱼和鲭鱼等。含精制糖食物、高脂肪酸奶和红肉等容易引发炎症的食物,应该限制为每周一次。
拜尔表示:“为保证骨骼强健,还应该食用更多含钙食物。”其中包括低脂酸奶和乳酪,脂肪含量1%或更低的牛奶、以及绿甘蓝、芥兰、羽衣甘蓝和白菜等绿叶蔬菜等。
4. 保持恰当的姿势
我们小时候经常被告诫要站直。事实证明,这个建议能够保持膝关节和髋关节健康。
拜尔表示:“姿势在人体关节中发挥着重要作用。从脊柱到髋关节、膝关节和腕关节,姿势的影响可能长期累积,引发关节疼痛。虽然姿势的影响可能与长期髋关节和膝关节疼痛有关,但其主要影响是加剧关节存在的基本问题。糟糕的姿势习惯会让疼痛加剧。”
他建议许多患者注意自己的姿势,尤其是久坐的患者;要选合适的鞋子,而且要使用人体工学设计的工作站。
他还建议患者警惕所谓的“科技颈“,即因大量玩游戏或使用手机导致的脖子和上背部疼痛。
拜尔说道:“需要根据身体状况纠正任何姿势问题。如果久坐者发现髋关节或膝关节疼痛增多,一定要站起来活动。在飞机上也一样,你可能长时间保持一个姿势。你可以向骨科医生寻求姿势方面的建议,了解如何减少关节疼痛和长期风险,以及这些关节存在的基本问题是否可能是导致不适的直接原因。”(财富中文网)
译者:刘进龙
审校: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.”