Spring is a good time for sports, but don’t let your knees hold you back

The Yellow Emperor's Classic of Internal Medicine says: "The third month of spring is the time for the beginning of the new year. Heaven and earth are both alive, and all things are flourishing. Sleep late and get up early, walk around the courtyard, let your hair down and relax your body, so that your spirit can grow." This introduces the natural changes in spring and people's daily life and exercise methods. Spring is the time when all things sprout, and it is also a good time to exercise. Appropriate outdoor activities in spring can help you absorb qi and preserve essence, strengthen your physical fitness, and thus better resist various respiratory diseases and infectious diseases. With the arrival of the Rain Water solar term, the weather is gradually getting warmer. Many people who have reduced their exercise due to the cold winter are now starting to make spring exercise plans.

Lu Jianhua, chairman of the Science Popularization Branch of Zhejiang Association of Traditional Chinese Medicine and chief Chinese medicine practitioner of the Orthopedics Department of Zhejiang Provincial Hospital of Traditional Chinese Medicine, pointed out that the knee joints are the hardest hit areas of bone diseases in spring. The main reason is that the weather in spring is changeable and the temperature difference is large. Wind, cold and dampness invade the human body's muscle surface meridians, causing poor circulation of qi and blood. At this time, you must keep warm when exercising, and pay special attention to avoiding cold in the knee joints to avoid knee osteoarthritis.

What is knee osteoarthritis

Lu Jianhua introduced that knee osteoarthritis is a common chronic joint disease in clinical practice, which is mainly manifested by knee pain, joint swelling, limited activity, and muscle atrophy in the late stage. Knee osteoarthritis is not actually an infectious inflammation. It is a disease caused by the brittleness of articular cartilage as people age, the damage of cartilage due to uneven pressure, and excessive joint activity and accumulated strain. It is a manifestation of joints in the aging process, so it is also called senile arthritis, which is more common in middle-aged and elderly people over 50 years old. Obesity, a history of knee trauma, long-term squatting or climbing stairs, and long-term coldness of the knee joints can also cause knee osteoarthritis.

From the perspective of traditional Chinese medicine, knee arthritis belongs to the category of bone arthritis in arthralgia. Patients are often older, and most of them are caused by liver and kidney deficiency, insufficient qi and blood, and malnutrition of tendons and bones. Some relatively young patients, such as athletes and long-distance runners, suffer from long-term overwork of joints, which damages tendons and bones, stagnation of qi and blood, and malnutrition of tendons and bones. In addition, the occurrence of the disease is also related to the invasion of external evils such as wind, cold, and dampness. Evil qi blocks the knee meridians, causing poor circulation of qi and blood, resulting in pain, swelling, stiffness, heaviness, soreness, or poor flexion and extension of the knee joints.

Self-identification of knee osteoarthritis

Lu Jianhua pointed out that the pain of knee osteoarthritis gradually worsens, and in severe cases it affects walking, and is often accompanied by knee joint deformity. When patients are in the early stages of knee osteoarthritis, the pain is mild and occurs occasionally, so it is easy to be ignored until the pain gradually worsens and persists. At this point, the severity of osteoarthritis may have developed, and this disease must be treated as soon as possible. Don't think it's a small matter and it will pass if you just endure it.

Lu Jianhua said that the final diagnosis of knee osteoarthritis often needs to be confirmed by symptoms, signs, laboratory tests and imaging performance. However, patients can also preliminarily judge the severity of their disease based on pain during the onset of the disease. For example, if the knee joint is swollen, painful, and limited in movement without obvious trauma, and the symptoms are aggravated by joint movement and relieved with rest, it indicates that the knee osteoarthritis is in a mild or moderate state; if the pain persists and it still hurts when resting, this is a serious signal of local inflammation in the joint, indicating that the knee osteoarthritis is basically in an advanced state. At this time, due to the serious loss of articular cartilage, the pain symptoms persist; if the pain symptoms continue for more than 6 months, it is chronic pain. Once it is chronic pain, the patient's life and psychological feelings will be seriously affected.

Knee osteoarthritis, TCM treats both internal and external factors

Lu Jianhua explained that the current treatments for knee osteoarthritis are mainly divided into physical therapy, oral medication, sodium hyaluronate and glucocorticoid injections, etc. For more severe knee osteoarthritis, arthroscopy or artificial joint replacement surgery is required. Traditional Chinese medicine has its unique clinical efficacy in the treatment of knee osteoarthritis. The treatment methods include oral and external Chinese medicine, which can regulate the overall function from the inside, nourish the liver and kidney, strengthen the tendons and bones, and promote blood circulation and remove blood stasis, and can also relax the tendons and dredge the meridians, warm the meridians and dispel cold and dampness from the outside to treat local symptoms.

There are many traditional Chinese medicine prescriptions for the treatment of knee osteoarthritis. In terms of treatment principles, they can be roughly divided into tonifying the liver and kidney, strengthening the tendons and bones, activating blood circulation and removing blood stasis, dispelling wind and dampness, warming the meridians and unblocking the collaterals, clearing away heat and removing dampness, and nourishing qi and blood. A relatively typical prescription is Duhuo Jisheng Decoction. The main drug in the prescription is Duhuo, which is good at treating wind, cold and dampness between the tendons and bones of the lower limbs; it is supplemented by Fangfeng, Qinjiao, Cinnamon, and Asarum to dispel rheumatism, disperse wind and cold, and dredge the meridians. It is supplemented by Viscum, Eucommia, and Achyranthes to tonify the liver and kidney and strengthen the tendons and bones. Codonopsis, Poria, and Licorice can tonify qi and strengthen the spleen, while Angelica, Rehmannia, White Peony, and Chuanxiong can tonify blood and activate blood circulation. The combination of these medicines embodies the characteristics of dispelling rheumatism, stopping arthralgia and tonifying the liver and kidney, and tonifying qi and blood, treating the symptoms and the root causes at the same time, and taking into account both the evil and the righteous. Other prescriptions include Bushen Zhuangjin Decoction, Qunbi Decoction, Simiao Pills, Taohong Siwu Decoction, Bazhen Decoction, etc., which should be used according to the syndrome type.

In addition to taking Chinese medicine internally, you can also use Chinese medicine fumigation, hot compress, external plaster, massage, acupuncture and other external treatments. Among them, acupuncture treatment has a good effect on the early and middle stages of knee osteoarthritis and can effectively relieve symptoms in a timely manner. Acupoints such as Nei Xiyan, Yanglingquan, Liangqiu, Sanyinjiao, and Zusanli are often selected to dispel wind and cold, relax muscles and tendons, reduce swelling and relieve pain, and replenish qi and blood, which have a good effect on knee joint pain.

Lu Jianhua introduced a Chinese medicine fumigation and massage method to patients with knee osteoarthritis: take 10g of moxa leaf, 9g of perilla, 12g of Sichuan pepper, 6g of cinnamon, 10g of ginger skin, 15g of galangal, 6g of asarum, 15g of spatholobi, 10g of radix schizonepetae, 9g of safflower, 6g of roasted chuanwu, 6g of roasted caowu, 30g of rhizoma smilacis Glabrae, decoct for about 30 minutes, fumigate with a towel or gauze for about 30 minutes, scrub clean and massage both legs, first rub the pain point on the inside of the knee joint 30-50 times; then press Zusanli acupoint, Yanglingquan acupoint, Yinlingquan acupoint, etc. 30-50 times; finally pat both sides of the knee 30-50 times. For patients with knee joint disease, insisting on using this method of fumigation and massage can help the knee circulate qi and blood, warm the meridians and relieve the discomfort caused by knee osteoarthritis.

Lu Jianhua also introduced that Zhu Danxi, a famous Chinese medicine expert of Zhejiang School, believed that blood flows when it encounters heat and coagulates when it encounters cold, so all diseases with coagulation of qi and blood can be treated with warm moxibustion. Knee osteoarthritis can also be treated through ginger moxibustion. The specific method is: select fresh ginger, cut ginger slices with a thickness of about 3mm along the maximum diameter, and pierce 9 needle holes to facilitate the penetration of heat. Take the six acupoints of Xuehai, Liangqiu, Xiyan, Dubi, Yanglingquan, and Yinlingquan. Light one moxa stick each time and place it on the ginger slices. Place the ginger slices on the above acupoints and moxibustion them in turn. When the skin is red and painful, rotate the acupoints. After the moxibustion treatment, flex and stretch the knee joints. 2 times/day, 20 minutes/time, 7 days as a course of treatment, and moxibustion for 2 courses in a row.

Three parts treatment and seven parts maintenance

"With the diversification of work and lifestyle, knee osteoarthritis is becoming younger and younger. At the same time, with the aging of the population, the incidence of knee osteoarthritis is gradually increasing, so as clinicians, we feel that the number of patients with knee osteoarthritis is increasing."

Lu Jianhua said that in the face of knee osteoarthritis, 30% depends on treatment and 70% depends on maintenance. And maintenance should start from a young age. It is recommended to do the following:

1. Keep warm: When the ambient temperature changes, keeping warm is the key. People with knee discomfort should try to wear long pants and knee pads to keep warm and prevent knee injuries. Especially now that it is the transition season between winter and spring, pay attention to keeping the knee joints cold and frozen, and avoid direct exposure to air conditioners or electric fans in summer.

2. Lose weight: There is a correlation between knee osteoarthritis and weight. Weight loss can relieve joint pain and limited mobility. Therefore, obese people should control their diet, lose weight, reduce the load on their joints, and consume more foods containing protein, vitamins and minerals.

3. Moderate exercise: Try to avoid activities during the acute phase. Those in the remission period should move the joints appropriately to strengthen the muscles and ligaments around the joints, such as swimming, cycling, and appropriate walking. The amount of activity should be enough to make the body sweat slightly. Try to avoid going up and down stairs, climbing mountains, and squatting. Elderly patients can use tools such as canes and walkers to reduce the load on the knee joints.

4. Balanced diet: Necessary nutritional supplements and dietary control are very necessary for the prevention and treatment of knee osteoarthritis. Patients with knee osteoarthritis need to ensure the health of joint cartilage through vitamins such as vitamin C and trace elements, eat more whole grains, fat-free or low-fat diets, fruits, vegetables, lean meat, beans and nuts. Avoid strong tea, tobacco, alcohol, coffee and foods containing a large amount of chemical additives to avoid aggravating joint symptoms. Patients with knee osteoarthritis generally have a cold and damp constitution, which can be conditioned through the warming effect of food. As the folk proverb "eat radish in winter and ginger in summer", in summer, the yang energy leaks out, and eating ginger can warm the middle yang, which has a good health care effect on the internal organs.

5. Wear appropriate braces: For those with mild valgus and valgus deformities of the knee joint, appropriate orthopedic braces can be worn. Elastic sleeves to protect the joints can be worn at ordinary times, such as knee pads, which can achieve a certain balance of the joint surface load. Strengthen joint function training, perform joint flexion and extension activities in a non-weight-bearing position to maintain the maximum range of motion of the joints, such as pedaling in the air. Avoid wearing high heels, wear soft and elastic "sports shoes" with suitable insoles.