The Pretend Fitness Thread


#8586

Yep. Descents improve balance , coordination and all that
I wouldn’t be particularly good at it. I just really enjoy it


#8587

Decent done well is actually really good for deceleration and arguably (again loaded well) a knee/ACL preventive.


#8588

That’s exactly when you should be lifting weights


#8589

@Mac is the poster boy for this carry on. Never did as much as kick a ball as a young lad and ran for the first time when he was 32. Now he’s swimming and cycling and buggy running to beat the band. He’ll do well to see 50.


#8590

He’s sticking his nose in everything


#8591

Its a well known TFK fact that I kicked Kevin Doyle up and down the football field several times.


#8592

BODY & SOUL

Coping with knee pain: how to keep your legs bendy, whatever your age

According to a recent report, a fifth of those over the age of 45 suffer from osteoarthritis in the knees. Peta Bee on the therapies that do and don’t help

Peta Bee

September 11 2018, 12:01am, The Times

More evidence for the effectiveness of knee braces is emerging

More evidence for the effectiveness of knee braces is emergingGETTY IMAGES

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Let me take a guess: you’re reading this because you have been experiencing a few problems with your knees recently. I’m not remotely surprised. In its State of Musculoskeletal Health report for 2018, Arthritis Research UK (ARUK) revealed that the joint is the most common site for osteoarthritis, with almost one in five people aged 45 and over suffering from it.

A degenerative condition caused by wear and tear, osteoarthritis is a result of joint surfaces becoming damaged and the protective cartilage that covers the ends of bones thinning over time. It leads to bones thickening and the movement of joints becoming painful. Obesity and old age remain the greatest risk factors, but a generation fixated with endurance challenges and intense exercise are also paying the price as their joints wear out.

When the damage is severe, surgery is often the only option. The NHS National Joint Registry revealed that the most joint replacements yet were carried out in the financial year 2016-17, with just fewer than 243,000 cases being logged. Of these, 108,713 were knee replacement (or revision) operations, a rise of more than 4,000 since 2015. In a bid to avoid such extreme measures many of us turn to treatments and therapies that claim to keep our knees healthy and strong. Yet exhaustive study has concluded there is almost no evidence that any of them work.

The latest warning about disingenuous claims for knee products made by the wellness industry comes from the Royal Australian College of General Practitioners (RACGP). In new guidelines published recently, the RACGP strongly warned against many of them, including surgeries and complementary therapies, including glucosamine, vitamin D and acupuncture, that it said “should not be offered”.

Philip Conaghan, a spokesman for ARUK and professor of musculoskeletal medicine at the University of Leeds, says that many of the popular joint treatments widely available in the UK are “just not any good” and best avoided. “There’s an awful lot of joint pain out there and unfortunately we don’t have a lot of scientifically proven treatments,” he says. “People with knee pain want hope and these products and therapies are amazingly appealing, but often a waste of time and money.”

GLUCOSAMINE AND CHONDROITIN
Worth a try? No
Dr Harry Nespolon, the president-elect of the RACGP, described glucosamine as “a classic example” of a faddy treatment that has little scientific merit. “People take it year after year, but there’s no good evidence that it changes the course of osteoarthritis,” he stated in the report. It’s available in two forms, glucosamine sulphate and glucosamine hydrochloride; there is more evidence in support of the latter, although the effect is “modest”, according to ARUK. Last year a team of Dutch scientists reported that the popular supplement has no more effect than a dummy pill. Their review of randomised controlled trials that included a total of 1,600 patients, found that at three-month and 24-month follow-up points, the supplement had no effect on knee (or hip) pain from arthritis.

Chondroitin, a naturally occurring component of cartilage, is often taken as a supplement in conjunction with glucosamine. “There’s no evidence that either are effective,” Conaghan says.

ACUPUNCTURE
Worth a try? No
Guidelines from the National Institute for Health and Clinical Excellence state that there is insufficient evidence to recommend acupuncture for osteoarthritis-related joint pain. Writing in the British Medical Journal ( BMJ ) this year, Asbjorn Hrobjartsson of the centre for evidence-based medicine at the University of Southern Denmark wrote: “After decades of research and hundreds of acupuncture pain trials, we still have no clear mechanism of action, insufficient evidence for clinically worthwhile benefit, and possible harms.”

VITAMIN D
Worth a try? No
Lots of people swear that vitamin D has slowed the progression of osteoarthritis. It is, after all, a vitamin crucial for bone growth and a healthy skeleton, but does it relieve joint pain in the way many think? Research says not and one randomised placebo-controlled study conducted at Tufts University in Massachusetts a few years ago found that taking vitamin D supplements neither reduced knee discomfort nor restored cartilage. “There may be reasons to take vitamin D supplements, but knee osteoarthritis is not one of them,” concluded the scientists who led the research, published in The Journal of the American Medical Association ( JAMA ).

HYALURONIC ACID
Worth a try? No
This gel-like substance is injected into the knee to lubricate the joint and act as a sort of shock absorber. One study of more than 50,000 patients published in 2015 in the journal PLOS One looked at patients with knee pain who were treated with one or more courses of these injections and compared them with more than 131,000 patients who had not had the treatment. People who had five or more courses of the injections delayed the average time to a total knee replacement by 3.6 years, whereas those who had only one course averaged 1.4 years until knee replacement and those who had no injections had their knees replaced after an average of 114 days.

Other studies have far less favourable outcomes. “The benefits seem to come from the fact that when you inject into a joint, you suck out some of the fluid,” Conaghan says. “If there’s any beneficial effect, it is very short-term and it’s not a treatment we would recommend.”

ARTHROSCOPIC SURGERY
Worth a try? Possibly
This keyhole surgery allows surgeons to see inside your knee with a tiny camera and to repair or remove damaged cartilage or treat an unstable kneecap. For most people it is not worthwhile, Conaghan says. “A small group who have a torn meniscus, a moon-shaped piece of cartilage, and who find their knee catches at 45 degrees and locks, might benefit,” he says. “But they are a minority and a locking knee is not the same as a stiff, gelling knee that most people with knee pain get after sitting for prolonged periods.”

Last year a study in the BMJ by an international panel of experts systematically reviewed 12 well-designed trials and 13 observational studies and concluded that for degenerative knee arthritis and meniscal tears the procedure resulted in no lasting pain relief or improved function. Three months after the procedure fewer than 15 per cent of patients experienced at best “a small or very small improvement in pain and function”, effects that disappeared completely within a year.

STEROID INJECTIONS
Worth a try? Possibly
These can work, but only in the short term. “Corticosteroids can reduce painful swelling, but we are talking a matter of weeks, not months,” Conaghan says. “They might be used for someone who is in extreme pain, but are not a long-term solution.” And there are downsides if used repeatedly because the steroids can speed the development of arthritis in the joint. In May last year a study published in JAMA by researchers at Tufts University found that the injection of a corticosteroid every three months over two years resulted in greater loss of knee cartilage and no significant difference in knee pain compared with patients who received a placebo injection.

KNEE BRACES
Worth a try? Possibly
According to ARUK, the use of knee braces to help with osteoarthritis knee pain is increasing and more evidence for their effectiveness is emerging. They seem to help to stabilise the kneecap so that it moves in the right direction. Again, money is easily wasted. Lucy Macdonald, a physiotherapist at the Octopus clinics in London, says that no brace can completely prevent rotational movement and knee braces with metal hinges offer no support. “Carbon-fibre braces are the most effective, but can cost hundreds of pounds, she says. “Otherwise opt for a cheap neoprene one, which will help to improve sensory feedback and keeps the knee warm for some benefit.”

MAGNETS
Worth a try? No
You can strap magnets to your knees or use magnetic mattress pads while you sleep, but will it make a difference to your knee pain? According to ARUK, evidence is “too patchy” to recommend magnetic therapy, which is said to work by increasing the circulation of iron in the blood, which helps to deliver nutrients to the joints. A trial at the University of York that was published in the journal Complementary Therapies in Medicine almost a decade ago found magnets to be ineffective in reducing levels of pain in people with osteoarthritis.

Build up strength slowly and switch to squats and lunges as you get strongerGETTY IMAGES

LEG RAISES AND LUNGES
Worth a try? Yes
According to Conaghan, the single most important thing you can do to reduce knee pain is to strengthen the quadriceps muscles in the front of your thighs. “It will lead to a 30 to 40 per cent improvement, which is far better than you would hope to get with pills and therapies,” he says. Start by walking widths in a swimming pool — the resistance of water will make your legs muscles work harder — climbing stairs and straight-leg raises from a chair. As you get stronger, switch to squats and lunges, wall-sits and step-ups or the Versaclimber at a gym.

WEIGHT LOSS
Worth a try? Yes
The more you weigh, the more shock is absorbed by your knees with every step you take and the greater the likelihood of pain. So it follows that losing some of your surplus poundage will help your knees. “Shedding 5 to 10 per cent of your weight — which usually means 5 to 10kg — has been shown to be beneficial for obese people with knee pain,” Conaghan says. Everyone should prioritise strength gains before weight loss, however. “Four weeks of doing quadriceps exercises and you will notice a dramatic improvement in knee pain,” he says. “Four weeks of weight loss won’t produce nearly the same benefits.”

RUNNING
Worth a try? Possibly
Of all activities, running gets the worst rap when it comes to knee damage. Its reputation is ill-founded, Conaghan says, with studies suggesting that runners are less likely to have knee problems than the general population. “For most weekend warriors running is a safe thing to do,” he says. “There’s no great evidence at all that it wears down the cartilage protecting your knees and, provided you have no existing injuries, it’s a good thing to do.”

IBUPROFEN
Worth a try? Yes
A study published in the Journal of the American Academy of Orthopaedic Surgeons last year ranked the cheap and widely available painkiller as one of the most effective measures for reducing knee pain in the short term. In doses of 200-400mg, it works by temporarily reducing pain and inflammation and, Conaghan says, while it helps with pain and stiffness “won’t repair a damaged joint and doesn’t affect the arthritis itself”, so exercise is needed. Other non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen, can also help, but should not be used for longer than a few days. Longer-term use of NSAIDs can cause stomach-related side-effects and even increase problems with your heart and circulation, and you should consult your GP before taking it on top of any other medication, advises ARUK.
arthritisresearchuk.org

THE KNEE EXERCISES

Straight leg raise
Sit well back in a chair. Straighten and raise one leg. Hold for a slow count to ten, then slowly lower your leg. Repeat this at least ten times with each leg every time you are sitting down. Add ankle weights as you get stronger.

Step-ups
Step on to the bottom step of stairs with your right foot. Bring up the left foot, then step down with the right foot, followed by the left foot. Repeat with each leg for as long as feels comfortable. As you get fitter, move to a higher platform such as a box or a bench.

Beginner squats
Hold on to the back of a chair or work surface for support. Squat until your kneecap covers your big toe. Return to standing. Repeat 10 to 15 times. As you get stronger, move away from the support and gradually squat until you can bend your knees to a right angle with thighs parallel to the floor.

Wall sits
Lean your back against the wall and hold thighs parallel to the ground in a squat position, or position an exercise ball against the wall and assume the squat position with your back against the ball. Hold for as long as is comfortable.

Lunges
Once you can master the above, add some lunges to your routine. Stand with feet hip-width apart and take a large step forward with one leg. Keep most of your weight on your front foot as you lower your hips, keeping the front foot flat (knee directly above the ankle) and back heel lifted. Raise back up and repeat on the other side. Perform six to eight on each leg.


#8593

Running is a killer. Road running, might as well be taking a sledge hammer to the knee.


#8594

Have you heard that the earth is round mate?


#8595

Meep meep.


#8596

Obviously a lot of those things are obviously mad and of no use.

The exercises provided are not the best go-to though. Some may form part of the solution but only part.

2 things are re largely at play.

Sedentary lifestyle + people are really too weak for many of the modern weekend warrior races.

So sedentary life has to be attacked 1st. But leading as little a sedentary lifestyle as makes sense (everyone can sense and up every 20 mins, do not care who you are).

Then you have to correct your movement before going on to trying mad stuff.

Physios continue to underprepare people. However their biggest crime is their shitty programs even in terms of presentation. So many of them still scribble out nonsense on a piece of paper. “The physio gave me exercises but I lost the piece of paper” is an extremely common line I hear.
For 50-60 euros per 30 mins people deserve more.


#8597

Evidence doesn’t bear that out. Running on road not that much different to running track or on grass Impact wise.

The difference may actually be the person who runs on track or field are at it longer and better prepared.


#8598

Do you follow johnny holland on social media?


#8599

:grin:


#8600

No

Why?


#8601

:grinning::grinning:


#8602

Just curious. I think youd find it interesting


#8603

He is not coming up


#8604

He is on instagram. Has been putting up lot of his workout videos over time. Now looking to launch some kind of paid version. He is a qualified nutritionist as well which is what i would find more interesting


#8605

Has he some sort of moniker?

Not easy to find.

Is he spelling it Johnny Holland?

Put up a link tgere