What Causes Knee Snapping?

When you're working out, or playing your favorite sport, a snapping sensation within your knee can cause pain and frustration, and can lead to buckling or giving way, falling, and eventually, damage to the cartilage surfaces of the joint. The snap results when some structure within the joint is momentarily caught between the moving bones, tension is applied and is then suddenly released, much like plucking a guitar string.

The three most common causes for the painful snap are synovial flaps, torn menisci and loose bodies.

The most frequent source of snapping is a synovial flap or plica. The inside of every synovial joint is lined by a normally thin and pliant membrane, called synovium. Synovium produces a drop or two of joint fluid, which nourishes the articular cartilage and provides lubrication for the joint surfaces. This membrane often has a few small thin folds, left over from embryonic development, which can grow larger, thicker and stiffer to become larger structures, fibrous flaps or shelves, that get can get caught and stretched between the moving parts.

Pain is caused by traction, pulling on the nerves of the surrounding tissues, and the snap is due to the sudden release of tension, when it breaks free.

A torn meniscus can also cause a snap. The two tough, crescent-shaped meniscal fibrocartilages, medial (inner side) and lateral (outer side), that cushion and guide the knee, are often torn in athletic activities, especially the sudden twisting or cutting maneuvers in soccer, football, or basketball.

But tears can also occur by degeneration, just from getting older. Here, the substance of the cartilage becomes softer and begins to shred and fragment, eventually evolving into a tear, especially when repetitively crushed as with deep squatting. The meniscus tear fragment, like the flap of synovium, can displace and get caught between the moving femur and tibia, causing pain by traction, like a hangnail does, then snap when suddenly released.

Loose bodies are little pieces of cartilage and/or bone that are knocked out with trauma, fall out from a joint surface due to disease (osteochondritis dessicans), or are actually grown, like pearls, within the synovial membrane (synovial chondromatosis/osteochondromatosis), and then break free inside the joint. Like the synovial flaps and meniscal tears, these fragments can get caught between the moving parts.

Regardless of cause, significant snapping within the knee is always abnormal and needs to be addressed.

Above all, don't ignore it. You want to identify the source with an accurate diagnosis and prevent permanent damage to the joint. But in the short term, you can try some conservative measures to try to resolve the snapping.

Here's what you can do:

1. STOP whatever activity causes painful, recurrent snapping.

2. REST the knee in extension, that is, out straight. Every snap can potentially damage the articular cartilage, so that can be prevented by avoiding, or minimizing joint motion.

3. Apply moist HEAT a few times a day, for 15-20 minutes each time. If the snapping is of sudden onset, apply ICE for the first 48 hours, THEN begin to apply heat.

4. Try some OTC anti-inflammatory (NSAID), like Advil (2 tabs, 4X/day) or Aleve (2 tabs, 2X/day), provided you have no stomach problems, like ulcers, or a history of GI bleeding, and be sure to take it WITH FOOD OR MILK. If inflammation has caused a synovial plica to swell and thicken, this regimen should shrink it, by reducing inflammation.

5. If you don't get relief within a few days to a week, then it's probably not from acute inflammation and the snapping structure is now fibrous tissue, or cartilage, which will not shrink, even with reduced inflammation. Then, you need to SEE AN ORTHOPAEDIST, for definitive evaluation and treatment. Don't be afraid--it's what you DON'T know that will hurt you and no one can force you to have surgery. But if someone is trained to DO surgery when it's needed, then you will be getting a complete picture of your condition, including ALL your options.

6. If you don't see a doctor at this point, the repetitive snapping of an internal derangement can damage the articular cartilage of the joint and eventually result in arthritis. Therefore, if conservative treatments fail to promptly relieve pain and snapping, to prevent permanent joint damage, arthroscopic surgery is usually required, to remove the source of the snapping.

The Role of Diet and Exercise in a TMJ Treatment

Most people suffering from a temporomandibular joint (TMJ) syndrome held a common misconception that a TMJ treatment alone can relieve them of jaw pains and, ultimately, of the TMJ syndrome.

Since a TMJ syndrome is closely connected to other disorders such as plugged ears, neck pain, and fibromyalgia, addressing the syndrome by a TMJ treatment alone would not suffice. This is where the role of diet and exercise comes in.

Diet and exercise, in fact, figure significantly in any physical treatments that patients undergo. Diet can affect the pain associated with TMJ. Among the popular diet changes people incorporate in their TMJ treatment is the avoidance of foods with sugar, yeast and preservatives, cutting back on wheat and dairy, and eating more red meat for iron, zinc and vitamin B12.

Other than the content of your diet, dentists specializing in TMJ treatment also advise their patients to check the consistency of the food they eat on a regular basis. Softer foods are preferred over hard ones since overworking the jaw can add to the pain. Chewing gum and other chewy edibles such as candies should also be avoided to avoid stressing the jaw.

Besides watching your diet, there are also exercises designed for people suffering from TMJ. While diet and exercise alone cannot solve all TMJ-related problems, having them as a supplement to your TMJ treatment can expedite healing. In some serious case, it is advisable to seek the help of an expert apart from doing these exercises.

Most of these exercises can be performed at home. It would be wise to follow a strict TMJ exercise plan and take down notes for monitoring and evaluation purposes. The notes are also helpful during your visits to the dental clinic. You can readily answer questions related to your condition thereby helping your doctor find the appropriate treatment.

In doing TMJ exercises, make sure you place a mirror in front of you. Open and close your mouth slowly. When you have TMJ, you can easily notice that your jaw is not aligned. Repeat the opening and closing of your mouth for ten times to help the jaw re-learn how to open and closely correctly. Make repeated attempts at opening your mouth correctly.

To alleviate muscle pain due to TMJ, a different set of exercise is suggested. First, while facing a mirror, slowly open your mouth as wide as you can. Slowly close it. Repeat the opening and closing procedure. Repeating this step for at least 3 times a day can help you relieve your muscle pain.

If your jaw continues to click, close your mouth and move your tongue back then slowly open your mouth until your tongue moves away. Repeat this step twice. If you jaw shifts sideways, slowly open and close your mouth without shifting to the side. Repeat this step five times. If you want to ease the tension in your jaw, open your mouth downward and slowly close it.

Knee Pain and Stiffness - How You Can Be Pain Free With a Combination of Pilates & Physical Therapy

Are you using the handrail more and more often when you go down the stairs. Are your knees failing you?

More people are now seeing their doctors because of painful joints, muscles and tendons than for the common cold, and the knee joint is responsible for over 20 million doctor visits each year in the US alone. Your knee plays a major role in the chain of weight bearing in the leg. It has to respond to ground forces from below and the load of your body from above. It is a relatively simple joint, but it has to be ready to quickly react to force from the ground while balancing the load of the rest of the body at the same time. Your knee is at the mercy of what's going on in the joints directly above and below: the hip, pelvis, ankle and foot.

Although there are many reasons for knee pain (arthritis, meniscus and ligament damage for example), long term relief of knee pain has to start with an assessment of your whole structure. This assessment begins with your feet to see how they influence the alignment and forces at the knee. Any joint is only as good as its structure, and poor alignment in the feet and ankles has a negative influence on the knee, creating muscle imbalances and eventually pain and stiffness.

The hip joint also has a similar affect on the knee - poor mechanics and muscle imbalances in the hip creates problems for the knee. And because the socket of the hip joint is formed by the pelvis, it has to be aligned correctly too. In fact, when doing a full assessment of the knee, the whole body must be evaluated, since any structural imbalances in the body can affect the knee's ability to function.

The good news is that a well balanced Pilates-based Physical Therapy program addresses the whole body. Pilates is a recent addition to many Physical Therapy programs and is rapidly growing in popularity throughout the world. Combining Pilates with Physical Therapy will improve your body awareness, alignment, strength, flexibility and balance. You'll learn how to move with more efficiency and less pain.

At first, new and balanced movement habits feel weird and unfamiliar because they're foreign to your nervous system. Working with a skilled Pilates trained Physical Therapist will help you understand your own unique postural and movement habits and help you practice correct patterns effectively.

Here are a couple of things you can do right now to find out how your knees stack up:

1. Stand in shorts, barefoot in front of a full length mirror and look at your leg alignment. What do you see? Are there any funny angles between your hips and your knees? What about your feet? Do you have an arch on the inside of your foot? Can you see that your whole leg influences the alignment of your knee? This includes the alignment of your pelvis, since the pelvis is the top of your hip joint. Be aware that when you do any exercise "for your knees", you must also consider the rest of your body, especially the foot, ankle and hip.

2. While standing, imagine a line going through the center of your leg from your hip joint, through the center of your thigh, your knee joint, the center of your lower leg, ankle and out the 2nd toe. This is the ideal alignment for your leg. A word about your hip joint: did you know that your "hips" are not the wide bones of your pelvis, but the place where you crease when you bend your knee towards your chest? This is where your heel should line up when your foot hits the ground when walking. The hip joint itself is really quite narrow - about the same distance apart as your sits bones in the back.

3. When you stand, walk and exercise, the alignment of your whole leg affects which muscles you use to move. And the way you use your muscles strongly influences your alignment. Be very aware of keeping correct alignment from your pelvis to your foot - hip to 2nd toe - so that you create good balance around your knees. If you do exercises like squats and leg press, do you pay attention to your leg alignment? Your knee program will be far more effective if you do. Remember that pain is your body's way of telling you that something's not right, so if you can't modify your position to relieve the pain, skip the exercise. Remember also that not every "recommended" knee exercise is right for every knee - you need to find out what's right for your knees.

The point is that your knee pain is usually just a result of the alignment you set up from the ground (you feet and ankles) and the load you put on them from above (your hips, pelvis and trunk). Figure out how to de-stress your knee joints by changing your whole-body alignment and your knee pain and stiffness will resolve.

If you have knee pain and want to find out how to get relief, see a Pilates trained Physical Therapist who will assess your whole body, rather than looking only at your knees. A Pilates exercise program, with a home routine, is a great way to reduce pain and stiffness in your knees, and a 2nd pair of experienced eyes will help you sort out your unique imbalances. Then you'll know exactly what to do for YOUR knees.

How do you find a Pilates trained Physical Therapist? Many PT clinics now offer Pilates, and many Pilates centers employee Physical Therapists. Check your local PT clinics and Pilates centers. And make sure that your practitioner has completed a comprehensive Pilates training program.

Copyright © Park Meadows Pilates 2008

Instant Gout Pain Relief With Baking Soda

Looking for instant gout pain relief? Then you've come to the right place. Here, you'll discover how baking soda can bring almost immediate relief from gout pain without the need for drugs with their well-known side effects.

Baking soda can bring you more or less instant gout pain relief. And who would have suspected that something that many of us have lying in a kitchen cupboard could be such a potent weapon in the fight to get fast gout pain relief?

Not only can it act alone as an effective natural remedy for gout, but, baking soda can also help the effectiveness of the non-steroidal anti-inflammatory drugs (NSAIDs) that you doctor usually prescribes to relieve the pain of your gout symptoms.

But even without drugs you can get almost instant, certainly fast, gout pain relief using baking soda (bicarbonate of soda) because of its several benefits such as:-

- an increase in body fluids that help your kidneys to flush uric acid out of your system
- improved uric acid solubility for easier excretion from the body
- dissolution of uric acid crystals to help reduce the pain

You need to add half of a teaspoon of baking soda to 8 ounces of water in a large glass. Drink a glass immediately before going to bed, and, first thing on getting up. Drink a further glass every 2 to 4 hours between meals. If need be, follow this routine daily until your symptoms disappear.

Be careful not to take more than 4 teaspoons of baking soda in any 24 hour period. And, because baking soda is very high in sodium you need to go on to a very low sodium diet, or better still, cut-out salt from your diet altogether.

Also, if you suffer from high blood pressure -- hypertension -- talk to your doctor before using this remedy. It is a good idea to talk to your doctor about this treatment in any case.

Many gout sufferers have experienced very fast gout pain relief with this method. But, there are a number of other things you have to consider in terms of getting rid of your gout. For example, your weight, diet, lifestyle, family history, etc.

And if you continue to suffer frequently recurring gout, there is a danger of permanent joint damage and kidney problems over time. Plus, of course, once having suffered a gout attack, you're now much more likely to have more.

Hip Arthroscopy

Hip arthroscopy is a form of arthritis of the hip which causes a loss of this cartilage surrounding the hip joints and ligaments. The arthritis buildup causes changes in the joint fluid in and around the joints, which ultimately leads to an irritation to the lining around the joints. The reaction from this process causes more inflammation and more fraying which is a vicious cycle. The pain most people encounter with this condition is much different than most joint pain problems with one major issue being that it can keep someone from sleeping through the night.

Until recently the treatment options for hip pain were somewhat limited and the possibility of a hip replacement was virtually guaranteed. Even though the techniques in use today have improved the lives of a great many people, there are no long term guarantees and obsolescence is inevitable with every implant. No matter how good the circumstances may be or how well someone may seem to recover from the procedures, the implant will simply wear out and will need to be replaced.

Until a more suitable material can be created, hip arthroscopy may postpone some of the damage by helping to break the vicious cycle caused by the arthritis. One of the biggest benefits of the hip arthroscopy is that it has a much simpler process of recovery as compared to other process such as open hip surgery. Almost immediately after a surgical procedure, a person can work on regaining motion around the joint by doing gentle strengthening exercises on a regular basis. Many times a patient will work with a physical therapist for assistance with these exercises and stretches to insure that they are being done properly which could speed up the recovery process.

No procedure is without some level of risk and hip arthroscopy is no exception. One of the more common risks has to do with injury to the articular cartilage of the hip by the instruments used to perform the arthroscopy procedure. Although it is possible for this to happen with arthroscopy of any joint, the possibility of it happening with hip arthroscopy is much greater due to the joint being "tight" and difficult to access. The upside is that when an injury does occur, it is almost always minor and inconsequential. Now days with more modern instrumentation being used, and the experience levels of surgeons growing, the complication rate of this procedure is much lower.

TMJ Relief Now Using the Feldenkrais Method

The temporomandibular joints (TMJ) are the points where the lower jaw attaches to the skull. The TMJ is a ball and socket, with the skull being the socket, and the top of the jaw bone the ball. TMJ disorder is a term used to describe chronic inflammation of the temporomandibular joint.

Common symptoms of TMJ disorder include:

- pain in the TM joints associated with jaw movements.
- locking episodes.
- limited range of opening the mouth.
- facial pain or facial muscle fatigue.
- noises in the jaw like clicking, snapping, and popping.
- frequent headaches.

While mouth guards and medications work for some, TMJ therapy at the Feldenkrais Center is approached systematically. The Feldenkrais practitioner understands how the jaw attaches to the head and functions in a very particular way:

- The head is heavy and must sit on the spine in a way which allows the jaw to work properly.

- The relationship of the head to the neck and spine is altered in nearly all patients with TMJ disorder.

- Any deviation in the head and spine places an excessive strain on the entire musculoskeletal system, including the muscles and joints of the TMJ.

The Feldenkrais Method approach to TMJ treatment assumes faulty interactions between body parts can cause excessive strain and pain in places remote from the problem. For example: a stiff upper back could be the underlying cause of TMJ pain by contributing to the altered position of the head and jaw, or the belly may be so weak that the head and jaw sit forward, a position unnatural and stressful for both areas

TMJ relief is the result of improving key relationships within the head and neck, and optimizing the function of the jaw as it relates to the rest of the upper body. Feldenkrais therapy involves the whole body, including Feldenkrais exercises, the goal being to optimize key relationships and prevent your jaw from being injured again. The Feldenkrais Method is a systematic method to improve human movement and general functioning. Feldenkrais uses simple, gentle movements to reorganize posture, flexibility, strength and coordination and in doing so relieves TMJ pain. A contemporary approach to pain management, Feldenkrais integrates mind and body, harnessing the power of brain plasticity to help the body function more efficiently. More efficient use of self creates environments within which chronic pain and injuries can heal. Discover what Feldenkrais can do for you.

Arthritis and Joint Pain - Little Known Causes Of Pain In Your Joints And Arthritis

Each of us will experience muscle or joint pain at some time in our life. Is it arthritis?

Most of us have no idea what causes pain or why we have pain. This is not something we learned growing up. We will blame old age or arthritis as the culprit. We may have no clue that something we are doing, or not doing, may be causing our discomfort.

What if people knew the true cause of their pain?

It is exciting to know that almost all joint and muscle pain, including other pains like sciatica and migraines, is caused in full or in part by muscle imbalances.

There are natural laws which govern how our bodies work. These laws state that if something occurs in one part of our body, something must happen elsewhere to compensate for the first event.

For example, we cannot have one high shoulder and the other shoulder in neutral. If one is high, the other must be low. If one hip is forward, the other must be in a more rear position. Not only does this happen, it happens often.

And when we have pain, almost all health care practitioners and massage therapists will treat the hurting area. If the pain is new, only a day or two old, then the cause of the pain may be where the hurt is.

But when the pain is longstanding, the hurting area is only a symptom. The cause of the pain is elsewhere. This is where the natural laws come in. Equal and opposite stresses are occurring.

Most medical practitioners and massage therapists offer treatment for the symptom, even though the painful area is generally not what caused the pain. Understanding the cause and effect of pain, and the roles that muscles play, is something most of us did not learn in school.

And beside physical treatments such as massage which are occasionally offered, drugs and surgeries are routinely offered.

Drugs address symptoms and can have side effects.

Surgeries may or may not reduce the pain, which is why fewer back procedures are performed now. Surgeries also may have detrimental long term effects. Surgeries may treat the symptom without treating the cause. An example would be a hip replacement, when the initial cause of the pain was an anatomical leg length difference, which was not addressed.

When we were little, we had perfect balance.

When we grew up, due to school and work and lifestyles, we lost some of our balance. Some of us lose a lot of it. We have over 600 muscles, and most of us only use the same sixty or so. So we develop pain.

We get out of balance and into pain.

But, what if people understood the causes of their pain?

What if they knew simple, self help movements, tools and tips which can easily be implemented by most people to bring balance back?

What if they could reduce or eliminate their arthritis and joint pain?