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"If you ain't living on the edge, you're taking up space"

You might lose your joint cartilage forever if you ignore smart rehabilitation progressions.

21/4/2018

1 Comment

 
Picture
The "she'll be right" attitude that is necessary in survival circumstances does not belong in the first 6 weeks after joint injury. Let's get science-y on you. Fancy losing your cartilage FOREVER after a joint swelling when you ignore sound clinical care and guidelines? If you don't value your cartilage, ignore the following advice.

Here's the gist:

Should a person have a swelling in a joint, it is expected that the joint cartilage will NOT tolerate the same load as that experienced when they got injured, for at least 6 weeks. IF.....IF the person has another swelling, be very very careful, because if you have a 3rd setback within 6 weeks, expect an irreversible loss of articular cartilage. That's right - you will never again get joint cartilage to repair. Now you're set for osteoarthritis,

Pivotal research in rabbit articular cartilage has shown that synovitis induces a 20% loss of proteoglycans within 24 hours, and 30-60% within 5-7 days (Lowther and Gillard, 1976). The chondrocytes replaced the proteoglycans within 42 days, unless visible erosion was present and unless two repeat stimulus-led inflammations occurred, at which point chondrocytes were seen to be dead (Carmichael et al, 1977), visible erosion exists (Gillard and Lowther, 1976) and unable to replace lost proteoglycans (Lowther and Gillard, 1976; Carmichael et al, 1977). This is accompanied by a general decrease in metabolism in articular cartilage following an inflammatory response (Byers et al, 1985).

Lowther, D. A., & Gillard, G. C. (1976). Carrageenin-induced arthritis. I. The effect of intraarticular carrageenin on the chemical composition of articular cartilage. Arthritis Rheum, 19(4), 769-776.

Carmichael, D. J., Gillard, G. C., Lowther, D. A., Handley, C. J., & Santer, V. B. (1977). Carrageenin-induced arthritis. IV. Rate changes in cartilage matrix proteoglycan synthesis. Arthritis Rheum, 20(3), 834-840.

Gillard, G. C., & Lowther, D. A. (1976). Carrageenin-induced arthritis. II. Effect of intraarticular injection of carrageenin on the synthesis of proteoglycan in articular cartilage. Arthritis Rheum, 19(5), 918-922.

Byers, S., Handley, C. J., Lowther, D. A., & Sriratana, A. (1985). Carrageenin-induced arthritis. VI. Alterations in amino acid transport by articular cartilage in acute inflammatory arthritis. Ann Rheum Dis, 44(7), 477-484.
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1 Comment
Alison Pritchard link
9/1/2019 06:28:48 pm

Add Haem into the mix and even more destruction!

Cartilage damage as a result of hemarthrosis in a human in vitro model.

Roosendaal G , Vianen ME , van den Berg HM , Lafeber FP , Bijlsma JW
The Journal of Rheumatology [01 Jul 1997, 24(7):1350-1354]

Results suggest a direct irreversible harmful effect of whole blood on cartilage, whereby MNC and RBC together are the main factors. Taking into account that the concentration of blood during hemarthrosis approaches 100% and the natural evacuation time of blood from a joint is about 4 days, our results suggest that prompt evacuation of intraarticular blood or prevention of intraarticular bleeding might be crucial in preventing cartilage damage.

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  • Book
  • Sports Physiotherapy
    • Telehealth Sports & Spinal Physiotherapy Consultations
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  • Articles
  • Blog
  • About
    • Masterclasses >
      • Advanced Palpation Masterclass
      • Masterclass Summit 2020
      • Max Velocity Training For Physios
      • How Strong Is Strong Enough?
      • Masterclass Bundle 1
      • The 3 Unstoppable Ways to Get Your Ideal Career In Sport
      • Clinical reasoning stems disruptive innovation - “Change or be changed"
      • Neuromobilisation for recovery
      • Shop
      • Scott Hopson: Stress & Expression
      • Alternative Physiotherapy Strategies For Calf Injuries
      • How to implement a movement philosophy approach in a first division professional soccer team. A real case scenario with 3 years follow up
      • Re-Designing Your Warm-Up To Increase Effectiveness Through Co-Operative Strength And Physical Therapy
  • Contact
  • Video Drills
  • Home
  • Appearing on these podcasts
  • Exercise Tubing Program