All net proceeds support hospital programs Are You Still Hip?

Presenting Team Jody Strik - Manager of Work-Fit Total Therapy Centre Henry Candelaria, BPHE, DC Doctor of Chiropractic Medical Acupuncture Provider Advanced Practice Clinician Alexandra Tarkowski, BHSc, DC Doctor of Chiropractic Medical Acupuncture Provider Active Release Techniques® Provider B.ScKin, B.ScPT, M.C.P.A., MBHM (Cand.) Medical Acupuncture Provider

Agenda Review the Anatomy of Hip/Knee Identify Early Signs and Symptoms of Osteoarthritis Referred Pain Patters that can replicate Hip/Knee Pain Discuss Management Options Alternative Medicine - What Works? Interactive Session

Anatomy of the Hip Joint

Anatomy of the Knee Joint

Muscles

Morning Joint Stiffness Joint Inflammation Inability to bend to the ground without pain Constant aching pain in the joint Pinching sensation when crossing legs Difficulty with transitional movement from sit to stand Limping Joint Pain Limited Range of Motion Crepitus (Crackling, grinding noise with movement) Early Signs & Symptoms

Signs & Symptoms Knee Pain Stiffness Swelling Popping Crunching Knee Buckling or Locking Up Morning Stiffness Difficulty climbing or descending stairs Inability to squat to the ground without pain Feeling of knee locking or giving out Limping Pressure behind knee Synovial Joint

Referred Pain Pattern Normal Disk Degenerative Disc Bulging Disc Herniated Disc Thinning Disc Degenerative Disc

Spinal Anatomy Vertebrae Facet Joints Intervertebral disc Ligaments The Lumbar Spine

Management Visit a reputable rehabilitation centre Ensure they have the right modalities and equipment to assist you in getting better faster Combination of active and passive care is necessary Manual therapy: mobilizations, manipulations, soft tissue therapy Active Release Techniques ® Pain management: Acupuncture, IFC/ TENS Supervised exercise program specific to complaint and pattern** **Individualized rehabilitation programs

Current Evidence American College of Rheumatology 2012 Recommendations for the Use of Nonpharmacologic and Pharmacologic Therapies in Osteoarthritis of the Hand, Hip, and Knee Arthritis Care & Research Vol. 64, No. 4, April 2012, pp 465–474 DOI /acr © 2012, American College of Rheumatology MARC C. HOCHBERG, et al Table 3. Non-pharmacologic recommendations for the management of knee OA We strongly recommend that patients with knee OA should do the following: Cardiovascular / resistance land-based exercise Aquatic exercise Self-management programs Manual therapy in combination with supervised exercise Patellar taping Custom Orthotics Thermal agents Walking aids, as needed Tai chi programs Acupuncture Transcutaneous electrical stimulation

Current Evidence Table 5. Non-parmacologic recommendations for the management of hip osteoarthritis (OA) We strongly recommend that patients with knee OA should do the following: Cardiovascular resistance land-based exercise Aquatic exercise Lose weight (for persons who are overweight) Self-management programs Manual therapy in combination with supervised exercise Group arthritis classes Thermal agents Walking aids, as needed

At Home Management ICE OR HEAT Ice - initial stage ( hours) Ice reduces inflammation and pain. Apply crushed ice in a bag, package of frozen vegetables or a gel pack. Apply for only 15 minutes maximum and repeat every 2-3 hours. Heat may be used after 48 hours. Maintain proper posture Avoid flexing forward, twisting/reaching out. Stabilize the back & deep core muscles keeping your back straight and your chin tucked in. Strengthen your quads and gluts as these are the major stabilizers for the hip and knee joint. GOOD HABITS FOR PREVENTION

Alternative Medicine 1.National Institutes of Health. National Center for Complimentary and Alternative Medicine. “Questions and Answers: NIH Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT).” Glucosamine Chondroitin MSM Naturally found in connective tissues in the human body, such as those covering the ends of bones in the joints. Glucosamine is extracted from animal tissues (crab, lobster or shrimp shells). Chondroitin is found in animal cartilage (tracheas or shark cartilage). MSM, also known as methyl sulfonyl methane, is a compound found naturally in (cow's milk, meat, seafood, fruits and vegetables). Glucosamine, chondroitin & MSM are believed to impact the cartilage degeneration process of osteoarthritis in the following ways: Helps slow or prevent the degeneration of joint cartilage. Helps alleviate existing joint pain. Has very few side effects. May not offer the desired pain relief for all osteoarthritis patients. At the time of this article, the benefits and risks of taking glucosamine, chondroitin & MSM have not been definitively proven, and long term studies are needed to better understand their effects.

Circulation and Lubrication Postural Correction Interactive Session Glut and Quad Activation Balance

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