Dr Shridhar Archik, well known Orthopedic Surgeon, with a degree in Orthopedics from Oxford University, specializes in joint replacements, spine and management of complex trauma.
Dr. Archik was trained at the Nuffield Orthopedic Surgeon for joint replacement surgeries and also worked as a lecturer in the department of orthopedics Oxford university.
Here, in an interview with Pooja Biraia, he explains the various ways in which one can how best to delay the age-related bone weakening process and have healthy bones.
How can one best prevent himself from having to undergo knee replacement?
Knee replacement is done when a person suffers from osteoarthritis of the knee. Osteoarthritis is a process similar to the process of graying of hair – sooner or later it is bound to happen. Basically, as one ages, the process of the wear and tear of the joints becomes inevitable. Though there is no way by which one can prevent the aging process, what one can best do is to age gracefully, so that the need of surgery is eliminated. It cannot be guaranteed that one may never need to undergo knee replacement, one can best, delay the process of weakening of the bones, from a younger age. Fitness gained at a young age, goes a long way in preventing oneself from age related diseases later on in life. So, from young age if you start having a routine where you exercise well, your diet is perfect, and you don’t overload your knees unnecessarily, you will sail through life smoothly. Prevention actually starts at an early age.
For those Indians over 50 years of age, too much activity can lead to wear and tear of the bones while too little, can make them stiff. How much activity is too much?
The reasons that lead to wear and tear of the bones are different from the reasons that keep the body flexible. The logic for the wearing out of the knee is simple: When you walk, your knees carry a load which is exactly equal to your body. But if you use your knees for any anti gravity activities, the load in them turns to six times your body weight. For instance, in case of Indian toilets, when you squat and want to get up, you are loading the knee by six times, in each visit. The same rule applies when you climb stairs, which is also against the gravity. So, by doing these things over and over again, you are actually loading your joints. Remain active, but refrain from indulging in too many anti-gravity activities.
There is a controversy surrounding the benefits of milk for the bones. Comment
The most logical and scientifically proven answer to this question is that milk is indeed good for the health of the bones and joints. This is simply because bones become weak due to a lack of calcium. And milk, being naturally high in calcium content, is the best dietary intake for those who suffer from weak bones and joints. Thus milk can never harm your bones; they in fact, keep them healthy.
Do Calcium supplements provide cent per cent benefits?
The benefit of a calcium supplement depends on the calcium salt you intake. Mind you, it is not the brand, but the tablet you buy from the chemist, basically has different calcium salts. The calcium tablet you buy in the market contains calcium carbonate, which is chalk, and the other salts are calcium citrate, calcium lactate and calcium gluconate. Now on the basis of the type of salt you take, the body’s absorption would differ. All the standard brands which people know are calcium carbonate because they are cheaper. But the other salts are much more effective, and those should be bought. Also, the time you take the tablet affects the way it is absorbed. Hence, one must adhere to the timings prescribed by a doctor. The body has got a bio rhythm by which calcium taken at night is absorbed better. So if you need to take only one tablet, you take it at night. Ideally you should take a tablet that has calcium citrate salt, because it doesn’t need stomach acid for absorption, hence, you can take the tablet anytime, even without food and citrate salts are absorbed better than carbonate salts.
We all spend a lot of time sitting at one place in offices, how can we best manage our posture, and relieve the aches?
This has to do with ergonomics. Many a times, the interiors of the office and the design of a person’s workstation has a lot to do with his bodily health. For instance, the PC should be at eye level, when you sit your elbows and wrists must rest and your posture must be correct. A correct posture is a ninety degree posture, which means that if the height of your chair and PC table are correct and your feet rest flat on the ground, then your legs will be at 90 degrees to your feet, your thighs will be at ninety degrees to your legs and your entire spine will be at ninety degrees. If seen from the side, a plum line drawn through your ear lobe should pass through your shoulders and hips straight. If you adhere to this posture, then you won’t have any work related aches. Also, it is advisable to take in-between breaks and walk through the office, rather than sit on the chair for eight long hours.
Women are known to suffer from osteoporosis more than men.
This relates to the post menopausal type of Osteoporosis. This means once a lady attends menopause, the production of the hormone estrogen stops and eventually the calcium content in the bones gets depleted. So women in India, who attain menopause by the age of 45, start losing calcium. As women start facing the problem by the age of 45, it goes on increasing with increasing age, while, men are exposed to Senile Osteoporosis which starts at the age of 65.
Which are the activities not suitable for the health of joints and bones?
One should always remain active, but must not get onto the extreme ends of a spectrum. For instance, on one side are young and old who don’t exercise at all, while on the other, are those who are seen to be extremely active. Moderation is the key. Jogging on the treadmill is a high-impact exercise. The more you use the incline of the treadmill, which goes against the gravity, the more you damage your joints. Similarly, when you indulge in squats with weights on your shoulders, the moment you come up, you are against gravity. So, exercise has to be customized. The best way to remain active without harming your bones and joints is to swim, because the gravity is eliminated. Another example is cycling, wherein you can cycle stationary or moving, and don’t end up damaging your knee. Third such activity is brisk walking in the park. But it is not advisable for those over 50, to jog on concrete roads as the load on knees is more. Also, walking on the treadmill, elliptical, upper and lower body weights are advisable.
What are the various must-haves that promise healthier bones?
To maintain, strong and healthy bones, you must include calcium and iron and essential fatty acids in your daily dietary intake. First, a good quantity of calcium can prevent the softening of the bones. And for this, you must have milk and milk related products, four almonds a day, green leafy vegetables, fish among others. Fruits that contain omega 3 fatty acids are beneficial for the protection of your knee joints. Flaxseeds and fish contain a lot of omega 3 fatty acids, and you can also get omega 3 fatty acids capsules over the counter which you can have once a day.
What are the chances of Indians suffering from knee related problems in the coming years?
Statistics are staggering. In a study that was conducted, it was found that chances of Indians above the age of 55, suffering from knee related pain is as high as 90%. And the chances of an Indian above 55 years of age, actually ending up with a knee replacement, is currently 2% of the population. So, if you multiply the population of India by two, then these are the numbers of knees which will get replaced. In India, the chances of knee arthritis is very high, because of the way we squat and sit. If you go to Europe, chances for hip arthritis are more than knee arthritis. This is also because, Europeans don’t squat on the floor.
Dr Shridhar Archik is currently attached to Lilavati hospital and Shushrusha Hospital, Mumbai.
