Full Transcript Introduction: Knee Pain and Golf 0:00 What if the thing that's quietly messing with your golf game has been hiding inside your knee all along? 0:06 You still love this game, mostly, but lately it's been coming with a catch. 0:10 You've tried the brace, you're icing it after your rounds, You skipped a tee time or two with you friends because it aches. 0:18 you've got ibuprofen in your bag that sits right next to your tees and now you are taking it before you play just to stay ahead of it. 0:24 And it mostly works until about the seventh or eighth hole. 0:28 And then by the time you step off the ninth, that familiar ache is right there. 0:33 Nothing dramatic, just that dull, nagging reminder that something is not quite right. 0:39 You're still having a good time, you're enjoying the sunlight, the social time. 0:43 But part of your brain is somewhere else. 0:46 half in the conversation with your buddies and it's half just waiting for that knee to ease up. 0:51 If that sounds familiar to you, hit subscribe. 0:55 Every week I help golfers understand what's going on and how to stay on the course for free. 1:00 No fluff because that low grade annoyance, it has a name and its worth knowing. 1:06 Now here's what nobody is telling me. 1:08 That ache that's inside your knee is not just age, it isn't something that you have to just accept as part of getting older. 1:14 It is your body sending you a very specific message and it has a cause and a fix. 1:19 The rust inside you knee, is stealing the game you love. 1:23 And I think it's time we talk about it.
What Knee Arthritis Is 1:25 I'm Dr. 1:25 Gayan Puvendor. 1:26 I am an orthopedic physician, a golf lover, and for the last 15 years I've helped thousands of golfers stay on the course without resorting to surgery. 1:34 If you've been here before, we've tackled the medial meniscus and the MCL. 1:40 We're going to go a little deeper into that joint. 1:42 Today what we're talking about is knee arthritis, what it actually is, why golf accelerates it, and what you can do right now to protect what have left 1:50 and keep playing the game that you love. 1:52 So pull up a chair, grab a seat, because I think this one really matters. 1:56 Let's start with the big question. 1:58 What actually are arthritis? 2:00 Here's what's happening inside. 2:02 Your knee is covered with something called articular cartilage. 2:05 Articular is just fancy doctor talk for something that's at the joint. 2:10 And normally it's smooth and it shiny and its slippery like ice. 2:14 The best way to visualize this is think of the white glossy surface at end of a chicken bone. 2:19 That's cartilage. 2:20 It's entire job is to absorb the shock and let your bodies glide past each other without friction. 2:26 Now arthritis happens when that cartilages starts to break down. 2:30 When arthritis sets in, that surface gets thinner, It gets rough, it gets ragged, and eventually you start hearing about something called bone grinding 2:38 on bone, which is exactly where that deep aching and sometimes even sharp pain is coming from. 2:44 That's your knee and that's arthritis. 2:46 So let me give you a picture that is going to stick around with you. 2:49 Think about a door hinge. 2:51 Brand new from the store, it swings smooth and silently, and it's effortless. 2:55 That was your knee when you were younger. 2:56 Now, picture that same hinge after years of rain and heat and cold. 3:02 It gets stiff. 3:03 it gets creaky. 3:04 You try to force it open and grinds. 3:08 Old hinges give you twinges, and for you golfers, those twingers show up right when you need that knee the most.
Why Golf Strains an Arthritic Knee 3:14 Now, where do you feel it? 3:16 Most golf players that talk to me with knee arthritis describe it as a deep, dull ache, usually on the inside of the knee or in the front. 3:23 They will complain to be about stiffness in morning, kind of like a hinge that needs about 10 minutes to warm up before it starts to work properly. 3:30 They may complain about pain that's worse after sitting for a long time and then standing up. 3:35 And specifically for golfers, that grinding, burning sensation that starts to creep in around the sixth or seventh hole and really starts get angry by 3:44 around ninth. 3:44 Does any of that sound familiar to you? 3:47 If it does, I want you to know that it's not just aging. 3:51 It is actually a mechanical problem. 3:54 and mechanical problems fortunately have solutions. 3:57 So why is golf so hard on an arthritic knee? 4:00 Here's what makes golf uniquely brutal on arthridic knees. 4:03 And this is where it gets really interesting for somebody like me. 4:06 For a right-handed golfer, your left knee or your lead knee is the anchor of your entire swing. 4:12 So during your golf swing, there are two very specific things that happen to that knee, both of which are absolutely devastating if there's already arthritis present. 4:22 Problem number one is rapid rotation. 4:25 Now during you backswing, your left knee has to rotate inwards towards your body. 4:29 We call that adduction. 4:31 Then on the downswing it has rapidly rotate away from your buddy. 4:35 You call it abduction, back and forth, snap, every single swing. 4:40 Now, imagine that on a fresh, healthy hinge. 4:42 It's fine, a little wear over time, but not even noticeable. 4:46 Now imagine the same motion on that rusty hinge, that snap and twist isn't just stress, it's grinding, scraping, the rough, 4:56 ragged cartilage catching on itself with every rotation. 4:59 That's why golfers with arthritis often feel a sharp twinge mid-swing. 5:04 right at impact. 5:05 Problem number two is compressive load. 5:08 So on top of rotation, during your downswing, you're also driving your entire body weight forward onto your lead leg.
Hip-Knee Self Test and Diagnosis Differences 5:14 That forces going through the joints at Impact and it's significant. 5:17 We're talking up to four times your bodyweight. 5:19 Remember me, I'm 200 pounds, that's 800 pounds of bodyweigh going though that knee. 5:23 When my cartilage is healthy or your cartilages healthy, no problem. 5:27 It absorbs it, it bounces right back. 5:29 But when the cartledge is thin or it's starting to go away in spots, that force gets directly into the bone. 5:35 And that's where the pain makes you wince on your follow through. 5:39 That's the ache that doesn't go way after the round. 5:41 So between the rapid rotation and the compressive load, your arthritic left knee is fighting a war on two fronts every time you step up to the tee. 5:50 Okay, I want you to do something here with me. 5:52 This is our self test. 5:53 If you're sitting down, please stand up. 5:55 You're going to a quick test that takes about 10 seconds and can tell you a lot about what's happening on your swing. 6:00 Here is what I call the hip knee connection. 6:02 Number one, stand on you left leg only. 6:06 Slightly bend the knee. 6:07 Just a little softness, just like you are getting ready to address, not a deep squat. 6:11 Try to rotate your hip. 6:13 Slowly turn them to the right like you're starting your backswing. 6:16 What did you feel? 6:17 If your hips feels tight, like it's hitting a wall before your head can fully rotate, that is a huge red flag. 6:24 Here's why. 6:24 Your body needs rotation to swing a golf club. 6:27 If you hip isn't giving it to you, your knee is going to try. 6:30 your knee will twist extra hard to make up for what your hip is not doing. 6:34 And for an arthritic knee, every single extra degree of rotation is more scrape of bone on bone or rough cartilage. 6:41 Did you feel a pinch in the knee when you tried that? 6:43 Did feel pull? 6:44 Was there any discomfort? 6:46 That is your body telling you exactly where the problem is and now you know what to do about it. 6:51 Now, I know some of you have watched my MCL video at my meniscus video, and you might be sitting there thinking, Dr. 6:56 Prevendor, how do I which one that I have? 6:59 It's a great question, so let me do a really quick breakdown for you. 7:02 MCl pain, as we talked about before, lives on the inside edge of the knee. 7:06 It is often sharp and localized, you can usually put a finger right on spot.
On-Course Fixes and Off-Course Exercises 7:10 It feels like a pull or instability when you're shifting your weight, and it often happens after a specific awkward swing or a tweak or stumble or an overreach. 7:20 Meniscus pain, a little deeper inside the joint. 7:22 It's often mechanical. 7:24 The knee catches, it clicks, It locks during rotation. 7:28 There's a sharp, specific, nagging pain, and it often gets worse the more that you use it. 7:33 Arthritis pain is a little different. 7:35 It's little more diffused, it's broader, deeper, a littler duller. 7:39 it builds over the round rather than hitting you all at once. 7:42 Worst first thing in the morning, then it loosens up, but then comes right back after a sustained hard activity. 7:48 Doesn't follow one specific tweak per se, its been creeping in for years. 7:52 Now, if you're not sure which one you have, go see a doctor and get some imaging or get an exam. 7:57 Knowing the difference is the first step. 7:59 So let's talk about some quick fixes that you can do on the course. 8:02 This is a part that came for, right? 8:04 What can you actually do about it? 8:06 Well, let start with what you change right now, today, on The Course. 8:09 Quick fix number one is flare your lead foot. 8:12 Remember that door hinge analogy? 8:14 This fix is like oiling the hinge right before you use it. 8:17 Before you swing, turn your left foot towards your target about 20 or 30 degrees. 8:22 This helps open up the door at the hip and allows your hip rotation to guide your swing rather than being forced through your knee. 8:30 Less twist at knee means less grinding and it means more pain. 8:34 It's really that direct. 8:35 Try it on the range first and I think you'll feel a difference immediately. 8:38 Quick fix number two is shorten your backswing. 8:40 A full aggressive backsing demands maximum rotation. 8:44 So if your hips are stiff and your knee is arthritic, a long backsling is not going to be your friend right now. 8:50 Do a three quarter back string with a more controlled rotation. 8:54 This will reduce the stress on that lead knee dramatically. 8:57 Yeah, you're going to lose a little bit of distance, but you are going gain a lot of pain free holes down the road. 9:01 So now let's talk about what you can do off the course because the best protection for the arthritic knee is the muscles surrounding it. 9:09 Stronger muscles mean less load on the joint and less pain. 9:13 Here are five of my favorite exercises that I recommend to all of golfing patients. 9:17 Exercise number one is a straight leg raise. 9:20 Lie on your back, lift your left leg while keeping it straight. 9:23 This is going to help build that quadricep muscle, that's the muscle on the front of your thigh, without putting any pressure on you knee joint itself. 9:29 Think of it like strengthening the support beams of you door without rattling the rusty hinge. 9:34 Exercise number two is hamstring stretches. 9:37 Hamstrings that are tight pull on the back of your knee and they add extra stress during your follow through. 9:43 So flexible hamstrings will really take that load off. 9:46 Even 30 seconds a day makes a difference. 9:48 Exercise Number Three is step ups. 9:51 Use the bottom stair or a really small step. 9:53 Step up slowly with control. 9:55 This mimics the late shift that you do in your golf swing and trains your leg to handle it with less compensating stress on the knee. 10:02 Exercise number four is calf raises. 10:05 Strong calf rises stabilize your lower leg. 10:08 So when your calf is doing the job, your knee doesn't have to fight to stay aligned during your rotation. 10:13 And number five, our favorite, glute strengthening, hip bridges. 10:17 this one is really underrated. 10:19 Lie on your back, Bend your knees and push your hips towards the ceiling.
Warning Signs and Final Takeaways 10:24 Strong gluteal muscles can take the rotation off of your knee. 10:27 Remember, when the hip is weak, the knee picks up the slack. 10:31 Build the hips, protect the knees. 10:33 Now if you've noticed, none of these require a gym membership. 10:36 These are just five minutes a day. 10:37 Your knee will thank you by the 18th hole. 10:40 Now, I want to be straight with you here because I'd rather be honest than just tell you what you want hear. 10:45 Arthritis is manageable and you can keep playing, but there are certain warning signs that mean that your body is telling you very loudly that it needs 10:52 more than this YouTube video. 10:54 Here are your red lights. 10:55 Number one, if your knee gives out or buckles when you shift your weight. 10:58 number two, you hear a loud pop followed by intense pain or swelling. 11:03 Number three, your knee is physically locking up. 11:05 It's getting stuck and it's refusing to straighten. 11:08 Number four, you can't bear weight on it. 11:10 You can walk to the next hole or to your golf cart and you cant stand comfortably. 11:20 And number six, the joint looks different. 11:23 It's visibly deformed or it looks like it's out of place. 11:25 Don't trade your long-term mobility for that one more round of golf. 11:29 And I mean that. 11:31 The game will always be there. 11:32 Your knee, if you ignore it long enough, might not be. 11:35 All right, so let's bring this all together. 11:37 Your left knee is the anchor of your golf swing. 11:40 When arthritis sets in, when that hinge starts to get a little rusty, every rotation, ever ounce of body weight you drive through that joint can cause 11:49 you or cost you. 11:50 The pain you feel is real and it has a cause. 11:54 Tight hips shift the load to the knee that it can't handle. 11:57 Rapid rotation scrapes already damaged cartilage. 12:00 And all of that is fixable, or at the very least, it's very manageable with the right mechanics and the muscles. 12:06 Flare that lead foot, strengthen those glutes, do your leg raises, and please listen to your body when it is flying the red flags. 12:14 Now it time for my standard disclaimer. 12:16 Yes, I am a medical doctor, but I'm not your medical. 12:19 Not yet, anyway. 12:20 If your knee hurts, go see a professional in person. 12:23 This information is meant for education, not specific medical advice for your situation. 12:28 Now, if you found this video helped you, please hit like and subscribe because every week I'm coming back here to help you stay on the course. 12:36 And if have a specific question about your need or your swing, drop it in the comments because I am reading them all. 12:41 I m Dr. 12:42 Gayan Puvendran and I ll see you on The Fairway.
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