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Monday, October 19, 2020

Running Safely: How to Stay Active Without Arthritis Pain

Posted By: Advancing Care
WMCHealth experts shed light on a same-day procedure to help keep athletes and weekend warriors on track.

By Laurie Yarnell

Relief for Aching Knees:

An outpatient procedure can help some with osteoarthritis of the knee get back in action in just days.

Like more than 27 million people in the United States, you may suffer from osteoarthritis (OA), a degenerative and progressive breakdown of the joint most commonly caused by the wear and tear of aging, prior injuries, obesity and/or genetics. The knee is the most common site for OA, and for many, the condition may interfere with such activities as running (see adjacent article).

But a minimally invasive, image-guided procedure called geniculate artery embolization (GAE), performed at the Ambulatory Care Pavilion at Westchester Medical Center, the flagship of the Westchester Medical Center Health Network (WMCHealth), now offers new hope for these patients.

To make an appointment with an orthopedic specialist, call WMCHealth Advanced Physician Services at 914.909.4168 (Hawthorne), 845.896.4178 (Fishkill), 845.383.1759 (Poughkeepsie), 845.368.5884 (Suffern) or 845.987.5400 (Warwick).

“Arthritis can cause overgrowth of blood vessels and sensory nerve fibers that transmit pain,” explains Samuel McCabe, MD, an interventional radiologist who performs the procedure. “GAE reduces or eliminates this abnormal blood flow, reducing the amount of pain experienced.”

While not for everyone, “GAE fills a need for a specific group of patients: Those with knee pain affecting their lifestyle but only mild arthritic changes not advanced enough to warrant a surgical knee replacement. GAE is not effective for other causes of knee pain, such as a torn meniscus or ligament,” adds Dr. McCabe.

To determine a patient’s suitability for GAE, the patient is first examined by an orthopedic surgeon, like Howard Luks, MD, Chief of Sports Medicine and Arthroscopy at WMCHealth (see adjacent article) in order to obtain a referral for the procedure. He performs a physical exam and reviews the results of a standing X-ray to determine the degree of arthritic changes.

“Patients are often under the misconception that they need surgery for severe arthritis,” says Dr. Luks. “But there are other options, like knee embolization, which are effective for patients who don’t have bone-on-bone arthritis but still have severe pain and swelling that doesn’t respond to other measures.”

Are you interested in geniculate artery embolization? Here’s what to do:

  1. Make an appointment with an orthopedic surgeon for an evaluation. Call 914.493.2500.
  2. Obtain authorization through your insurance provider.
  3. Schedule a consultation at Advanced Imaging. Call 914.493.2500, or request an appointment online at westchestermedicalcenter.org/advanced-imaging.

What exactly happens in GAE?

GAE, or geniculate artery embolization, is a one-hour outpatient procedure performed under moderate sedation in Westchester Medical Center’s Ambulatory Care Pavilion. Dr. McCabe enters the arterial system through the upper thigh and performs the entire procedure through that access point.

Guided by fluoroscopy’s real-time moving images and intermittent contrast dye injections, he infuses microscopic particles into the arteries around the knee. “The patient is not opened up; there are no stitches, just a pinhole for the infusion, and there’s minimal discomfort associated with the procedure,” he says. “Some patients feel immediate relief and are back in action within a day or two.”

Running Safely

A Q&A with orthopedic surgeon Howard Luks, MD, Chief of Sports Medicine and Arthroscopy at Westchester Medical Center.

What’s the most important thing for a new or returning runner to understand?

Avid runners and other athletes may suffer from one of many overuse injuries during their years of running. Luckily, there are strategies to minimize the risk of developing these injuries in the first place. Similarly, athletes returning after an injury need to be patient and give their bodies a chance to readjust to training.

What is the most common cause of running injuries in returning runners?

This advice applies to all runners: Don’t run too far, too fast. Instead, train slow to run fast. Remember, you can’t go from a couch to a 5K overnight, even if you have previous running experience.

What are some COVID-19-related running consideratons?

When COVID-19 came about, I saw many patients with overuse injuries. Their schedules had changed, and they began ambitious running routines without the proper preparation. On a separate note, when it comes to COVID-19, it is much safer to run or exercise in the open air vs. indoors, where there is a greater risk of infection.

How should a runner work to increase distance and pace?

Go slowly over four to six months and never increase more than 10 percent a week (i.e., don’t go from 10 miles one week to 20 the next). New or returning runners can start with walk/runs, alternating walking and jogging.

What pace do you recommend?

Most runs should be at a slower, conversational pace, so you can talk to a partner. Experienced runners can add one or two faster runs per week. But don’t overdo it on every run, so you don’t end up in my office!

More Tips From Dr. Luks

• New runners with medical issues or a family history of heart disease should consult a primary care physician first.
• Research confirms that the proper shoes are the ones that are most comfortable. Try them out and reject those that “fit” but aren’t comfortable.
• Hydrate in very hot weather and for long distances, but, generally, don’t force water; instead, drink to your thirst. For shorter runs, of less than 15 miles, sports drinks are unncessary, due to the excessive sugar content.
• Other than stress fractures, many injuries do not require you to stop running; still, it’s always a good idea to check with a doctor.

To make an appointment with an orthopedic specialist, call WMCHealth Advanced Physician Services at 914.909.4168 (Hawthorne), 845.896.4178 (Fishkill), 845.383.1759 (Poughkeepsie), 845.368.5884 (Suffern) or 845.987.5400 (Warwick).