Plan a fitness regime for good knees: Dr Nadkarni

Knee guru, Dr. Dilip Nadkarni, is an orthopaedic surgeon specialized in treating sports and fitness related injuries.

Dr. Nadkarni’s forte is Arthroscopic or keyhole surgery of the knee.

A postgraduate teacher for orthopaedic surgery, Dr. Nadkarni is on the faculty to train fitness professionals at the American College of Sports Medicine.

He is affiliated to Lilavati Hospital, Mumbai; has a private practice in SantaCruz and also operates at Saifee hospital in south Mumbai.

Dr. Nadkarni has written 3 books Knee Problem No Problem, REAL Fitness and Calm Sutra and has brought out a DVD on tackling knee problems called ‘Knee Problem No Problem’. He also gives lectures on TV, Radio, at Sports Clubs, Rotary and Lions Clubs, Social Organizations and Corporate Bodies.

He launched the Fit India Movement to promote fitness.

Dr. Nadkarni took time off his busy schedule to answer Sify readers’ questions on arthritis, knee pain and related orthopaedic issues. Read the chat transcript here.

Back pain needs to be diagnosed. Thorough clinical examination and tests like X rays and MRI may be necessary to know the cause of your back problem. Pl try and see a spine specialist who will be able to throw more light on your condition.

My mother, about 73 years old has back as well as knee problems. How do you assess her condition?
It is common for 73year old to get some back and knee problems. If they are disturbing get her checked by an orthopedic surgeon.

my name is sadhan basak. i am 34 years old. i have back pain and LS pain since 8-9 years. i can’t sleep at night for this pain. i have done digital x- ray of that particular area but nothing seen in x-ray plate. please give me a solution
You need to get an MRI of your spine and see an orthopedic surgeon.

Hi Doctor. I have continuous muscle like pain in left neck (back of shoulder) emanating towards left chest for last 3 months. Diagnosed with deficiency of Vitamin D3 and Vitamin B12 The pain is still not subsiding after 1.5 months of course.
Pl check your posture. Start stretching and strengthening execises for your neck muscles. See an ortho surgeon if the pain persists.

i hv bn suffering frm “diffuse disc bulge at L4-L5, L5-S1 casuing mild thecal sac and bilateral neural compression” & “loss of posterior concavity of L3-L4 disc” since last 2 year what cn i do(any exercises, etc.
Pl do not start any exercises till you see a spine or neuro surgeon.

I have diagnosed with water retension in both the knees. Also, I have told that there are signs of early osteoartherites. Presently i have signs of tennis elbow. Please advise as to what sort of treatment I should go. Thanks.
Pl get your RA test and Serum uric acid tests done. X rays of your knees and an ortho consult will help find the cause of fluid in your knees.

how to increase stemina
Aerobic exercises like cycling, swimming, running will help you inc stamina.

my husband has hip pain on and off, he is refusing to see a doc. age 45. is it normal?, drives car, no exercise, normal weight slight potbelly
pl convince him to see a doc. Hip pains should not be neglected.

how to differentiate between RA and osteoarthritis?
Clinical history, number of joints involved, age of onset, Knee X rays, blood test like RA factor will help diff bet OA and RA.

have pain in left shoulder acute at times. how to prevent this?
Do not neglect shoulder pains. Pl see your orthopedic surgeon and see the end of it.

doctor, can disc bulge patients ever get back to normal life?
Of course, I myself had a disc problem. With good physio exercises I am back to gymming and golf.

i had mild disc bulges with protrusion in L1 to S1 3 yrs back but even now i have pain. if i increase activity it gets worse. will it get better over time? am 39 now, exercising regularly, normal weight
I am sure you are developing your back and core muscles. Good posture and fitness should help you. If pain persists an Orthopedic consult is a must.

apart from Xray what are the other diagnostic mehtods available to find the root causes of knee pian
A good clinical examination from an Ortho surgeon is a must. MRI is a good test to see what causes knee pain.

Dear Doctor, Knee problem is persisting for last 5 yrs.BMD is T -1.0 Age 57.Kindly advise. Mrs.Chandra
Apart from the BMD, you will have to get an Xray of the knees to look for Osteoarthritis. Pl see your local ortho surgeon or send your Xrays at

hi doctor, my mother has alkaptonurea. is it debilitating? she also has osteoarthritis and severe knee pain
You will need to consult a Gen Med specialist for the alkaptonurea. for the osteoarthritis she needs a good physiotherapy program to cope with the pain. If the pain is too severe consider seeing an Ortho surgeon,

im overweight with knee pain. how to test for arthritis?
An xray of knees done standing will show signs of Osteoarthritis. There are blood tests for the other variety Rheumatoid arthritis.

Sir, Last week while carrying a heavy cartoon box, my right knee got twisted little bit. Definitely, nothing happened to the bone. But my walk is not normal. Not able to climb the steps like earlier. Kindly advise me what to do?
Pl see an orthopedic surgeon. If there is swelling apply ice and rest it.

i have pain in my left hand ring finger mainly while folding it. am 38 nw. is it arthritis?
If there is a clicking sound when you fold or straighten it could be a trigger finger.

is osteoarthritis hereditary?
Yes, there are genetic factors associated with primary Osteo arthritis.

will being physically active prevent osteoarthritis?
Yes, to a large extent. Cycling, swimming and stretching exercises are good. My DVD Knee Problem No Problem could help you plan a fitness regime for good knees.

my son has leg pain-calf muscle and ankles, plays a lot – 16 yrs, is it growing pains?
Most likely these should be growth pains. If they persist pl see an orthopedic surgeon.

is there any way of detecting bone cancer? what are the normal symptoms?
Bone scans and MRI scans are used to detect bone cancers.

is there any symptom to ligament tear – my sis got tear in knee suddenly in bed

the common symptom of ligament tear is instability or buckling.

doc, does cervical disc bulge worsen with age, im 40 nw and on n off, it flarees up, wrking in IT firm, maintain good posture
Pl keep good posture and perform stretching exercises at work. Pl take frequent breaks and drink lots of water.

am 37, started bone pains;diagnosed as osteopinea; osteoporosis and little bit of arthritis effect.can this bone damage be stopped.please advise me and i am staying abroad,when i come to india i will go for full checkup
Good walks outdoors, stretching and strengthening exercises should help you till you see an orthopedic surgeon.

My wife under went knee replacement by Dr. Keith Berrand from US at Fortis with the close consultation and Dr. Sreenivas. even after 3 1/2 mths after oper, swelling on her leg. Is it normal? want her to go for replacement in left leg also. ur advice pl

It is better you consult your orthopedic surgeon for the knee swelling. If satisfied with the result in right knee, go ahead with left too.

I yusufdhilla &my wife zohra dhilla has lot of pain in our knees & back also joint pain, we have less fitness, always we feel weaknes,&restless
A good exercise program will help you both. Join a gym or start walking wearing good sports shoes.

am 60, my knees, back pain L4-L 5 started since 2 mths. underwent angioplasty; 1 medicated stent 2yrs back. on ecosprin 75, atorvastatin 5 mg. diagnosis after x-ray and mri due to aging. doing physiotherpy, light execises knee, back.would like ur opinion.
Yes, keep the light exercise program going. It will help your cardiac as well as orthopedic status.

have the arthritis problem since 10 yrs, i am unable to walk properly , i am under medication so that to relive my knee pain,oi would not like to to be operated,pl suggest
Pl consult a physiotherapist and get yourself a stretching and strengthening prog for your knees. Keep body weight low and you have a chance of escaping surgery.

Ht 5 ft 7, wt 83kg; sportsperson in my teens; am 40 nw. Knee pain in family; last 7 to 8 years i have severe pain; if I sit down, I cant get up, morn need hot shower for 15 mins to be able to move. Please advice
Pl get your knee joint Xrays done and clinically seen by and orthopedic surgeon. In menatime you could cycle or swim to maintain fitness.

am 53,some years backs,right knee started paining; consulted dr, they told me due to age, from last one wk, bad kneepain, all activities with pain, wt 62 kg,no bad habits,pure veg, physically fit no health prob. what to do
You may need and MRI to study your joint structures. You could send me the report on

Am tennis player. Got medial meniscus tear on left knee. On blood thinner tabs for DVT from Feb 2012. before starting serious tennis would like to take ur advice.
You may need arthroscopic meniscal treatment. Your surgeon would advice stopping blood thinners in the peri operative phase.

Good morning Dr. i completed 7 months of my ACL surgery but still i am not able to walk long & run? i am doing all exercises by the help of DVD – Knee Problem -No Problem & doing cycling also 3km-4km in a day.

Hi Deepti, Running is advised after about 9 months from ACL surgery. You are most welcome to see me in Mumbai at end of 9 months.

Frozen shoulder can it be cured what do u suggest
Of course frozen shoulder can be set right. Exercises and painkillers do the trick in initial stages. If that fails we can treat it by manipulation under anesthesia.

At the base of my thumb (joint with palm) I get severe pain and my top part of thumb has gone stiff and has to be adjusted if turned back -is it a tendon break or arthritis,? maria -Lucknow
I will need to see your X ray to understand your problem. Pl consult your local Orthopedic surgeon.

I developed pain in knees 4 yrs back,when used to go downstairs.It was osteopenia.I improved on Ca intake and got relief. But now again I find it not so comfortable climbing up and down stairs. Is it something else developing. Kindly advise. Regds
Try building your quadriceps muscles to get strength for stair climbing. My DVD Knee Problem No Problem could help you perform these exercises at home.

My father has been advised for a knee replacement surgery, will there be any DON’Ts after the surgery?
Usually we advise persons not to sit on low furniture or cross legged. Also impact sports and running are to be avoided.

I am 43 years old last two three months only my two legs knee pain started i had shown to the doctor but he had given some calcium medicine and suggest me to do some exercise . please suggest me some good home remedies.
Cycling will help most persons with knee problems to shed weight and strengthen knees safely.

Are oils like sandhisudha which claim to cure joint pain, worth the money. My parents(aged 65 &58) often have knee pain and feel difficult to walk stairs . Is there any permanent remedy without doing operation?Please suggest
I have no experience with these oils. Ask them to avoid stairs as far as possible. You could get tips from my DVD Knee Problem No Problem for preventing further damage to knees.

My Mom has a severe knee prob. Both her legs gt swollen-up too aft evry few days. Shes been advised a surgery. Lately shes gained a lot of weight also. I hv 2 ques to ask * Wht kind of food should she be consuming & avoiding? * Is surgery advisable?
Surgery is the answer if she is in great pain. Lots of green vegetables, drink lots of water and take supplements like Calcium and glucosamine. Weight loss is very important if she wants to avoid surgery.

Iam 65, have severe knee pain at times. Do regular exercise like walking (brisk), cycling 20 min. Still at times pain is bad. Knees get frozen if sit for 2/3 hs

I am happy that you are exercising. I would recommend that you continue cycling and reduce brisk walking. Good stretching exercises will help you. You could get a copy of Knee Problem No Problem DVD to learn these exercises.

sir i am 5, 7 and half , 80 kg , go for brisk walk regularly since last 8years. nowadays i get pain on certain days in my right knee, more so on the back of knee and have problem in walking fast and this goes away on its own .pl suggest what to do
I think for 5,7 height you need to shed a few kilos. Try cycling to get rid of 3-4 kilos and then resume walking. If pain continues Orthopedic opinion is a must.

My mother age 65 cross she suffer from knee pain, all orth. Dr. given solution only operation, but she not ready to do operation inthis ege. what we do for her, any medicine / oil for her is available, we cant see her pain.
Your mother could follow a physiotherapy program. Lose weight and take supplements like glucosamine. If she can cope with the pain and her mobility is good, no need for surgery.

You have not told me your age. Knee pains while climbing or descending stairs could benefit from a clinical examination from an orthopedic surgeon.

I have problems in my left knee.My age is 48,height 6’1″ and weight 100 KGs.I regularly excercise in a nearby GYM and at that time i do not feel any pains,generally it pains after i get up after sitting continiously for two-three hours in one place
As with most knee problems weight reduction could be helpful. Weight training to build quadriceps and hamstring muscles would help. If you need to sit for long hours, pl take breaks and stretch your legs. If pains continue see an orthopedic surgeon.

While exercising …jacking or treadmill walking, some times I feel pain at my legs…….. this is not happening all the times, how to avoid this pain ….
Be sure to warm up gradually, stretch your muscles before starting to walk. Try and avoid walking on inclines.

is there any way osteoporosis can be prevented?
Osteoporosis can be prevented to some extent with good outdoor exercise, nutritional supplements like Calcium, Vit D and Proteins. Weight bearing exercise like walking and weight training in the Gym can be helpful.

I am 41 year old, house wife, slim weight residing in Mumbai.
Since past many years having acute pain in both the knees on upon repeated diagnosis it was noticed that my cartilages have been damaged severely. As such gap in knee is virtually finished at least from one side of knee. The reason of this and allied (Pain in bones, falling of hair, decay in teeth etc. are many related/un-related) problems could not be ascertained precisely. IT is lack of calcium absorption of gene mutation etc. are labeled but I am not convince at all. May be medical science can not tell exactly.
1. What could be the reason of such a stage in this early age?
41 age is too early to get such severe degeneration in the Knee. There could be an underlying cause for this affliction. Clinical examination and other investigations could help us find the cause.

Now I have been suggested knee transplant in both knees which I have been avoiding / delaying for past 6-7 year now. Hidden reasons for the same was to wait for stem cell technology or synthetic culturing of cartilage etc. etc. but not sure if there has been any substantial progress in this field and then will it be applicable in my case. Except very low Vitamin B3 level all other tests are more or less in order.
Stem cell therapy is in its infancy as far as degenerative knee disease is concerned.

2. Could there be any relation of other problems with the reason of bone problems? (I feel there should be some link with the grass root of problem which is still not clear)
Further investigations may reveal metabolic conditions. Bone density also needs to be studied.

3. Is there any alternative therapy or technology or medicine which could avoid operation ?
Maintaining low body weight, exercises to stretch and strengthen the muscles around the knee could be helpful.

4. Seek an appointment to get check up and decide for operation with Dr. Nadkarni.
Most welcome to see me.