I don't see any info on Fish or fish oil amounts? My knee issue cleared up using high dose pure fish oil sup (6g per day split am/pm), mackerel, trout and salmon min of 3 times a week. Eliminated calcium sups, took ice bath 6am and 10pm every night for two weeks (to increase testosterone) followed each bath by localised therapy with either infrared lamp or ultrasound for 10mins. I've been strict paleo for 7months with only some goats milk for my tea. Tons of kerrygold and the fattiest grassfed/slow reared meat my local farm can supply. Mutton in the Crock pot is a real find :]! Hope you find this helpful. Good luck.

I have arthritis in my family but don't have any symptoms yet (I'm 41), but it is something I worry about and try to prevent against.

The things I focus on are vitamin D supplements and a lot of omega-3's through either diet or supplements (I prefer diet but supplements are a good source) and keeping my legs strong and flexible. You might consider adding fish oil capsules.

The last time I tried Glucosomine/Chondroitin it wrecked havoc on my stomach, but I think it was helpful in recovering from a soft tissue injury around my knee.

My brother has had a lot of knee injuries/problems and he does a lot of strength-building / maintaining exercises such as squats and knee presses. During the PT recovering from my knee injury we did a lot of this too. Standing on a balance board, wall squats with a big ball, "monster walk" (walk across the room in a squat with a resistance band around ankles). The idea is to strengthen the muscles not only directly around the knee, but those that aid in lateral/twisting motions and balance. I think kettlebell swings would be good for this too. I think it makes sense that improving the muscles will take stress off of the joint.

The PT was through a chiropractor who practiced something called the "Graston method" which involves using metal tools to massage and smooth out the soft tissue around the affected area. Sounds kind of strange but it got me from unable to walk to running 2-3 miles within about 6-8 weeks. Not sure if this would work for you but you might check into it.

You might also consider yoga, which can be great for both flexibility and strength building. I find Iyengar style yoga to be a much more physically challenging than other types.

Rhonda 7 months is not long enough with joints that bad......you need to get a few blood tests done. Go get ultra sensitive crp and vitamin d level done with reverse T3. You must be optimal in those three tests before you have surgery. If those are not optimal you may still get better clinically without surgery. That is what I do on my spine patients.

Along the lines of exercise, diet can only do so much, but if you are loading your foot or hip differently or inefficiently, your knee will suffer. You stated you had hip surgery too, and all of that will affect how your body functions overall.

Add broth made from slow-cooked bones.

Rhonda, take care with the running. I know they are only short sprints but if your knee has OA, restrict the impact exercises and you will have less pain. 7 months is not a long time on a healthful paleo diet. You have made fantastic progress already, but you will make more over the next 7 to 12 months with both weight loss and pain relief. I recommend low impact high intensity resistance training for my patients (I'm an MD Rheumatologist with an interest in ancestral nutrition and in a previous life was a fitness instructor!). You can perform sprints on an exercise bike and on a cross trainer (not quite as effective as running, but still incredibly beneficial).

Taking fish oil is an obvious requirement. I don't think you need to worry about your thyroid function with your recent (excellent) weight loss and your current levels of physical activity. Neither do I think that high sensitivity CRP is of any use whatsoever. If you are carrying an extra 50 pounds it will be high...big deal. Lose the weight and keep eating paleo and it is highly likely to come down. Getting your hydroxy vitamin D levels checked is a good idea though. But if you don't, simply take 2000 IU/day throughout the winter, early spring and late autumn and your will obtain and maintain 'normal' levels.

If you still have prolonged episodes of problematic pain, try a 'steroid' injection (methylprednisolone or triamcinolone). In my experience, this may give several months of relief, thereby keeping you more active.

Good luck

My knee pain and instability was diminished but not gone after surgery. Improving strength and flexibility of the muscles around the knee helped make the pain go almost totally away for good.

For strength I stick with deadlifts and squats. Low volume (<20 minutes), low reps (<6), low sets (5-6) high resistance (>body weight). Two or three times per week. I never go to the gym till I feel fully recovered.

For flexibility I use Active Isolated Stretching (AIS). I recommend at least 4-6 weeks of cautious AIS before adding weightlifting and then a gradual build up of weight resistance using a periodized approach adapted to your recovery ability.

If the knee is extremely painful, start out doing your AIS extremely slowly in the warmest pool you can gain access to. A large, deep Jacuzzi is ideal.

I also use Chikly Method lymph drainage to drain excess fluid if the knee becomes swollen.

Ping me if you need more tips.

Be well,

Ben Fury

If in fact your knee is bad enough to require surgery try to strengthen your leg muscles as much as possible and then get the surgical repair done.

I too suffered lack of sleep and/or poor quality sleep for too long before I had my knee replacements done. By the time I had surgery I was so bow-legged I looked like a cowboy. :(

I had one knee done in May and the next done in July the same year. After a few hissy weeks of recovery I was glad I did. I now get restful sleep.