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New study suggests weight loss drugs like Ozempic could help with knee pain. Here’s why there may be a link

<p><em><a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/christina-abdel-shaheed-425241">Christina Abdel Shaheed</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>The drug semaglutide, commonly known by the brand names Ozempic or Wegovy, was <a href="https://theconversation.com/the-rise-of-ozempic-how-surprise-discoveries-and-lizard-venom-led-to-a-new-class-of-weight-loss-drugs-219721">originally developed</a> to help people with type 2 diabetes manage their blood sugar levels.</p> <p>However, researchers have discovered it may help with other health issues, too. Clinical trials show semaglutide can be effective for <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032183">weight loss</a>, and hundreds of thousands of people around the world are using it <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">for this purpose</a>.</p> <p>Evidence has also shown the drug can help manage <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2306963">heart failure</a> and <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403347">chronic kidney disease</a> in people with obesity and type 2 diabetes.</p> <p>Now, a study published in the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403664">New England Journal of Medicine</a> has suggested semaglutide can improve knee pain in people with obesity and osteoarthritis. So what did this study find, and how could semaglutide and osteoarthritis pain be linked?</p> <h2>Osteoarthritis and obesity</h2> <p>Osteoarthritis is a common joint disease, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">2.1 million Australians</a>. Most people with osteoarthritis <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">have pain</a> and find it difficult to perform common daily activities such as walking. The knee is <a href="https://pubmed.ncbi.nlm.nih.gov/37675071/">the joint most commonly affected</a> by osteoarthritis.</p> <p>Being overweight or obese is a <a href="https://pubmed.ncbi.nlm.nih.gov/25447976/">major risk factor</a> for osteoarthritis in the knee. The link between the two conditions <a href="https://pubmed.ncbi.nlm.nih.gov/26821091/">is complex</a>. It involves a combination of increased load on the knee, <a href="https://www.nature.com/articles/s41413-023-00301-9">metabolic factors</a> such as high cholesterol and high blood sugar, and inflammation.</p> <p>For example, elevated blood sugar levels increase the production of inflammatory molecules in the body, which can damage the cartilage in the knee, and lead to the <a href="https://pubmed.ncbi.nlm.nih.gov/30712918/">development of osteoarthritis</a>.</p> <p>Weight loss is strongly recommended to reduce the pain of knee osteoarthritis in people who are overweight or obese. <a href="https://pubmed.ncbi.nlm.nih.gov/31908149/">International</a> and <a href="https://www.safetyandquality.gov.au/sites/default/files/2024-08/osteoarthritis-knee-clinical-care-standard-2024.pdf">Australian guidelines</a> suggest losing as little as 5% of body weight can help.</p> <p>But losing weight with just diet and exercise can be difficult for many people. <a href="https://pubmed.ncbi.nlm.nih.gov/26180980/">One study</a> from the United Kingdom found the annual probability of people with obesity losing 5% or more of their body weight was less than one in ten.</p> <p>Semaglutide has recently entered the market as a potential alternative route to weight loss. It comes from a class of drugs known as GLP-1 receptor agonists and works by increasing a person’s sense of fullness.</p> <h2>Semaglutide for osteoarthritis?</h2> <p>The rationale for the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403664">recent study</a> was that while we know weight loss alleviates symptoms of knee osteoarthritis, the effect of GLP-1 receptor agonists was yet to be explored. So the researchers set out to understand what effect semaglutide might have on knee osteoarthritis pain, alongside body weight.</p> <p>They randomly allocated 407 people with obesity and moderate osteoarthritis into one of two groups. One group received semaglutide once a week, while the other group received a placebo. Both groups were treated for 68 weeks and received counselling on diet and physical activity. At the end of the treatment phase, researchers measured changes in knee pain, function, and body weight.</p> <p>As expected, those taking semaglutide lost more weight than those in the placebo group. People on semaglutide lost around 13% of their body weight on average, while those taking the placebo lost around 3% on average. More than 70% of people in the semaglutide group lost at least 10% of their body weight compared to just over 9% of people in the placebo group.</p> <p>The study found semaglutide reduced knee pain significantly more than the placebo. Participants who took semaglutide reported an additional 14-point reduction in pain on a 0–100 scale compared to the placebo group.</p> <p>This is much greater than the pain reduction in another <a href="https://pubmed.ncbi.nlm.nih.gov/36511925/">recent study</a> among people with obesity and knee osteoarthritis. This study investigated the effects of a diet and exercise program compared to an attention control (where participants are provided with information about nutrition and physical activity). The results here saw only a 3-point difference between the intervention group and the control group on the same scale.</p> <p>The amount of pain relief reported in the semaglutide trial is also larger than that reported with commonly used pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/35442752/">anti-inflammatories</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">opioids</a> and <a href="https://www.bmj.com/content/372/bmj.m4825">antidepressants</a>.</p> <p>Semaglutide also improved knee function compared to the placebo. For example, people who took semaglutide could walk about 42 meters further than those on the placebo in a six-minute walking test.</p> <h2>How could semaglutide reduce knee pain?</h2> <p>It’s not fully clear how semaglutide helps with knee pain from osteoarthritis. One explanation may be that when a person loses weight, there’s less stress on the joints, which reduces pain.</p> <p>But recent studies have also suggested semaglutide and other GLP-1 receptor agonists might have <a href="https://www.sciencedirect.com/science/article/pii/S1043661822002651">anti-inflammatory</a> properties, and could even protect against <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6731440/">cartilage wear and tear</a>.</p> <p>While the results of this new study are promising, it’s too soon to regard semaglutide as a “miracle drug” for knee osteoarthritis. And as this study was funded by the drug company that makes semaglutide, it will be important to have independent studies in the future, to confirm the findings, or not.</p> <p>The study also had strict criteria, excluding some groups, such as those taking opioids for knee pain. One in seven Australians seeing a GP for their knee osteoarthritis <a href="https://pubmed.ncbi.nlm.nih.gov/34527976/">are prescribed opioids</a>. Most participants in the trial were white (61%) and women (82%). This means the study may not fully represent the average person with knee osteoarthritis and obesity.</p> <p>It’s also important to consider semaglutide can have a range of <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">side effects</a>, including gastrointestinal symptoms and fatigue.</p> <p>There are some concerns that semaglutide could reduce <a href="https://www.sciencealert.com/experts-are-concerned-drugs-like-ozempic-may-cause-muscle-loss">muscle mass</a> and <a href="https://www.healthline.com/health-news/ozempic-muscle-mass-loss">bone density</a>, though we’re still learning more about this.</p> <p>Further, it can be difficult to access.</p> <h2>I have knee osteoarthritis, what should I do?</h2> <p>Osteoarthritis is a disease caused by multiple factors, and it’s important to take <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard/information-consumers-osteoarthritis-knee-clinical-care-standard">a multifaceted approach</a> to managing it. Weight loss is an important component for those who are overweight or obese, but so are other aspects of <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">self-management</a>. This might include physical activity, pacing strategies, and other positive lifestyle changes such as improving sleep, healthy eating, and so on.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/243159/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/christina-abdel-shaheed-425241">Christina Abdel Shaheed</a>, Associate Professor, School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstocl</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/new-study-suggests-weight-loss-drugs-like-ozempic-could-help-with-knee-pain-heres-why-there-may-be-a-link-243159">original article</a>.</em></p>

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Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead

<p><em><a href="https://theconversation.com/profiles/belinda-lawford-1294188">Belinda Lawford</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/joshua-zadro-504754">Joshua Zadro</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/rana-hinman-1536232">Rana Hinman</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">updated treatment guidelines</a> from the Australian Commission on Safety and Quality in Health Care.</p> <p>So what is knee osteoarthritis and what are the best ways to manage it?</p> <h2>More than 2 million Australians have osteoarthritis</h2> <p>Osteoarthritis is the most common joint disease, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">2.1 million Australians</a>. It <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">costs the economy</a> A$4.3 billion each year.</p> <p>Osteoarthritis commonly <a href="https://pubmed.ncbi.nlm.nih.gov/33560326/">affects</a> the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles.</p> <p>Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs.</p> <h2>Is it caused by ‘wear and tear’?</h2> <p>Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is <a href="https://pubmed.ncbi.nlm.nih.gov/31192807/">not caused by</a> “wear and tear”.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/21281726/">Research shows</a> the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">not required</a> to diagnose knee osteoarthritis or guide treatment decisions.</p> <p>Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have <a href="https://pubmed.ncbi.nlm.nih.gov/37795555/">shown this</a> in people with osteoarthritis, and other common pain conditions such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9545091/">back</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/33789444/">shoulder</a> pain.</p> <p>This has led to a global call for a <a href="https://pubmed.ncbi.nlm.nih.gov/38354847/">change in the way</a> we think and communicate about osteoarthritis.</p> <h2>What’s the best way to manage osteoarthritis?</h2> <p>Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">include</a> education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines.</p> <p>Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms.</p> <p>Health professionals who use positive and reassuring language <a href="https://pubmed.ncbi.nlm.nih.gov/35750241/">can improve</a> people’s knowledge and beliefs about osteoarthritis and its management.</p> <p>Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/36593092/">paracetamol and anti-inflammatories</a> and can <a href="https://pubmed.ncbi.nlm.nih.gov/26488691/">prevent or delay</a> the need for joint replacement surgery in the future.</p> <p>Many types of exercise <a href="https://pubmed.ncbi.nlm.nih.gov/30830561/">are effective</a> for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you.</p> <p>Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time.</p> <p>Weight management is important for those who are overweight or obese. Weight loss <a href="https://pubmed.ncbi.nlm.nih.gov/34843383/">can reduce knee pain and disability</a>, particularly when combined with exercise. Losing as little as 5–10% of your body weight <a href="https://pubmed.ncbi.nlm.nih.gov/36474793/">can be beneficial</a>.</p> <p>Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. <a href="https://pubmed.ncbi.nlm.nih.gov/33786837/">Recommended medicines</a> include paracetamol and non-steroidal anti-inflammatory drugs.</p> <p>Opioids are <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">not recommended</a>. The risk of harm outweighs any potential benefits.</p> <h2>What about surgery?</h2> <p>People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement.</p> <p>Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain.</p> <p>However, high-quality research <a href="https://pubmed.ncbi.nlm.nih.gov/24369076/">has shown</a> arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis.</p> <p>Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">53,500 Australians</a> had a knee replacement for their osteoarthritis.</p> <p>Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management.</p> <p>The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments.</p> <h2>I have knee osteoarthritis. What should I do?</h2> <p>The <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">care standard</a> links to free evidence-based resources to support people with osteoarthritis. These include:</p> <ul> <li>education, such as a <a href="https://www.england.nhs.uk/wp-content/uploads/2023/07/making-a-decision-about-knee-osteoarthritis-v1.pdf.pdf">decision aid</a> and <a href="http://www.futurelearn.com/courses/taking-control-hip-and-knee-osteoarthritis">four-week online course</a></li> <li>self-directed <a href="https://healthsciences.unimelb.edu.au/departments/physiotherapy/chesm/patient-resources/my-knee-exercise">online exercise</a> and <a href="https://myjointyoga.com.au/">yoga</a> programs</li> <li><a href="https://www.gethealthynsw.com.au/program/standard-coaching/">weight management support</a></li> <li>pain management strategies, such as <a href="https://www.myjointpain.org.au/">MyJointPain</a> and <a href="http://www.paintrainer.org/">painTRAINER</a>.</li> </ul> <p>If you have osteoarthritis, you can use the <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">care standard</a> to inform discussions with your health-care provider, and to make informed decisions about your care.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/236779/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/belinda-lawford-1294188"><em>Belinda Lawford</em></a><em>, Postdoctoral research fellow in physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/joshua-zadro-504754">Joshua Zadro</a>, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/rana-hinman-1536232">Rana Hinman</a>, Professor in Physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">original article</a>.</em></p>

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Squats and lunges might help you avoid knee surgery

<p>Whether it’s another round of squats and lunges, or a longer wall sit, researchers say working those quads could help lower your risk of a knee replacement.</p> <div> <p>In Australia, <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions/contents/arthritis" target="_blank" rel="noopener">about 9% of the population</a> has osteoarthritis, a condition known to lead to hip and knee surgery in severe cases. About 14 million Americans suffer from knee osteoarthritis, about half are expected to face knee replacement surgery. </p> <p>But new research offers hope, finding stronger quadricep muscles could play a role in avoiding knee replacement surgery.</p> <p>A study presented to <a href="https://press.rsna.org/timssnet/media/rsna/newsroom2023.cfm" target="_blank" rel="noopener">annual meeting</a> of the Radiological Society of North America, offers hope to people with arthritis, finding stronger quadriceps could help in avoiding a knee replacement.</p> <p>The two most important muscles in the knee are the extensors or quadriceps, and the hamstrings. Quads are the strong muscles located at the front of the thigh, which play a key role in gait. Hammies at the back of the thigh, are essential for hip and knee flexibility.</p> <p>The two muscles act as opposing forces, allowing physical activity while also protecting the knee. An imbalance can change the body’s biomechanics, and may progress to osteoarthritis.</p> <p>Using MRI scans – from the time of surgery as well as 2 and 4 years prior – researchers analysed thigh muscle volume in 134 participants from a national study called the Osteoarthritis Initiative. </p> <p>Using artificial intelligence to compute muscle volume from the MRI scans, the researchers compared 67 of the cohort who had a total, single knee replacement with 67 control participants who had not undergone knee replacement surgery.</p> <p>They found patients who had a higher ratio of quadricep to hamstring volume had significantly lower odds of a total knee replacement. Higher volume hamstrings were also associated with lower odds of surgery.</p> <p>The results suggest strength training – focusing on the quadriceps – may be beneficial, both in people with arthritis as well as the general population.</p> <p><!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --> <em><img id="cosmos-post-tracker" src="https://syndication.cosmosmagazine.com/?id=289325&amp;title=Squats+and+lunges+might+help+you+avoid+knee+surgery" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" />Image credits: Getty Images</em></div> <div> </div> <div><em><a href="https://cosmosmagazine.com/health/body-and-mind/squats-and-lunges-might-help-you-avoid-knee-surgery/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/petra-stock/">Petra Stock</a>. </em></div>

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Federer sends tennis world in a spin

<p dir="ltr">Roger Federer has sent the tennis world in a spin after announcing he may be pushing back his retirement. </p> <p dir="ltr">The 40-year-old Swiss player was welcomed to a standing ovation and a huge round of applause when he appeared at Wimbledon on Sunday for the traditional parade of champions.</p> <p dir="ltr">Federer, who has been struggling with his right knee after undergoing three operations to help repair damage to his meniscus and cartilage, then announced exciting news to tennis fans.</p> <p dir="ltr">“I hope I can come back one more time. I’ve missed it here," he said.</p> <p dir="ltr">"Of course I've missed being here. I would have loved to be here. I knew walking out here last year, it was going to be a tough year ahead.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">With eight singles titles to his name, <a href="https://twitter.com/rogerfederer?ref_src=twsrc%5Etfw">@rogerfederer</a> 🏆 🏆 🏆 🏆 🏆 🏆 🏆 🏆<a href="https://twitter.com/hashtag/Wimbledon?src=hash&amp;ref_src=twsrc%5Etfw">#Wimbledon</a> | <a href="https://twitter.com/hashtag/CentreCourt100?src=hash&amp;ref_src=twsrc%5Etfw">#CentreCourt100</a> <a href="https://t.co/ucGLn0wW6q">pic.twitter.com/ucGLn0wW6q</a></p> <p>— Wimbledon (@Wimbledon) <a href="https://twitter.com/Wimbledon/status/1543582911466700800?ref_src=twsrc%5Etfw">July 3, 2022</a></p></blockquote> <p dir="ltr">"Maybe I didn't think it was going to take me this long to come back. But the knee has been rough on me.</p> <p dir="ltr">"I didn't know if I should make the trip, but I'm happy standing right here, right now."</p> <p dir="ltr">Federer has played at Wimbledon every year since his main-draw debut in 1999 but had to sit out in 2022 due to the long recovery on his knee. </p> <p dir="ltr">"I've been lucky enough to play a lot of matches on this court. Feels awkward to be here today in a different type of role," he said.</p> <p dir="ltr">"But it's great to be here with ... all the other champions. This court has given me my biggest wins, my biggest losses."</p> <p dir="ltr"><em>Image: Getty</em></p>

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Glimmer of hope: World reacts to Federer's sad news

<p>Swiss tennis legend Roger Federer has posted a new video to his Instagram account giving his legions of fans an update as to his health status.</p> <p>“I will be on crutches for many weeks and out of the game for many months,” the 20-time Grand Slam title winner said.</p> <p>But in even sadder news, many sports commentators are now asking whether we’ll ever see Federer playing competitively again – given that the Swiss star is now 40 and the knee surgery will take him out of the sport for “many months.”</p> <p>Federer's decision immediately rules him out of the US Open, where he has been champion five times and which starts in two weeks.</p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/tv/CSmtPCfIl66/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="13"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/tv/CSmtPCfIl66/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Roger Federer (@rogerfederer)</a></p> </div> </blockquote> <p>“I’ve been doing a lot of checks with the doctors on my knee ... I hurt myself further during the grass-court season and it’s just not the way to go forward,” Federer added.</p> <p>“They told me ... to feel better I’ll need surgery. I decided to do it.</p> <p>“I want to give myself a glimmer of hope to return to the tour in some shape or form.</p> <p>“I am realistic, don’t get me wrong. I know how difficult it is at my age to go through another surgery. I will try it. I want to be healthy, I want to be running around.”</p> <p>Federer, who has played just 13 matches in 2021, underwent two knee surgeries in 2020. He had already pulled out of the Tokyo Olympics to rest his knee.</p> <p><em>Photo: Getty Images</em></p>

Caring

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Bride dislocates her knee during first dance

<div class="body_text redactor-styles redactor-in"> <p>Julie Benn and Paul Richter were forced to postpone their wedding due to the coronavirus pandemic but walked down the aisle on July 3rd.</p> <p>Unfortunately, their wedding wasn't without a massive hitch as the two took to the dance floor for their first dance.</p> <p>A TikTok video posted by Richter's sister Liz showed the awful turn the first dance took as the bride, Julie, dislocated her knee in a freak accident.</p> <p>“(They‘re) holding my knee in place, supporting it, and it was blinding, searing pain,” she told<span> </span><a rel="noopener" href="https://people.com/human-interest/bride-dislocates-knee-during-first-dance-returns-reception-after-hospital/" target="_blank"><em>People</em></a>.</p> <p>“I have a lot of respect for athletes who play through their injuries. I never dislocated a knee. I broke a bone when I was a kid, but nothing else. So it was shocking, disbelief.”</p> <p>She was rushed to the hospital on her wedding day, where it was confirmed by doctors that she had dislocated her knee.</p> <p>She decided to return to the wedding after being discharged at 10:30 pm.</p> <p>“I felt like a professional athlete for a second. I got out of the car and there are people taking pictures,” Mr Richter told<em><span> </span>People</em><span> </span>of the moment they returned to their wedding. “I‘m like, ’This is how they feel. I get it now.’”</p> <p>On TikTok viewers labelled the wedding incident “so crazy” and said Ms Benn needed a first dance “re-do”.</p> </div>

Relationships

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A day in the life of your knee

<p>It’s cosy beneath these blankets, but I want out. I am achy and inflamed, brittle from a motionless night. I wait for The Body to register my familiar morning stiffness. C’mon, get up already so we can work out these kinks.</p> <p>He flings his feet over the side of the bed and plants them on the floor. I’m not gonna lie: straightening out under all 95kg of him takes some serious grit. I brace myself for the load. My upstairs neighbour, the thigh muscle, contracts and yanks the quadriceps tendon, which pulls on my kneecap to make the leg extend. I’m a hinge, with pulleys that bend and straighten me.</p> <p>The other knee snickers. He’s not in as bad a shape as I am. The quads and hamstrings like to joke that I’m their little marionette. Yeah, real knee-slapper, guys.</p> <p>As he gets dressed, The Body flips on the TV to catch replays from last night’s football game. Oh, dear. What’s this? His team’s running back suffered an ACL (anterior cruciate ligament) tear? Side-tackled while all his weight was on one foot. Body, cover your eyes, for goodness’ sake! Why does he make me watch this? He’s wincing, too, because I suffered that same injury about 20 years ago. It still haunts us.</p> <p><strong>The story of my demise</strong></p> <p>The Body had been out of college for ten years and had let all of us (muscles, ligaments, and tendons) go to pot. Not that I blame him. You know the drill: sit all day at a desk, meet friends for happy hour. Who has time for exercise? Then, one weekend, he joined a pickup basketball game. Just ran right out there like the college athlete he no longer was – no warming up, no taking it easy – and snap! Tore my ACL. It’s the string that runs through my centre, connecting the thighbone to the shinbone, and it keeps me from wobbling all over the place. Worst day of my life. I heard a pop and felt a wave of excruciating pain wash over me as The Body fell to the ground.</p> <p>That’s the reason I’m so craggy before my time (I’m only 49). Surgery and physical therapy did get me working perfectly again. But ligament tears leave us knees with a 50-50 chance of getting arthritis within ten to 20 years. My cartilage, the protective tissue on the ends of bones that keeps them from grinding against each other, may not ever fully recover.</p> <p>Finally, The Body decides to switch the TV to the weather report. The meteorologist is calling for fair skies. Yeah, right – I know better. I get extra achy just before it rains, and I’m throbbing. The Body’s doctor says he hears that complaint all the time but isn’t quite sure why the pain worsens. His best guess: when air pressure drops, my already inflamed joint swells even more, irritating the nerves. Before he limps out the door, The Body grabs his umbrella to be safe. Good call, my man.</p> <p><strong>The scale makes me sad</strong></p> <p>The Body pulls into a drive-through on the way to work to get coffee. Thank goodness he’s nixed those sausage, egg and cheese breakfast sandwiches. With all this additional weight he’s put on, I’m like a toothpick supporting an anvil. Not only is The Body’s belly crippling me, it’s also putting my better half, the “good knee”, at serious risk for arthritis. My partner is almost three times more likely to get it, due to The Body’s extra-large size.</p> <p>Happily, the scale has been on a downward trend lately. This past month, The Body has lost 2kg, which has taken 9kg of stress off me.</p> <p>He shuffles into the office. Man, is it cramped under this desk. The Body feels my discomfort and swallows a couple of ibuprofen. They’ll help quell the pain for a few hours, but alas, they are not a permanent solution. Lately, the doc has been saying that eventually The Body will need to – gulp – replace me.</p> <p>Actually, it sounds worse than it is. I’ll say goodbye to my worn-out cartilage. My bones will be resurfaced and plated with metal. True, I’ll barely recognise myself, but what’s The Body’s alternative? Hobble around for the rest of his life? That’s not much fun for me either.</p> <p><strong>Can we get some exercise?</strong></p> <p>Ooh, it’s his wife on the phone. We’re going to the gym after work – hurrah!</p> <p>As we head inside, The Body sees his wife sprinting toward him in heels. Ouch. Glad I’m not one of her knees. She didn’t grab an umbrella and doesn’t want to get drenched. Hey, lady, worry about your joints, not a few raindrops. High heels are a torture device, and women are more prone to knee issues than men are to begin with. But she’s young and fit, which will protect her … for now.</p> <p>Not that I’m in love with The Body’s “comfy” sneakers. “Stability athletic shoes” sound good, but the more rigid the shoes are, the more stress they put on me. I wish he’d swap them for flat, flexible shoes with soles that let your feet bend.</p> <p>There are still plenty of activities he can do – swimming, biking, Tai Chi … old-people exercise, he calls it. But I love it all because it keeps me from getting worn and rusty. It used to be that if I got injured, they’d put me in a cast. Boy, was that dumb. In order to regenerate, cartilage needs to move and endure weight-bearing activity. The Body takes a spin on the elliptical. Woo-wee ! I feel better than I have in days. I can’t wait for the weight machines. Strong muscles help support and stabilise my joint.</p> <p><strong>My favourite meal</strong></p> <p>Back at home, The Body’s wife whips up a dinner of salmon, sweet potatoes and broccoli. I am pumped. The Body doesn’t think much about how his diet affects me, but it’s important. I’ve got low-grade inflammation, and fatty fish like salmon may slow down my disease. See, inflammation is the body’s defence against injury. It causes swelling and pain. That’s great when there’s an actual enemy. But with chronic inflammation, the body keeps fighting even when there’s no threat. And that can contribute to my arthritis.</p> <p>The Body yawns, and I’m relieved. He loves to burn the midnight oil and doesn’t realise that sleep can ease my pain. I think tonight’s gym session tuckered him out. The Body is being sweet to me tonight – sleeping on his side with a pillow wedged between me and the other knee. If I’m happy, The Body can get a good night’s rest. Now, that’s what I call a real joint effort.</p> <p><em>Written by Jill Provost. This article first appeared in<a href="http://www.readersdigest.com.au/healthsmart/tips/A-Day-in-the-Life-of-Your-Knee"> Reader’s Digest.</a> For more of what you love from the world’s best-loved magazine, </em><a href="http://readersdigest.innovations.co.nz/c/readersdigestemailsubscribe?utm_source=over60&amp;utm_medium=articles&amp;utm_campaign=RDSUB&amp;keycode=WRN87V">here’s our best subscription offer.</a></p> <p> </p> <p><img style="width: 100px !important; height: 100px !important;" src="https://oversixtydev.blob.core.windows.net/media/7820640/1.png" alt="" data-udi="umb://media/f30947086c8e47b89cb076eb5bb9b3e2" /></p>

Retirement Life

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Adam Sandler blasted for repeatedly grabbing "The Crown" star Claire Foy’s knee

<p>Adam Sandler has been slammed for repeatedly touching Claire Foy’s knee during an interview on The Graham Norton Show, leaving Foy and fellow guest Emma Thompson looking very uncomfortable.</p> <p>Viewers immediately took to social media to question why the actor kept placing his hand on the The Crown star’s knee when she made repeated efforts to move it away.</p> <p>Unfortunately her efforts to pat away his hand went unnoticed as Sandler soon returns his hand back on her knee.</p> <p>Emma Thompson, noticing Sandler’s repeated gesture, also looked on in confusion.</p> <p>Sandler seemed oblivious and continued telling his story, touching the leg of Thompson as well, his co-star in the new Netflix film The Meyerwitz Stories.</p> <p><iframe width="560" height="315" src="https://www.youtube.com/embed/-R6UzMN_z3o" frameborder="0" allowfullscreen=""></iframe></p> <p>One viewer wrote on Twitter: “Claire Foy replacing Adam Sandler’s hand onto his own knee rather than hers, was the perfect ‘haha don’t touch me again’ move #GrahamNorton.”</p> <p>While another said: “Adam Sandler has no social awareness of how awkward he seemed to be making Emma Thompson and Claire Foy #stoptouching #GrahamNorton.”</p> <p>A spokesman for Sandler described the actor’s actions as a “friendly gesture”.</p> <p>It comes after the Harvey Weinstein scandal in Hollywood, with a string of A-listers accusing the powerful executive of a string of sexual assault crimes, including a number of rape allegations.</p> <p> </p> <p> </p>

News

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Exercises you can enjoy even with a bad knee

<p>If you have bad knees from arthritis, previous injuries, or (<em>ahem</em>) old age – you may worry that exercise could be off limits for you.</p> <p>Sadly, some sports such as tennis, netball, squash, skiing, basketball, golf and soccer are particularly hard on the knees and should be avoided.</p> <p>But with a little planning, you can still enjoy the health benefits of regular exercise.</p> <p>Today we have four great options that you can enjoy - even with a dodgy knee.</p> <p><strong>1. Walking</strong></p> <p>The cheapest form of exercise there is, walking is available to everyone. It’s best to stick with the flat ground, and ideally go for softer surfaces such as grass if possible to reduce strain on your knees. Walking on the beach is another option if you focus on the sand near the sea rather than the soft sand.</p> <p><strong>2. Cycling</strong></p> <p>You may have thought that cycling would be out of the question, but if you focus on gentle slopes and mostly flat terrain you can comfortably take part. The good thing about bike riding is that you aren’t stopping and starting, which puts pressure on your knees. Find a nice bike path, join a cycling group, or just go for a ride around your (hopefully flat) neighbourhood.</p> <p><strong>3. Yoga</strong></p> <p>Yoga is great for your fitness as well as for reducing stress. While there are some poses that are not ideal, the great thing about yoga is that it can be adapted for any special needs. So just let the yoga teacher know your situation and he or she will be able to give you alternate moves to suit your knee. Many yoga studios will offer drop in classes that you can show up to as required, or you can save money by buying a pack such as 10 classes for a reduced rate.</p> <p><strong>4. Swimming</strong></p> <p>Whether it’s swimming laps at your local indoor pool, or getting out into the ocean, swimming is the top choice for those with bad knees. The water supports your weight, meaning there is less pressure on your joints. Why not try committing to a certain number of laps each time you swim, and then try beating that time? Or join a swimming club if you enjoy the social aspect of it too. It’s important not to overdo it as this will make you less likely to stick with it long term.</p> <p>Have you got any tips for other exercises to do with bad knees? We would love to hear from you in the comments.</p>

Body

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Why men get down on one knee to propose

<p>Many of our traditional wedding customs come from Queen Victoria's marriage to Prince Albert, where the infamously headstrong monarch popularised the white satin wedding dress at a time when coloured gowns were en vogue. </p> <p>However according to Dr Kirby-Jane Hallum, honorary Academic at the University of Auckland's Faculty of Arts and author of Aestheticism and Marriage in Victorian Popular Fiction: The Art of Female Beauty, the original 19th century celebrity wedding doesn't give us all the answers.  </p> <p>"The origin of the tradition of getting down on one knee is unknown but it can be thought as part of established courtship, engagement and marriage rituals.</p> <p>"It invokes both religious and courtly symbolism because it can be viewed as an act of humility. For example, Catholics bend on one knee as a sign of respect before taking their seats for the Mass. Knights bend down on one before the king when being knighted."</p> <p>Hallum's own work highlights that the "husband's position as master is acknowledged through nineteenth-century legal frameworks".</p> <p>"Under 19th-century common law, a wife was in many ways regarded as the property of her husband," she said.</p> <p>"I would argue that the idealisation of women for their beauty, innocence and virtue during this period meant that the suitor would bend his knee when asking for of the object of his affection's hand in marriage as an act of reverence."</p> <p><em>Written by Janan Jay. First appeared on <a href="http://www.stuff.co.nz/" target="_blank"><strong><span style="text-decoration: underline;">Stuff.co.nz</span></strong></a>.</em></p>

Relationships

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UK terror attack brings London to its knees

<p>London has been left reeling after a terrorist attack outside Westminster, in which a car ran over several pedestrians and a police officer was stabbed outside parliament.</p> <p>Four people have been confirmed as casualties, including the stabbed police officer and the attacker, and at least 20 other people are still being treated for injuries.</p> <p>While specific details on the incident remain hazy, reports can confirm that a large vehicle ran down pedestrians on Westminster Bridge, before crashing into the railings surround the parliament. The suspected driver left the vehicle then walked into the parliamentary precinct where he attacked the officer before he was eventually shot.</p> <p>London's assistant police commissioner Mark Rowley said, "This is a day we planned for but hoped would never happen. Sadly it's now a reality. We will continue to do all we can to protect the people of London."</p> <p>Foreign Minister Julie Bishop confirmed no Australians were caught up in the attack in a statement from Washington, “I extend the Australian's Government's deepest sympathies over the incident. I understand the British police are treating it as a terrorist incident until other information comes to hand. I can assure Australians that to this point no Australians have been identified.”</p> <p>Amongst the terror, moments of bravery and humanity have shone through.</p> <p>Sadiq Khan, the mayor of London, released a stoic statement on Twitter with the message Londoners will never be cowed by terrorism:</p> <blockquote class="twitter-tweet"> <p dir="ltr">Londoners will never be cowed by terrorism. <a href="https://t.co/SidIuIztvu">pic.twitter.com/SidIuIztvu</a></p> — Mayor of London (@MayorofLondon) <a href="https://twitter.com/MayorofLondon/status/844631399713947648">March 22, 2017</a></blockquote> <p>Writing for <a href="https://www.theguardian.com/" target="_blank"><span style="text-decoration: underline;"><strong>The Guardian</strong></span></a>, Jonathan Freedland shared the story of a brave MP who had tried to save the officer who was stabbed, “On any other day, Tobias Ellwood might be seen as just another Tory MP. But then came word that he had given CPR and mouth-to-mouth resuscitation to a policeman who lay wounded – and with it a reminder that the MP, a former army officer, had lost a brother in the Bali bombings of 2002.”</p> <p>The attack comes on the one year anniversary of last year’s terror attack in Brussels, where suicide bombers killed more than 30 people at an airport and metro station.</p> <p>Our deepest sympathies go to those affected. </p> <p><em>Video credit: Facebook/Aaron Tsang via Storyful</em></p> <p><em>Hero image Credit: Twitter/James West via Storyful</em></p>

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