How Long Does It Actually Take Knee Arthritis To Progress?

 

In this video, I’m going to show you how to clearly tell where you are in the four stages of knee arthritis. I’m bringing this to you today, because this is the widespread staging system that is used throughout all healthcare in order to determine how severe your knee osteoarthritis is.

In other words, if you’ve been to the doctor, and they’ve told you that you have knee arthritis, or you plan on going to the doctor at some point, this is what you can expect to hear from the doctor, they’ll give you a stage most often to tell you how severe your specific knee arthritis is, they use these stages to judge the severity and then determine what treatment you should be getting.

Based on your current situation. I’m going to tell you why the staging system is good, and why it’s bad towards the end of the video as well. There are some major flaws with this system, because we just don’t know fully we don’t fully understand as a healthcare profession, how knee osteoarthritis progresses, and how to manage it properly, without surgery. So be sure to watch to the end of the video to catch all those flaws.

Right, I’m going to get my very artistic drawing right here apologize for the, it looks like my one of my kids drew this, but it was actually me. So there’s four stages, but it starts with stage zero. So technically, there’s five stages, it’s zero through four, we’ll catch the end here in a second, just going to get a little bit closer to help me explain here stage zero.

So in stage zero, that’s a healthy knee. That’s what we would call pre arthritic, or you don’t have any arthritis, you feel good. This is probably where you are, if you’re in your younger years, if you didn’t have any issues, you have a happy face with your knees. If somebody asks you how your knees heal, people respond, I feel fantastic. I don’t have any problems; I can do whatever I want, and I feel fantastic.

You may have had injuries in your younger years, but nothing that would show up on an x ray, because that’s how you determine arthritis is the X ray. That’s like the number one thing that orthopedist or surgeons use to classify your arthritis problem, they’ll put that together with how you feel your symptoms, and your subjective feeling like pain and stiffness and that kind of thing. You also have full motion. In state zero, you have no limitations in motion whatsoever.

You feel great. Now in stage one in the green right here, you begin to have some irritation I drew one little tiny red dot can barely see it right next to the kneecap. That circle is a kneecap so thigh bone kneecap, and then your shin bone is right here. At this point, most people don’t feel much pain, they might have a tiny bit of pain, maybe a tiny bit of stiffness, and it barely lasts anything, they usually aren’t visiting the doctor at this point. And you’d have to get an MRI or an x ray to detect this amount of problem inside of the joints.

Most people just rest and it feels better, it is not really limiting in any way. If for some reason you did go to the doctor like you had some other problem like a meniscus tear, or ligament problem like an ACL tear, and they took x rays of your knee, they might tell you that there’s a little bit of a decreased space in the joint meaning the space between the thigh bone here and the shin bone.

And they might tell you that you have some small wear and tear or degenerative changes in the cartilage. But it’s rarely seen in reality, we don’t see many people in stage one visiting the doctor unless it’s for some other knee problem because it’s so minor at this point. If you’re in stage one, what you’ll feel is some stiffness, when you first get up out of bed in the morning, that goes away within steps, I mean literally like three, four or five steps and you don’t really deal with anymore.

Or if you’ve been sitting for a long time and then you go to get up, you might feel some stiffness for those first few steps after getting up. And then you’re fine. The classic that I see is people been sitting for a little bit, you know, like 30 minutes an hour or more. And they kind of cool off, they’re not warmed up in their body anymore.

And then they go to get up and they just are slow to get going. And then they’ll blame it on age typically they’ll say don’t get old, it’s hard getting old or you don’t want to be old, these old knees and you just have some stiffness, and then you kind of shake it off after the first few steps. And then another sign that happens is if people are sitting for too long with their knees bent, the compression going into the joint begins to cause some pain.

So they’ll say I can’t tolerate sitting through a whole movie I can’t tolerate, tolerate sitting on the couch for too long or at a meal too long because I need to stretch out my legs and move them around a little bit because there’s irritation inside the joint or inflammation inside the joint. That’s the very definition of arthritis. Arth means joints and itis means inflammation.

But none of these symptoms are very long lasting, they really just last for moments. And then once you get moving, you are fine again. So stage one is minor knee arthritis. Now stage two right here is going to be mild knee osteoarthritis. It’s in stage two where people are more likely to begin to visit their doctor and when they go visit their doctor of course they’re going to order an x ray that’s the first reflexive thing that doctors do.

They rely heavily on X rays, which is good for our 03 itis. And you can see I drew the lines kind of thick here, because what they’re going to tell you is that you begin to have a little bit of bone spur formation, that’s what this mark is in that mark. It’s like some thickening in the bone. And then that you might have a decreased joint space as well, you can see there’s more space here in here compared to here.

And now just before you start criticizing my drawing, I didn’t draw everything like to scale on every single one, this is very much a rough sketch. But if he gets the point across, you have some thickening in there that shouldn’t be there, you might also get thinning in the joint space behind the kneecap and the thigh bone. That’s very common. And the symptoms that what you’ll feel is just a little more intense from stage one are the mild, the minor knee arthritis in the mild, this is minor, and this is mild arthritis.

In the mild arthritis, you’ll have even more stiffness, when you first get up in the morning or when you get up from sitting. So instead of shaking off in a few steps, it might actually take you a few minutes now of being on your feet before you shake it off. But people usually shake it off, they consistently will say, yeah, like the first five minutes, 10 minutes at most in the morning, my knee is stiff, I need to loosen it up, I need to maybe do some stretches.

And then I feel fine after that. Another thing that begins to happen with this individual, though with a person that’s in stage two in mild osteoarthritis is if they’re on their feet for too long, usually the threshold is like an hour or more, they start to notice some swelling in their knee joints. And of course, they say they need to get off their feet, their knees are hurting, and they kind of pay for it the next day, they’ll say that their knees stay swollen for a day or two or even longer.

It just depends on the how badly they overdid it, that time that they were on their feet. It could be something simple, like they took a trip, they were sightseeing, and they were on their feet much longer than they’re used to. Or spring cleaning happened decorating for a holiday season.

Doing a lot of cooking can set it off beginning a new exercise routine where you’re being more aggressive with the time on your feet, where you’re doing some impactful activity like you started in the walking program, or maybe you tried jogging again, because you had done that in the past, but you hadn’t done in a while.

Those types of activities that increased intensity and duration, intensity, meaning it’s more active than you’re used to doing. And then the duration meaning you’re on your feet for longer than you had been. Those two are a deadly combination to really flare up in arthritic knee and stage two, and cause some swelling that carries over for at least a day if not two, three, or four or a week or more depending on how bad it is.

Now, if the swelling is very bad, you’ll also see a limitation and range of motion. So what that means is the knee can’t bend all the way it can’t straighten all the way because of the swelling in the joints. Now it’s my belief that when people are in this stage, that’s when it’s kind of a slippery slope, it’s it starts to go faster and faster that way and it’s a lot harder to come back the other way. And what I just said right there come back.

That’s controversial. A lot of people think that it just goes one way and you can’t come back at all. But more on that later when I get to the flaws part of this video. So stay tuned, keep watching. Now since stage two is where you’re likely to be if you’ve just visited the doctor, what the recommend to you at this point is going to be things like bracing your knee. exercise and weight loss are very common recommendations as well.

 They might recommend medications and injections like anti inflammatory medications. NSAIDs is another name for them. Common ones would be ibuprofen and naproxen. You’re done doctor may recommend gel injections as well like hyaluronic acid injections, there’s a bunch of different injection types and we’ve got videos about that kind of stuff, I won’t go into the details.

But they’ll start to do the non invasive procedures or treatments meaning not surgery yet at this point in stage two, most doctors are going to be telling you that you’re not a candidate for surgery yet that you’re not, you’re not this bad over here where they’re recommending a knee replacement. They still want you to do things that do not involve surgery to make sure that you manage your pain here and recover.

The problem is people do the wrong things. And I’ve this whole channel on our section on knee arthritis goes heavily into what to do and what not to do. But make sure to go check out our knee arthritis videos and this is a another plug real quick. We’ve got a knee arthritis program. It’s called the knee arthritis recovery program that is designed to take you through every single step you need to go through.

It’s exhaustive, it’s comprehensive on what to do to make sure that you can fix your knee arthritis problem and go this way rather than that way. So you can find more about the knee arthritis recovery program down in the description below. Or if you just want to check out our YouTube videos about knee arthritis.

There’s a link for that in the description below too. Alright, Back to our staging system. So I didn’t go over the happy faces, let me just cover that. So you feel fantastic and stage zero, no problems. In stage one, you mostly feel happy, there’s just moments where you don’t feel too good. So the smiley face just got a little smaller, it’s a less of a smile. Here in stage two, you’re not that happy anymore.

Because now you have to go to the doctor, this is really interrupting your day you feel it just about every day, you’re limited in your motion, potentially, and you can’t be on your feet too long. You might even be having pain at night, when you’re sleeping, it’s waking you up. So you’re not a happy camper anymore.

However, it’s still not limiting you as much as it can and worse stages. So it does get worse. But right now you’re just, you’re grumpy. If this condition lasts, the problems that come in stage two lasts long enough, then you move into stage three.

And the specific conditions that I pay attention to as an expert, physical therapists are that swelling, if you chronically overdo it, somehow, like you’re on your feet too long, and you’re pushing through it, you’re forcing your way through things, which you might be doing on your own unknowingly, like you’re trying to walk, for instance, to exercise, but it’s irritating your knees.

Or maybe you’re being told to do things that are irritating you like maybe your doctor gives you a list of exercises to do or you’re going to physical therapy or some other treatment specialists that you hope is going to help you. But their treatment is actually making you worse, it’s making you become more irritated, more stiff, more swollen, then you’ve got to stop that.

The first thing to do is talk with your healthcare provider about it, make sure they’re aware, because maybe they’re not aware that what they’re doing is hurting you. And you need to tell them that very much. It’s just a communication problem very much of the times.

But if you’ve tried that, and it’s just not working out, or your guts just telling you, you need to go see someone else, go see someone else about your knee arthritis problem, because you should not be chronically swollen, you should not be chronically irritated, you should be able to reduce the irritation, so that you’re not progressing into the worst stages of knee arthritis. Or let’s talk about stage three.

If you’re in stage three, you’re certain that you have arthritis at this point, there’s no question usually in earlier stages, people are kind of thinking that they might have arthritis, they’re like, well, it could be a meniscus problem, it could be maybe a ligament problem, or I don’t know my knee just some sometimes hurts, and then sometimes flares up if I do too much.

But by this point, they’ve had enough chronic swelling from phase two, that they’ve progressed into phase three, where there’s a lot more active irritation going on. That’s why the red here, and you can see the joint space there is severely decreased compared to this one, there’s still a little bit more. But of course, it’s even this one’s even better. This is a lot more like the normal side over here. So the joint space is tremendously decreased.

And it’s usually just one side of the joint. That’s why I drew it that way. Because it’s the inner part of the knee that tends to get compressed first. Not always, that’s just what usually happens, I can give you a percentage of which patients I’m sure there’s a stat out there, somebody can dig up. But that’s what we commonly see.

So in this stage, there’s consistent stiffness in the knee, they’re dealing with it daily, definitely in the mornings, lots of stiffness in the mornings, they may have more motion in their knees Sunday than others.

Some days, you might still feel like they can move all the way. But other days, you might feel like their knee just is completely stiff and doesn’t want to bend or straighten all the way they have some motion, but not all the way.

The knees just thicker on that side. Very often, muscles start to get a little smaller in the leg, usually because they’re they’re babying the knee often, so they’re just not using that leg as much. In stage four, it’s getting bad if they haven’t gone to the doctor and stage two.

In stage three, what people are usually doing is they know they should go to the doctor, but they don’t, or they’re definitely going to the doctor, they’re not afraid to go to the doctor. Because you know, there’s people out there that don’t want to go see the doctor, if you’re out there. And you just you know, you know what’s going to be arthritis.

And you’re probably worried that the doctor is going to tell you that you need a knee replacement. And you know what it’s a legitimate concern because very often in stage three is when doctors start to make recommendations to go talk to an orthopedic surgeon and consider having a knee replacement surgery.

But often in stage three, they’re still going to tell you to try injections, medications, all the other treatment options that are out there that are not surgery, before going into surgery. Some of the other everyday limitations that people are going to run into this in stage three is because they’re going to have a more consistent loss of motion.

They’re going to have a lot of difficulty putting on their socks and shoes like you know being able to reach towards their feet. stepping in and out of a bathtub becomes difficult because they can’t bend their knee enough to step over the wall the tub and getting in and out of vehicles is often very difficult because you’ve got to bend your knee all the way they people with stage three or worse osteoarthritis in their knees, just have to plan their motions a lot more and be a lot more careful.

Otherwise they bend their knee too much, and it hurts them and potentially makes it swell more. Other things about stage three is simple things flare up the knee, like taking a wrong step, like Miss stepping, like stepping off a curb, and judging the not judging the height of the step very well, like stepping too abruptly doing just a little too much exercise or just a little too much walking.

Using stairs, like people avoid stairs very often when they’re dealing with the knee this bad. And if they just absolutely have to, it tends to really bother their knees. And they might even stay flared up the rest of the day going into another day or two. Usually, at this point, in stage three, they’ve been dealing with a knee problem for close to a year now it has been going on that long, it doesn’t always progress at the same rate.

Some people stay in stage one and two for many years, they might stay here for decades even, and never progress into stage three or four. And some people progress really fast. I mean, within a year, they have no problems whatsoever. And boom there towards the end of this staging system within a year.

Now let’s talk about stage four, I’m going to come over to the other end here. In stage four, it’s bad. At this point, you’re using a walker or a cane to get around your you can’t get around without one, without hobbling a lot. It is important for you to take pressure off your leg because your knee joint is so irritated, there’s no more space in the joint on either side on the inside and the outside of the knee joint.

The back of the kneecap, there’s no space there either, with the with how it interfaces, the thigh bone right here, the cartilage is severely worn out, if you actually get to peek inside of the joint there’s blotches of cartilage is gone. And very often, there’s enormous losses of motion, the knee cannot straighten out all the way. And it cannot bend all the way. And being able to go walking for exercise. People just scoff at it. They’re like, Ah, forget it, they can’t even do it.

They feel often like they’re at the point of no return. And when they go see the doctor, and they’re at this point, the doctor is very much are telling people well, you can try all the non invasive stuff, but you’re excellent candidate for a knee replacement surgery.

I mean, what’s the surgeon going to say if they see you walking in and you can and what you’re doing people in stage four, what they’re doing is they stand up from the waiting room and they’re hustling to get over to the doctor’s office if using a cane or a walker.

Because they can’t stand for more than a few seconds without immense pain in their knee, they lean off that leg or if it’s both knees, they want to sit down immediately. They very often have that Walker that has a seat on it so that they always have a place to sit down an x ray of the knee joint is going to be obvious for the surgeon, they’re going to look at it and say there’s no space in the joint, you have bone spurs all over the place, it’s just a last joint is what they’re going to tell you.

And you’re going to feel like that you’re going to be crying because it hurts and you can’t do anything, you can’t have a normal life, you can’t sleep well, you can’t be active. Very often people put on weight because you’re not as active. So they can’t exercise to manage their weight, right. And the exercise when they do try to exercise to help their weight, they flare up their knees.

So they’re caught in a vicious cycle of exercising, which is needed for weight management makes any worse. And you can’t exercise though because your knee hurts. So it’s you just can’t move. It’s difficult to move out of this phase. However we do you see people here in my clinic with all phases of knee arthritis, and they do get better, we just we just have to set proper expectations.

Because if you’re in stage four, and you have severe knee arthritis, that’s what this would be classified as you’re not expected to get back to being like stage zero over there, right there. Or even stage one or two, maybe you can get to stage three, maybe two, I wouldn’t realistically estimate that you’ll get there.

But maybe that’s what you want so that you can avoid having the surgery and get better enough to be able to do what you want to do to be able to do some simple things in life, like put on your socks and shoes, for instance. Alright, so that’s the staging system. I’m going to talk about the flaws of the staging system next, because I think that this is a good starting point in the healthcare industry and in the medical research.

This has largely been developed by people that are focused on arthritis and it’s great. It’s difficult though to systematize this kind of diagnosis or severity of diagnosis across everybody because everybody’s different, but some flaws that I think we need to move away from it’s going to take a long time. I’m making this video today you can check the date this video was released.

And I pretty much guarantee it the staging system is not going to change for decades this this system is going to be around for 20, 30, maybe 50 years or more, what I’m going to propose to you as a different way of looking at it, I’m probably looked at as controversial here as thinking very differently, which I’m okay with, you know what I treat patients the way that I that I think here that what I’m sharing with you, and we see some awesome success.

And there’s a lot of reasons why this staging system is upheld and a lot of beliefs behind it, too. And I won’t get into it, let me just tell you what the flaws are. The first flaw I want to mention is the assumption that you only get worse over time, because this is a degenerative condition. It’s really important what words are used the word degenerative, puts a certain thinking in people’s heads, healthcare professionals included degeneration means that it just breaks down as time goes on, and there’s no ability to make it better.

And that’s what this system is assuming that you cannot get any better. But we have a growing body of research out there, there’s research studies that show that you can have knee arthritis and one of the stages here and do a treatment, a non surgery treatment, like physical therapy, doing the right kinds of exercises, and decrease your irritation and feel better. Now notice, I did not say that your X ray will look better. If you had an x ray, and it’s got this kind of appearance on it, it’s got bone spurs and decreased joint space.

You go to the treatment to make it feel better. And if you take an x ray, after your treatment, after you’re already feeling better, your X ray might still look like that. And you might still be classified in stage two or three of knee osteo osteoarthritis, but it’s different. If you feel fantastic, who cares what stage you’re in, if you’re out walking out exercising, you can bend your knees just fine. And you can tolerate being on your feet for as long as you’d like.

But the general public has a belief and it’s because the health care providers as a whole also have the belief and they’re the ones communicating this with their patients, that if you begin to have knee arthritis that it only progresses in fact, some people believe out there that it’s like a disease like a sickness that you contract like a virus or like a bacteria, like how that would spread like how it spreads through your body and it goes to different areas.

But really, it’s a mechanical problem, meaning there’s forces that are accumulating over time. And that’s how your joint responds to those mechanical forces. Now, I’m not saying it’s purely mechanical, there’s definitely dietary influences hormone influences. And those can show up as like extra blood vessels to the area and other problems too.

There’s like hormones that are released histamine that’s released, there’s all kinds of chemical processes that happen in osteoarthritis, and there’s a lot of medications out there designed to begin to block them and modify all that stuff. But at the heart of it, I think there’s still an enormous mechanical component that isn’t being properly addressed.

And it’s just assumed that if you go do exercises, general exercise, without really paying attention to what kind of exercise you’re doing, that it’s either going to get better or not, literally, the recommendation from osteoarthritis experts around the world is to do exercise and lose weight, that’s like the most consistent, non-surgical best treatment that you can do. And I’m not disagreeing with that.

All I’m saying is, we need to get more specific at what kind of exercise and, and not pay too much attention to weight, if weight isn’t that big of a problem for you, because there’s lots of thin people, people that are not overweight, or people that have a little bit of extra weight, but not enough to really make a huge difference in a knee joint like this.

They need to pay attention to what kind of exercise they’re doing. Now, because they believe this is a degenerative process, and that it just gets worse. No matter what you do that it’s just going to happen. You’ll often hear doctors say when you’re in these early stages of knee arthritis, if you go visit the doctor, they’ll say, in five or 10 years, come back and see me you’ll might you might need a knee replacement at that point.

So they’re just subconsciously putting that out there because that’s what they believe. And that’s what they see. They don’t see people go through the right kind of exercise to actually alleviate the problem. So they just assume it’s a degenerative condition, and it’s not going to get any better, despite all the weight that you lost, or despite all the exercise that you tried out.

Now, the second flaw I’m going to point out to you is the belief that you cannot function properly in your joints without cartilage. And what I’m saying here is that you can have normal function of the joints and when I say normal, I’m not saying 100% I’m just saying you can be functional. Like you can bend your knee, okay, and you can do normal things.

Even if you have losses of cartilage in your joint, like if you’re bone on bone, for instance, the reason why I believe this is because we have a growing amount of research to on this, where there’s people that have known rotator cuff tears in their shoulder, meniscus tears in their knee, disc herniations and tears in their discs in their spine. And they have zero pain.

Maybe they had pain at one point, but it’s healed since then. And even though they have no pain, if you took an x ray or MRI of their of whatever body part it is, they still have a tear there, they still have damage that’s visible, however, it’s stabilized and they’re functioning. Okay, they’ve done studies like this, where they split people into groups of people that have like back pain, for instance, and people that are that are healthy to have no back pain, and they do MRIs on everybody.

And they find that the MRIs show all kinds of things in their back. And then they can give those MRIs to radiologists, which are doctors that know how to read MRIs. And they tell them categorize these MRIs into who has pain and who doesn’t. And what they find is the radiologists can’t do it just based off the MRIs, you need to talk to the individual to be able to correlate or you know put together the MRI and their symptoms, because you might have somebody who feels fantastic.

But it’s got bone spurs, torn discs, pinched nerves in their back according to their MRI, but the person will tell you, I didn’t even know I feel great that you can have the other end of it to where people have a perfect looking MRI, but that individual will tell you I’ve had back pain that is really bad and I’ve had it for a long time.

And their MRI looks just fine. And you can go from one to another as well like you can have a bad MRI feel fantastic and then begin to have pain or the other end of it, you can have pain in a perfect looking MRI, and then feel better or you can develop signs on your MRI and then even feel better at that point to that what I’m saying here is that MRIs the X rays don’t always correlate with the individual symptoms.

Which means that if your X ray looks like one of these in stage two, three or four, and your knee hurts right now, it’s possible that even though you’re bone on bone, and you have a loss of cartilage, it’s possible that if you do the right things, you can feel better. And what I recommend here on this channel, and with my patients that I see in person is a mechanical redistribution of weight said simply, we take the pressures off your knee joint using the right kinds of exercises.

And over time that offloads the area that’s being extra compressed in the knee joints, you look at the skeleton, usually it’s this inner part of the knee right here where the pressure builds up. And if you take pressure off that area by exercising the muscles and the hip and thigh correctly, then even though you have a loss of cartilage right here on that spot, right here behind the kneecap, you can begin to move more normally get some freedom of motion back in your knees, stretch it out of the way, and begin to put more pressure through your knee joint and distributed more evenly.

But it requires you having good strength up in the hip. That’s a muscle imbalances I’m talking about. And that’s what I talk about addressing all the time. Now, this staging system that I just went over, does not account for that it doesn’t account for the fact that you can feel better even though your X ray looks bad. And it’s based on a belief that you just get worse and worse over time, no matter what you do.

Now I’ve organized my systematic approach towards treating arthritis into what I call a phases instead of stages system. And I have it phases have similar phases. I don’t have a phase zero, but have phase 123 and four. And this is available in the knee arthritis recovery program that I mentioned earlier, you print this sheet out as part of the program, and you figure out what phase you’re on this side.

Just to give you a brief overview and phase one. This is where we look at it differently. Don’t forget the stages that I just talked about. If you’re dealing with knee osteoarthritis right now this is how you would need to look at your yourself to get into the right place where you feel better. In phase one, you’re just it’s severe pain, you have lots of loss of motion, you can’t really do a whole lot you can be on your feet, you’re having pain at night.

In phase two, it’s not as bad, you can do a little bit but it does flare up if you do too much. There are certain exercises to do here. And there’s different ones to do here, there’s certain a certain way to approach yourself in phase one. And there’s different things to do in phase two.

And then in phase three is when you’re feeling significantly better, you can actually do quite a bit but you still do run into some limitations. your range of motion might come back and it may not but you can still do quite a bit if your range of motion is manageable if you can work with it, in which we talked about all those details about how much motion you need to be able to get away with that get surgery.

And then in Phase four, this is your prevention and maintenance phase. This is where you where you are working on the right exercises like in the gym, for instance, or at home wherever you decide to exercise so that you’re not progressing into an irritated state again, and that’s what stops you from moving into a further stage that way. So I really think that I’m not a scientist, I would say I think I’m more of an expert clinician.

And I don’t have any research studies to back this stuff up. Besides our report our cases, you know, people giving us good reviews from the program that we have already built the knee arthritis recovery program. So my expert advice to you, if you’re dealing with knee arthritis is take this with a grain of salt. If you’re about to go to the doctor, and you just recently gone to the doctor, and maybe it’s even been a while you’ve known that you’ve had arthritis for years now.

This is the staging system that is commonly used. And if you’ve been told that you just get worse as time goes on. I would raise an eyebrow at that and not fully believe it. And if you’ve been told that you’re bone on bone in your knee, and that you need surgery, I would try to exercise correctly to move across these phases in a different direction.

This has been a huge help for my patients. This is what is the treatment approach that I use on my patients and we’ve seen them get so much of their life back without having to have surgery, rely on pain medications, or have to get injections every so often to feel better.

Okay, thanks for watching. Don’t forget to check out those links in the description below for our knee arthritis videos that we have available here on YouTube, as well as you can learn more about our knee arthritis recovery program. There’s a link for that down there. I hope to see you in the next video. Bye