Joints in Trouble: Self-Treatment

by Thomas Kurz

Information on this Web page is for educational use only, and is not intended as medical advice.
Every attempt has been made for accuracy, but none is guaranteed. If you have any serious health concerns, you should always check with your health care practitioner before treating yourself or others.
Always consult a physician before attempting any self-treatment.

In this article you will learn about a method of self-treating damaged joints of the ankle, knee, and hip. The method is developed by a renowned Russian chiropractor, Vitaliy Demyanovich Gitt. He presented this method in a series of articles published in the magazine Fizkultura i Sport.

Because many martial artists suffer the consequences of training conducted by unqualified, ignorant “instructors,” masters, etc., I decided to offer a synopsis of Dr. Gitt’s method. Who knows, perhaps it will benefit someone with hips and knees destroyed by the still “usual” stretching done in m.a. classes, or with ankles damaged by poor instruction for kicking and jumping.

Basic facts about joint damage

All joint damage is, or ends in, cartilage damage. Articular (joint) cartilage has no blood vessels, and so its contact surfaces obtain nutrients by diffusion from synovial (joint) fluid. (Parts of the joint cartilage that are closer to the bone, or to the joint capsule, are nourished through those structures, which are richly supplied with blood.) If the joint does not move, the fluid is not pumped into the cartilage, so its cells die. The joint surface becomes rough and uneven, and that is the beginning of trouble. Any injury that requires immobilizing a joint deprives that joint’s cartilage of normal nourishment—and may begin a process of cartilage damage.

So, for example, if you badly twist your ankle, you will have to keep it immobilized for a couple of weeks. Because of the immobility, the joint cartilage in your ankle will be deprived of normal nourishment and will be vulnerable to greater than normal wear and tear after you resume moving and loading your ankle.

Self-treatment for the ankle, knee, and hip joints

The gist of Dr. Gitt’s method:

Movement is necessary for nourishing joint cartilage and proper functioning of joints. But not all movement is good. Too much movement, with too much pressure on the joint, will hurt the damaged cartilage and speed up degenerative changes. Common wisdom such as “Exercise can’t hurt,” “The more you exercise, the better,” “No pain, no gain,” or “Movement heals” doesn’t always hold true. For movement to heal it has to be the right movement and in right doses. The same exercises that are good for people with healthy joints are destructive for people with already damaged joints.

Common exercises, by their considerable amplitude and pressure exerted on the joint, speed up degeneration of the damaged cartilage. Initially the exercises may make one feel better because of natural painkillers (endorphins) released when one exercises, but eventually the joint or joints become so damaged that nothing will mask the pain and no exercise can be done.

But the joint has to be moved to nourish the cartilage, so what to do? Dr. Gitt devised movements for each joint that pump joint fluid into the cartilage without irritating the sick joint. He called them Shaltay-Boltay. Boltat in Russian means to stir and to swing or dangle. Shaltat in Russian means to mess around or acting silly. Shaltay-Boltay is the Russian name of Humpty-Dumpty, and in the Russian nursery rhyme he sits on a wall and swings his legs.

So here are Dr. Gitt’s movements for the ankle, knee, and hip:

Ankles:
1. Lie on your back, legs straight. Point your feet up and down (dorsiflexion and plantar flexion). Do this with minimal tension (relaxed as much as possible) and with minimal amplitude.

2. Lie on your back, legs straight. Turn your feet in and out with minimal tension and minimal amplitude.

3. Sit on a low chair so the soles of your feet are flat on the floor. In a very relaxed way, “walk” with your feet, lifting and lowering your toes and heels. Amplitude of movements: up to one inch (1–2 cm). Do it for one hour total every day. This movement is good also for knees and hips.

Knees:
1. Sit on a tall chair or on the edge of a table so legs dangle freely above the floor. Relax your legs and swing them like pendulums. Amplitude of movements: a couple of inches (5 cm). Do this twice per day, for 10 to 15 minutes each session. If legs swell, stop the movements; lie down with legs elevated on a pillow.

2. Sit on a low chair so the soles of your feet are flat on the floor. In a very relaxed way, “walk” with your feet, lifting and lowering your toes and heels. Amplitude of movements: up to one inch (1–2 cm). Do it for one hour total every day. This movement is good also for ankles and hips.

Hips:
1. Lie on your abdomen, a small pillow under your feet. Distance between feet: whatever is comfortable. Relax as much as you can.

Do not try to lift your pelvis. Rock your hips slightly. Maximal amplitude of movement: more than one inch (3 cm). Do this from three times a day, for up to 10 minutes each time.

2. Lie on your back, with legs slightly spread out. If you want, place a small pillow under your knees. Turn your legs in and out so the movement happens in the hip joints. Maximal amplitude of movement: half inch (1 cm).

3. Sit on a chair, knees shoulder-width apart, feet on the floor. Lightly and without tension move knees in and out. Maximal amplitude of movement: half inch (1 cm). Initially, the better to control the amplitude, keep hands on knees.

In the previous three movements, just like in all Shaltay-Boltay movements, if feeling pain reduce the amplitude of the movement, put feet wider or narrower, or change frequency of movements, and relax more.

Do these three movements (or just the one you like most) in short sessions for a total of 3 to 6 hours per day (well, degenerative changes in a hip joint are not a laughing matter).

These three movements are effective at all stages or degrees of joint damage. The following one is for the initial stage.

4. Stand on one leg on some elevation so the leg with the damaged hip joint hangs freely. You may support yourself with the arm opposite to the hanging leg (so the leg is farther away from support). Make pendulum movements front-to-back and side-to-side. Do this 2 or 3 times per day, for up to 10 minutes each time.

In addition to such movements, it is necessary to additionally stimulate the joints by hitting them lightly. According to Dr. Gitt, hitting or tapping and slapping about the joint improves blood flow and restores elasticity of tendons and of the joint capsule. Hitting also provides very gentle shearing stress on the joint.

Hitting or tapping is done not directly but through another hand, held in turns on painful spots on and around the joint. Initially the hitting is done with the palm of the hand. With time, as the joint can take stronger impacts without hurting, the hitting can be done with a hammer fist and then with the edge of the hand (but still over the other hand). After hitting, the joint may be slapped lightly to activate blood vessels and nerves in the skin over the joint.

For those joints that are difficult to self-treat in this way, a helper is needed. During the hitting and slapping, muscles around the treated joint are to be relaxed, and there should be very little or no pain, but it is acceptable to have some pain (or increase of the usual pain) the day after.

Consult your physician before attempting any self-treatment.

Recommended reading:
Treating Worn-Out Joints