בלוג

שחיקת מפרקי הברכיים

בשלב מסוים בחיינו, רבים מאתנו יסבלו מכאבי ברכיים. מלבד בעיות עמוד שדרה, זו הבעיה האורטופדית הנפוצה ביותר. הסטטיסטיקה מלמדת שהחל מגיל 40, לכ 10% ישנם כאבי ברכיים, ואחרי גיל 70, השיעור מטפס ל 25%. כאבים אלה משפיעים באופן משמעותי על התפקוד היומיומי שלנו, לרבות תפקודים פשוטים כגון הליכה, עליה או ירידה במדרגות ועוד.
במערכות הבריאות בארץ ובעולם, מאבחנים שחיקה מפרקית (osteoarthritis) בהתבסס על צילום רנטגן באופן כמעט בלעדי. שחיקה כזו מצויה אצל 70%(!) מהאוכלוסיה מעל גיל 50. אנשים אלה יאובחנו כסובלים מניוון (degeneration) של הסחוס, למרות שזהו בסה"כ תהליך הזדקנות נורמאלי לחלוטין של הרקמות, ועל פי רוב אינו המקור לכאבים או להגבלת התנועה.
טעות נפוצה היא לחשוב ש"שימוש יתר" במפרק הברך מביא לניוונו. מחקרים מראים שאין כלל הבדל בתהליך הניווני בברכיים בין רצים ללא-רצים. האמת היא, שישנה שכיחות גדולה יותר של כאבי ברכיים בקרב אנשים המבלים את עיקר זמנם בתנוחת ישיבה. אנשים המעדיפים תמיד את המעלית על פני שימוש במדרגות, ונמנעים מעומסים על הברך, כגון כריעה מלאה, "מפאת גילם המתקדם", יהיו חשופים יותר לבעיות ברכיים.
מפרק הברך הינו מפרק מורכב מאוד מבחינה אנטומית, אך ברמה הפיזיולוגית הוא בין המפרקים הפשוטים ביותר בגוף. בניגוד למשל למפרק הכתף או הירך, ישנן בברך רק שתי תנועות עיקריות: יישור – פשיטת הברך קדימה, כיפוף – קיפול הברך כך שהעקב מתקרב לישבן.
כאשר מקור הכאב הוא בברך תמיד תהיה הגבלת תנועה לאחד הכיוונים הללו או לשניהם, וקל לבדוק זאת ע"י השוואה לברך השנייה. אם אין שום הגבלה בתנועה, מקור הכאב אינו מפרקי ויכול להיות שמדובר בבעיית גידים (אופייני יותר לאנשים צעירים), הקרנה מהגב התחתון, או בעיה שאינה אורטופדית כלל.
לאחר שזיהינו את כיוון התנועה המוגבל ביותר מבין שתי האפשרויות, כל שנותר לעשות הוא לתרגל את אותו כיוון באופן אינטנסיבי מאוד. פשוט להניע את הברך לכיוון המוגבל עד קצה גבול היכולת מס רב של פעמים. העוצמה והתדירות של התרגול יהיו תלויים בחריפות וחומרת הבעיה. כמובן שאם התפתחה נפיחות משמעותית בברך, עם כאבים עזים, עוצמת התרגול ותדירותו יהיו נמוכים יותר בשלב ראשון, ובהדרגה ניתן יהיה להעלות את הקצב.
בדר"כ, לאחר מספר לא רב של חודשים, ניתן להגיע בעז"ה להחלמה מלאה גם ממצבים שנראו אבודים, ושאין מנוס מביצוע ניתוח וכדומה.
אז קדימה לעבודה !

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