It gives me an immense pleasure to write this foreword for Dr. Vineeta Ketkar’s book titled Rope and Belt Therapy for Painful Knee Osteoarthritis.
As she rightly mentions the book bridges a gap between modern science & ancient wisdom for effective treatment of OA Knee Joint.
She explains as to how Yoga plays an important keyrole in non pharmacological treatment for OA Knee i.e. controlling pain and improvement in movements of Knee joint by Rope and Belt Therapy. Part I--gives comprehensive details of Anatomy, Kinematics, Pathophysiology and medical management OA Knee involving Patello femoral and Tibio femoral joints. She also explains, clinical history of the patient, examination of the affected knee joint, laboratory investigations and diagnostic imaging. In Medical management she mentions different modalities of treatment from non pharmacological to pharmacological (Drug Therapy) and various surgical procedures including chondrocyte transplantation.
Part lI-- briefs on evolution of science of Yoga; medical Yoga, medical yoga therapy, in this case,especially applicable to OA knee. She elaborates about, Rope and Belt Therapy playing an important role in the treatment of OA knee along with breathing techniques and behavioral guidelines.
Thereafter the author explains how Rope and Belt Therapy works by explaining its principles.She corelates its action with correction of mechanical axis, alignment of bones & plantar arches corrections. It is interesting to note as to how the rope and belt therapy helps in various corrections of the OA Knee Joint.
She has detailed about modified yogic postures as phase 1 & 2 which are to be practiced by patients everyday. This will be very useful to patients to slow down the progression of Osteoaethritis.She has explained in detail about the modality of ambulatory belts & the instructions for their use.This will help the patients of OA knee to be mobile. There after she has narrated the Rope & Belt Therapy ,to be given by experienced yogatherapists at therapy center. Here she explains the principles of distraction & weight distribution to minimize pain & improve mobility.
Finally scoring system used to assess the results will convince the readers of the book and patients of OA Knee who are practicing Rope and Belt Therapy. She guides about indications, contraindications and limitations of this therapy.
The book is a scientific document for OA Knee patients. However the proof of pudding lies in eating. The best proof, of the effective role of Rope and Belt Therapy in the treatment of OA knee is patient himself. The ultimate success of Rope and Belt Therapy will depend on the total co-operation of the patient.
I have not come across a book like this in which both allopathic treatment modalities are combined with Yoga in the form of Rope and Belt Therapy for OA Knee which is rampant in aging patients, women more than men. It must be stressed that Rope and Belt Therapy will be effective in Grade I & II of OA Knee patients, which can be stretched up to early Grade III.
For Grade III and Grade IV patients there is no option but undergoing TKR Surgery. If there is an involvement of one compartment only then either uncondylar replacement or HTO can be undertaken with excellent results. However it must be clarified that, those who have undergone unicondylar replacement or HTO, ultimately face TKR over a period of time.
Dr. Mrs. Vineeta Ketkar did her MBBS from LTMMC Sion, Mumbai and has been practicing as Family Physician since 1981. Because of her genuine interest in Yoga, she learnt Yoga in depth at Iyengar’s institute of Yoga in Pune for 10 years, and she worked as an instructor in Kabir Baug Yoga Institute, Pune for 14 years. After achieving the mastery in all aspects of Yoga, she decided to start her own institute which gave birth to Unnati Yoga Institute in 2006 at Hardikar Hospital. She got excellent response from day one. Over the years the Institute has trained 764 Medical and Yoga Professionals & has become a reputed centre of Medical Yoga in Pune which has treated 4600 patients.
She holds seminars from time to time for doctors & young aspirants of Yoga. She also trains young students for Government certified examinations in Yoga. With all her heavy schedule she has devoted focused time to write this unique book on Rope and Belt Therapy i.e Yoga Therapy for OA Knee joint.
My hearty congratulations to her on writing this unique book, perhaps the first one of this kind. I look forward to have more such books from her in years to come.
My best wishes to her in her future undertakings.
Padmashri Dr S.M.Hardikar. FRCS, Emeritus Professor Orthopaedic, Honorary Fellow of British Orthopaedic Association Founder Hardikar Orthopaedic Hospital, Now Multispeciality Hospital
Dr. Vineeta Ketkar is a dedicated family physician, practicing
modern medicine since 1981 in Pune, India. Her clinical practice is based
on counseling, educating the patients with a judicial use of medicines.
She firmly believes in the healing capacity of body & considers doctor’s
role as ‘Help to Heal’. She is always keen to find ‘Cause & effect’ angle
for each & every illness. Her quest is further enriched due to her study of
Yogic Science. She belongs to a rare community of committed modern
medicine practitioners with Yogic attitude. Her aim is to apply principles
of Ashtang & Hath Yoga in her clinical practice to take care of patient’s
She studied Rope & Belt Therapy under Dr. S.V. Karandikar for fourteen years. She also learnt clinical assessment, therapeutic protocol, periodic follow up, & educative activities with him.
She opted for an opportunity to work independently at leading Orthopaedic hospital in Pune- Hardikar Orthopaedic Hospital. The founder of the hospital Padmashree Dr. S. M. Hardikar sir appreciates the clinical benefits of Rope & Belt Therapy & advises it in selective cases.
At present, in addition to her family physician practice,she offers clinical & educational services at Gnosis Medical Yoga Foundation, Pune, India.
Dr. Vineeta Ketkar
Founder – Gnosis Medical Yoga Foundation
Rope and Belt Therpay was formulated by Dr. S.V. Karandikar around
year 2000. He started prescribing it at his renowned Yoga Therapy
Institute. Patients with mild to moderate Osteoarthritis found significant
relief from pain and stiffness. The therapy reduced the requirement of
pain relieving medicines, and enjoyed mobility which added quality to
their life. Severe OA cases, were benefited by 20% to 30%l relief of pain
and stiffness, which helped them to plan for surgical option.
After witnessing its efficacy with reproducibility and predictability, I started using it at Unnati Yoga Institute in Hardikar Hospital from 2006.I am highly obliged for the unconditional help & guidance received from Padmashri Dr S.M.Hardikar sir. This Therapy is to be given by trained Yogatherapists at well equipped Yoga Institute with wooden benches for patients to sit for therapy. Patients are not supposed to sit on floor.
I added a set of modified Yogic postures to be practiced by patients everyday. This practice is aimed at continued therapeutic effect for palliation and restoration.The modified Yogic postures are based on Classical Yogic postures. They are modified for their specific action and safety. They are called @Home Yogic Postures. They are taught to patients with instructions. These instructions are crucially important to develop awareness in patients, regarding the joints, their movements, muscles working on joints and their status to aim optimal erect posture.
As I was convinced and experienced the usefulness of Rope and Belt Therapy coupled with Yogic Postures, for osteoarthritis of Knee joint, I started an educational course for Medical and Yoga professionals in 2007 to reach society at large. I wrote a brief write up for covering various aspects of this therapy for this course. While teaching this subject to students, I found the need to write this book to explain the anatomy, pathology, clinical assessment and planning the Rope and Belt Therapy Schedule for OA-knee patients.
This book consists of two parts. First part gives a quick update of anatomy and joint kinematics with details of Pathophysiology of Osteoarthritis and its medical management. Second part is dedicated to the subject Science of Yoga, Medical Yoga, Medical Yogatherapy- the today’s need and Rope and Belt Therapy.
The Rope and Belt Therapy has two parts. One is ambulatory belts,to be learnt and used by patient in day to day life. Second is therapy to be given by trained Yogatherapists at therapy center.
It explaines @Home Yogic postures sequence; with it’s mode of action, instructions, figures and photographs.
The attempt is to give comprehensive information of Osteoarthritis with an innovative approach to minimize pain and stiffness and to improve mobility.
I humbly dedicate this book to B K S Iyengar Guraji who pioneered the use of Ropes and Belts in the practice of Yogic postures for perfection & to enhance their effects.
I also dedicate this book to Aacharya Dr. S.V. Karandikar, to fulfill the oath of promotion of Yoga therapy, taken at the beginning of his intensive teaching.
Rope and Belt Therapy and @ Home Yogic Postures are based on functional anatomy and aim at corrections in OA Knee patients. It offers a methodical approach to correct the weight bearing (mechaincal axis) of body. It guides patients for optimal posture, walking pattern, hence attends the spine, hip joint, knee joint, ankle joint and plantar arches.It brings about correction of mal-alignment of femur and tibia, distribution of half of HAT (Head, Arms and Trunk) weight equally in both compartments of knee joint.
This book helps to understand Anatomy and Joint kinematics of Knee joint. The content to explain these fundamentals are taken from Joint structure and function-4th edition by Pamela K.Levangie and Cynthia C.Norkin. In fact this book has motivated me to write my book. I could explain the modaility of action of Rope and Belt Therapy designs, with the help of joint kinematics described in this book. I am grateful to these authors and Publisher - F A Davis, copyright 2006, for giving me the written permission to use the contents of this book to explain Rope & Belt Therapy.
Now about the subject of Osteoarthritis, the description about introduction, epidemiology, pathology, pathogenesis and pathophysiology is taken from Harrison’s Internal Medicine- 15th edition volume2. I am grateful to the Publisher-Mc Graw Hill copyright 2001, for the written permission to use the contents.
Dr Bijlani sir’s six chapters on Yoga in Understanding Medical Physiology,opened new doors for me.I was deeply fascinated by his words & scientific correlation. I do not have sufficient words to express my gratitude towards him for wholehearted encouragement, I always receive from him.He has given me full permission to use his describtion, from all of his books, long ago. I sincerely thank JAYPEE for giving me written permission to use contents from this book.
I sincerely hope that this book will guide the Medical & Yoga professionals to help the society to minimize 1) use of pain relieving medicines 2) progression of Osteoarthritis of Knee Joint.
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