Written By Daniel Webster
Patients often believe that nothing can be done to treat arthritis apart from taking medication or invasive joint replacement surgery. What if you were told there are ways to significantly reduce pain and improve your function?
Arthritis occurs from either an incident that damages the cartilage of a joint or from years of pressure or load to a specific area in the body (wear and tear), affected by each persons individual biomechanics. The guidelines for treating arthritis strongly recommend two specific points that I stress regularly as a physiotherapist; exercise and the importance of maintaining a healthy body weight.
Patients with osteoarthritis of the knee for example should participate in a controlled program of strength exercises, low-impact aerobic exercise (swimming or bike riding) and re-learn specific movements. With each person we can assess the risk factors leading to the problem and how to change the pressure going through the affected joint. The trick is finding what can be modified to reduce the reliance on the sore joint and distribute those forces evenly throughout the body. For instance we might aim to increase the ankle or hip flexibility or strength, to do more work, and reduce the load to the knee. While this may be seen as “cheating,” it changes the way each person functions and has a direct impact on pain. These simple modifications can often have instant results whilst we also strengthen the important knee muscles with comfortable activities.
What happens if we stop moving the knee? If a joint is immobilized or protected unfortunately it does not respond well. The health of the articular cartilage in the joint is dependent on movement to get its nutrition. Without this regular activity the joint becomes stiff and looses it’s important shock absorbing properties. The good news is that after 2-3 weeks of appropriate exercise, these levels return to normal. Movement is required for healthy joints!
Particularly over the festive season we are all a little concerned about our health and how much we will eat over the Christmas break. Remember this little fact: for each kilogram of weight lost, the knee will experience a fourfold reduction in load during daily activities. Imagine how much better that knee may feel with that sort of change. Weight loss is simple in theory, yet often challenging in practice. We can complete simple exercises as part of a program to effectively and safely facilitate this change.
If you or someone you know has been diagnosed with osteoarthritis or chondral (cartilage) pathology keep your head up. There are many different options for treatment that can have a significant impact on your functional ability and quality of life, and we’d be more than happy to help guide this process.
Daniel is available for appointments at both our Cottesloe and Claremont clinics and happy to discuss your arthritis or knee concerns. Please give us a call to find out what treatment and exercises may suit you best.
Handley, C.J. (1995). Physiological responses to injury: synovial joint structures. In: Zuluaga M, Briggs C (Ed.), Sports physiotherapy: Applied science and practice. Canberra (ACT): Churchill Livingstone: 61–67.
Hunter, D. (2011). Lower extremity osteoarthritis management needs a paradigm shift. British Journal of Sports Medicine. 45, 283-288. doi:10.1136/bjsm.2010.081117
American Academy of Orthopaedic Surgeons (AAOS). (2013). Treatment of osteoarthritis of the knee: Evidence based guidelines (2nd Ed). American Academy of Orthopaedic Surgeons.