Knee osteoarthritis (OA) is a chronic degenerative joint disorder where the cartilage between knee joints wears down with time. It causes swelling and stiffness in the knee, making it difficult to do even the basic activities in life. Research suggests anyone above 20 can get OA. In Canada, at least 1 in every 7 adults has OA and the knee is the most commonly affected joint followed by hands, feet and hips. Physiotherapy is one of the first lines of treatment for knee OA. It reduces pain, improves joint function and empowers the individual to return back to an active lifestyle. This blog shares a detailed description of how physical therapy manages knee osteoarthritis and prevents surgery.
What Exactly is Knee Osteoarthritis (OA)?
Knee OA is the wear and tear of cartilage present between the knee joints. The breakdown of cartilage affects the entire knee joint along with its surrounding muscles, tissues and ligaments. The condition causes pain, limits mobility and progresses slowly over time.
There are two types of OA:
Primary- The cartilage loss occurs without any underlying reason. Age is usually the main reason behind primary knee OA.
Secondary- Cartilage loss occurs due to a specific known reason. It usually happens due to an abnormal force on the joint. Common causes of secondary knee OA are obesity, joint instability, joint injury, congenital defects and more.
What are the Early Symptoms?
People with OA may feel the following in the affected knee:
- Early morning stiffness
- Reduced mobility
- Pain after prolonged sitting
- Pain after increased physical activity
- A dull achy persistent pain
- Difficulty in putting weight on the affected leg
Who Can Have OA?
It was once assumed that OA is an “old person’s disease” because ageing causes degeneration of joints. Further studies, however, reported that osteoarthritis happens because the body fails to repair damaged joint tissues. The damage can happen at any age and for various reasons.
Age is one of the factors that cause degeneration of bones. Other reasons include joint injuries, obesity and poor joint loading.
What are the Treatment Options?
There are two modalities for treating knee OA which are conservative and surgical. The treatment for knee OA starts with conservative modalities. Surgery is recommended only if the former does not help the patient.
Physiotherapy is the main conservative treatment for OA knee.
The physiotherapy treatments involve:
- Patient Education
- Exercise Prescriptions
- Manual Therapy
- Lifestyle Recommendations
- Bracing
Knee osteoarthritis is curable and preventable. You should address the symptoms as early as possible to delay the progression of the disorder. Let’s take a look at how physical therapy treats knee osteoarthritis.
Four Crucial Ways Physical Therapy Manages Knee Osteoarthritis
Physical therapy provides several benefits to patients with knee OA. It reduces pain and swelling of the knee joint. The patients can return to their normal daily activities and prevent the condition from worsening.
Here’s how physical therapy benefits knee osteoarthritis:
Patient Education
Physiotherapists help people understand their condition, treatment options and the entire recovery process. They educate the patients on critical factors required to deal with knee OA right from an early stage. Once you become well-informed about your condition, you are more likely to stick to treatment plans and recover quickly.
What do the patients learn?
- The explanation of knee OA
- Pain and other symptoms associated with it
- Impact of activity changes on the condition
- Long-term management options
- Tips to lead an active, healthy lifestyle
Self-management is necessary to deal with chronic conditions and avoid complications. You can manage the condition on your own in the right manner when you completely understand the condition and are aware of the treatments that can help you recover.
Let’s say a 30-year-old woman has been diagnosed with knee OA. The physiotherapists help her understand the condition. So, now she knows what knee OA is and how her body weight and activities can affect the disorder. This knowledge gives the patient a sense of control over this situation. She also understands how certain lifestyle changes can improve her condition. This helps her become more proactive in managing the condition.
Exercise Therapy
Moving around with knee OA is no easy feat. But, movement is the best treatment for this condition. Exercise not only improves your joint function but also the overall quality of your life. Physiotherapists assess your lifestyle and the severity of your condition to design an individualized exercise program for your smooth recovery. Initially, they guide you through the exercises at the physiotherapy clinics. Once you reach a certain recovery stage, they teach you effective home exercises as well.
How do exercises help patients with knee OA?
- Strengthen the muscles around the knee
- Improve the flexibility of knee joint
- Increases your range of motion
- Remove pressure from the joints
- Improve joint coordination
- Restores normal, healthy functioning of the knee
- Reduces the risk of cardiovascular diseases
Examples of exercises
- Strengthening exercises(Straight leg raises, wall squats, step-ups)
- Range of motion exercises(heel slides, leg extensions, hamstring stretch)
- Stretching exercises(Quadriceps stretch, calf stretch)
- Aerobic exercises (Walking, swimming, cycling)
- Balance exercises (Single-leg stands, heel-to-toe walk)
There are different types of exercises and each serves unique health benefits. You should know the right exercises for your symptoms and the correct technique of performing them. This is where the role of physiotherapists comes into play. They customize the exercise programs according to what your body needs to return to normal life as quickly as possible.
Manual Therapy
Manual therapy is the hands-on manipulation of the affected soft tissues and joints that contribute to your knee OA. The physiotherapist checks for stiffness in your knee area before applying an optimal force on the region. This results in reduced pain, improved joint function and enhanced mobility.
Here’s how manual therapy impacts knee OA:
Improves knee joint mobility
The degeneration of cartilage results in stiffness in knee joints and surrounding tissues. Manual therapy techniques like joint mobilization address this joint stiffness and improve the range of motion.
The physiotherapist uses gentle movements to stretch or glide the knee joint. Consistent sessions with the professional reduce stiffness and make daily movements easier.
Reduces muscle tension
In knee OA, certain muscles of the knee become tight and others tend to weaken. This muscular imbalance can cause the patient to lose their balance and fall. Manual therapy releases the tight muscles and restores the lost balance.
The therapist applies a certain technique such as deep tissue massage to relieve the tightness in your hamstrings or quadriceps. The relief of tightness results in pain relief as well.
Reduces pain
Knee OA causes chronic pain, which often increases significantly after sitting for a long period of time. Manual therapy reduces this pain by boosting blood flow to the muscles and releasing tension from the muscles around your knee joint. Soft tissue mobilization, for instance, is a popular manual therapy technique which eases inflammation and reduces pain around the knee.
Corrects joint alignment
Poor alignment of the knee joint worsens the symptoms of knee OA. Manual therapy techniques help correct the subtle misalignments that contribute to wear and tear of the cartilage.
Lifestyle Recommendations
A stable body weight helps manage knee osteoarthritis. According to research, every 1% of weight loss results in a 2% reduced risk of knee replacement. So, physiotherapists provide you with lifestyle recommendations that help you maintain a healthy weight and stay physically active.
Some popular lifestyle advice for a healthy knee joint:
- Eat right.
- Drink plenty of water.
- Engage in exercises daily.
- Use supportive shoes that reduce stress on the knees.
- Replace high-impact sports with low-impact physical activities.
- Use assistive devices such as braces when required.
- Get regular physiotherapy check-ups.
The physiotherapist helps you integrate the recommendations so you can prevent knee OA and lead a healthy life. The recommendations differ from patient to patient depending on your health goals, injury and existing lifestyle.
When to See a Physiotherapist for Knee OA?
Knee osteoarthritis becomes worse with time. So, you should consult with a physiotherapist as soon as you experience the symptoms as discussed in the blog. Treatment for knee OA begins with conservative modalities such as physical therapy. The physiotherapist assesses, diagnoses and treats the condition by restoring the body’s ability to repair damaged tissues and joint problems. They prevent the symptoms from recurring by protecting joint function and maintaining optimal, pain-free knee movement. You should look for clinics near your location. If you are in Brampton, there are ample options such as Physiotherapy First which helps patients recover from OA.
