Staying Active with Knee Arthritis? If you are in the Charleston, Goose Creek, or Mount Pleasant area THIS following information is for YOU!!!
As physical therapists, we often hear our patients tell us that their knee arthritis keeps them from doing the activities they love. “I used to be a runner before my knee osteoarthritis got bad”. “I can’t play tennis anymore because I have bad knees.” “I used to lift weights but it made my knees wear out and degenerate.”
An osteoarthritis diagnosis is not a terminal diagnosis and it does not mean it is the end of your active lifestyle. As healthcare professionals, we need to do a better job of educating our patients about osteoarthritis. Way too often my patients have been told that their knees are so bad that they’re “bone on bone” or “they’re wearing away” or their “joints are degenerating.” These phrases can be scary. Often, these types of phrases imply there is nothing to be done, or the only solution is a total joint replacement. We need to decrease the stigma behind this diagnosis. We’re here to guide you back to a life that is full and active even with osteoarthritis.
What exactly is Osteoarthritis?
Osteoarthritis (OA) is the most common condition of the joints. We most often see it in the knees, hips, neck, low back, and finger joints. It usually crops up between the ages of 55 and 60. The smooth cartilage or cushion between bone surfaces thins out and breaks down and can result in joint pain and swelling, but what exactly causes this breakdown? Most people think it is the result of a culmination of years of physical activity. Many even think OA is the price paid for a lifetime of running or playing sports. In reality, OA starts due to a low-grade inflammation. Metabolism, genetic factors, weight gain, diet, and injury are all potential triggers to this low-grade inflammation. When this process is triggered, cells start to produce chemicals and proteins in our joints that are not good for cartilage cells. If your cartilage is exposed to these proteins and chemicals over time, then your cartilage becomes thinner and more rough and leads to a decrease in ability to withstand force. This decreased ability to withstand force can lead to pain, swelling, and more inflammation and the cycle continues.
What are the symptoms of Osteoarthritis?
The symptoms will differ from person to person, severity level, and where specifically your OA is located. Some of the more common symptoms include temporary stiffness in the morning or after sitting for a long time. Some people experience swelling (water on the knee). You may experience a general ache after doing any activity you’re not used to (like going up and down a flight of stairs). An individual may hear some grinding, clicking, or other joint noise. You might also notice your knee buckle, give out, or feel generally unstable.
Common misconceptions about knee OA
- Your x-ray does not tell the whole story. If there’s one thing I’ve learned as a physical therapist it is that imaging does not always correlate to pain and function. In the case of OA, we have had patients with x-rays that showed severe degenerative changes with very mild pain and awesome function. On the other side of the coin, we have also seen patients with very little evidence of OA on an x-ray, yet they have severe pain and poor mobility. Always remember you are not your image, and despite how bad your x-ray is or have been told it is, that is not the only factor to determine your prognosis. When it comes to OA, do not get surgery based on your x-ray alone.
- The grinding you may hear in your joint is not contributing to the progression of your osteoarthritis. Yes, joint noise is very common in knee osteoarthritis. Many times it is the result of rough joint surfaces or cartilage rubbing together. This noise can be unsettling, however, it is important to understand the joint noise is normal and not accelerating the progression of OA.
- Even if you have been told your knee is “bone on bone”, the most likely source of your pain is coming from nerve endings in the tissue called synovium. The synovium is a tissue that encapsulates your knee joint. It is full of nerve endings that can become very sensitive when inflammatory chemicals are present. This means you can have bone on bone OA and have very little pain when there is little inflammation present.
- Exercising will not wear out your knee faster. I see too many people that have been told to stop squatting, stop playing tennis, stop walking, and even to stop exercising all together in an attempt to stop the progression of their OA or to save their joints. The narrative for far too long has been that knee OA is caused by wear and tear. This notion implies exercise and physical activity causes OA, therefore, exercise will make it worse. This narrative needs to change. In fact, exercise is the single best treatment for OA when your pain is mild to moderate. Exercise has anti-inflammatory effects that can decrease the poor environment for cartilage. Proper exercise will strengthen your muscles surrounding your joints to improve load capacity. It will help cycle fluid in and out of your joints improving joint surface health and nutrition. A new exercise program may temporarily increase pain for a few weeks, but if you stay consistent you will see the benefits. Exercise is not the cause and in most cases it is the solution!
Best Exercises for OA?
- Resistance exercise. This type of exercise has the intention of increasing the strength and or performance of a specific muscle or muscle group. In the example of knee OA the muscles targeted would be in your thighs, calves, and buttocks. The type of resistance used comes in the form of free weights, weight machines, resistance bands, or your own body weight. This type of training will improve the joint’s ability to accept load and improve your movement mechanics. Some common resistance based exercises include: Squats, step ups, knee extensions, leg press, and leg curls.
- Flexibility exercises. The intent of this type of exercise is to increase range of motion. OA is associated with stiffness which can cause muscles to shorten and lose their extensibility. Stretching is a great way to combat this loss. Common flexibility exercises for OA include calf stretches, Hamstring stretches, quadriceps stretches, and hip stretches.
- Aerobic exercises. This type of exercise involves getting your heart rate up. Aerobic exercise has many benefits including decreasing risk of heart attack, and stroke, and in the case of OA it leads to a production of natural anti-inflammatory chemicals that are crucial for maintaining a healthy environment for your joint cartilage. Examples are: walking, jogging, biking, and using an elliptical machine.
- Balance exercises. With OA, there can be a loss of joint position sense. This means the nerves in your knee are doing a poor job of sending information to your brain about where your knee is in space. This can lead to more stumbling, knee buckle, and in severe cases more falls. It is important to safely challenge your balance to upweight the use off the nerves in your knee responsible for keeping your balance in order to prevent injury. Some examples of balance exercises are: single leg stance, standing on an uneven surface like a pillow, standing or walking heel to toe, or standing leg raises.
How Will Your Osteoarthritis Specialist in Charleston, Mount Pleasant, and Goose Creek treat your OA?
A good physical therapist will ask tons of questions in order to get to know not only your condition but what your goals and expectations are. They will collect information through a series of strength testing, range of motion measurements, and functional exams. They will design a program specific to your condition and current level of function. A solid program should be challenging but implemented in a graded fashion in order for your body and joints to adjust appropriately. You may get some pain when starting this program. However, as long as your pain stays under a 4/10 you are most likely okay to keep going as long as there is good communication with your physical therapist. Most of all, a good physical therapist will provide you with the tools to maintain self efficacy and joint health to reach and maintain your goals in the long term.
PHYSICAL THERAPY HAS BEEN PROVEN TO WORK AND CAN BE THE MOST COST EFFECTIVE TREATMENT TO FIGHT YOUR OSTEOARTHRITIS!
https://pubmed.ncbi.nlm.nih.gov/21402325/
Remember, you don’t have to accept a sedentary life just because you have arthritis. There are ways to manage this without drugs or surgery. We are here to help you meet your goals.
Give us a call at (843) 793-4466 or Click Here for our CONTACT INFO
Thank you for your time and attention
-Jack Maynard, Physical Therapist at Joints in Motion Physical Therapy and Wellness
