Osteoarthritis: Physical therapy for hip and knee pain

Osteoarthritis: Physical therapy for hip and knee pain

You’re no spring chicken, you have to make your peace with that.” Is that the response you got from a dismissive-someone when you described your hip or knee pain? Have you gone so far as to believing that about yourself? 

If you woke up with stiffness in your hip and knee, maybe even some creaking in your joints, you probably told yourself that you’re getting old, and life goes on? To your credit, the pain disappears in about 30 minutes, and you’ve forgotten it was even there as you go about your day. 

This is the biggest myth about Osteoarthritis (OA). 

Age is a factor but not always the cause for painful joints. This is great news; you don’t have to helplessly endure the pain, discomfort, and activity limitations that Osteoarthritis (OA) causes. 

Much like other conditions, Osteoarthritis, has a better prognosis, i.e., scope for complete recovery, when caught at its early stages.  

On the other hand, maybe your physician was optimistic about a pain-free lifestyle for you and you could not bring yourself to believe him. After all, the pain has become a part of your life and you’ve learnt to live with it for a few years. 

Regardless of the stage you’re in, this article is a kind and hopeful reminder: You do not have to accept the pain as if you are out of options.  

With physiotherapy, you can be relieved of your pain and enjoy an active lifestyle with varying levels of modifications. At Revere Physiotherapy, we guarantee 100% patient satisfaction. 

Let’s delve deeper into how Osteoarthritis comes about so you can make informed, empowered decisions about your health. 

What is Osteoarthritis? 

Osteoarthritis, the most common type of arthritis, is a degenerative condition that affects your joints and restricts function. Degenerative implies that without intervention, it gets worse with time.  

OA presents on a spectrum of severity, from asymptomatic to severely debilitating, in which case a surgical management of the condition becomes necessary. 

Causes of Osteoarthritis, hip pain and knee pain: 

Anatomically, the joint surface includes 2 bony ends and a cartilage structure between these bones that enables a smooth gliding motion to produce effective movement. Osteoarthritis occurs when this cartilage between the bones begins to break down and disintegrate. This is eventuated under different circumstances. 

Primary Osteoarthritis is when your joint undergoes degenerative changes due to no apparent reason. Such changes are attributed to age; however, research says that is debatable. 

Secondary arthritis, as the name suggests occurs due to factors such as obesity, underlying conditions like rheumatoid arthritis, history of direct injury to the joint etc. 

The most affected joints are the hip, knee, ankle, and foot. However, OA is known also affect smaller joints, such as the thumb. 

Risk factors for Osteoarthritis: 

If Age is not the cause for OA, then what is?

 
As mentioned earlier, the accurate cause of OA is unknown. However, in the last few years research has identified common risk factors for the disease and cause for progression. 

  • Obesity/ Body mass index- the theory is that the increased load on the joints can be responsible for wear and tear. 
  • Age- can be a factor, not everyone growing older has joint pain. 
  • Gender- women are more likely to have osteoarthritis. 
  • Previous injury such as fractures or ligament tears. 
  • Genetic factors- in some cases inflammation and healing can be affected by genetic factors. 
  • Specific occupation or activity can cause OA if there is an increased load on the joints for prolonged period of time.

Symptoms of Osteoarthritis: 

  • Pain 
  • Morning stiffness 
  • Swelling around the joint 
  • Decreased range of motion. 
  • Pain on palpation or after prolonged sitting 

 

Physical therapy management of Osteoarthritis: 

  • Physical therapy Assessment

The first step is the completion of a thorough assessment which includes detailed history- medical and social, and examination. Your physiotherapist will assess your pain, Range of motion on affected joints and neighboring joints, Muscle strength, Sensation, Posture and alignment, Functional tests, balance, and proprioception tests. 

  • Physical therapy treatment: 

Intervention for Osteoarthritis depends on the stage of the degeneration that is identified by your physiotherapist. However, there are some basic strategies that are used as foundational practices in the treatment of Osteoarthritis. 

  • Patient Education Evidence based practice protocols point to the importance of education about the condition, role of weight loss, long term management strategies and activity modification at home and work. 

  

  • Strengthening exercises You physiotherapist will prescribe an exercise regime to strengthen muscles around the joint as part of conservative management. Don’t worry about the pain as you will be taught non-weight bearing progressive resistance exercises. What that means is this; if you have knee pain and swelling, your exercises will be designed to keep you from standing or weight bearing on your painful joint. It is vital that you continue the exercises, best results are seen after 6 weeks of compliance with the exercise program. Contrary to popular belief, exercises make your muscles stronger and directly reduce pain. 

  

  • Manual Therapy techniques are especially useful for Hip OA with stretching and mobilization used as highly effective techniques for pain reduction and increased range of motion. 

  

  • Stretches For each exercise, you will be taught an accompanying stretch to enable range of motion and flexibility. 

  

  • Gait training Your physiotherapist will perform an assessment for assistive devices such as a brace for your knee, as indicated, and teach you the mechanics of your walk to reduce pain and improve strength. 

  

  • Low impact conditioning exercises From information gathered in your social history your physiotherapist will recommend low impact conditioning exercise such swimming, biking, ellipticals etc to both reduce Body Mass Index (BMI), if required, and improve overall health. 

  

  

Pre-operative Physiotherapy: 

In some cases, if there is a significant impact of OA on your lifestyle and activities or if conservative management proves inadequate, then your physician may schedule you in for surgical management. You will be advised to undergo a total hip replacement or a total knee replacement. 

It is important to comply with the exercise regime prescribed to you while you wait for your surgery as this will drastically reduce recovery times post-surgery. If your muscles are strong before the surgery, you will be able to return to preferred activities sooner than if they weren’t.  

  

At Revere physiotherapy, we have a team of specialists and experts who will assess your symptoms and provide you with the best treatment strategies to facilitate a thorough recovery.  

Book an appointment with our physiotherapist and experience quality care in good hands! 

If you have any questions, we offer a free 10-minute consultation to alleviate your apprehensions. Give us a call at 604-566- 5108. 

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