If Surgery Is Required
The meniscus may be involved in some cases of knee OA. In the past, surgery to repair or remove parts or all of this cartilage was common. Current research, however, has shown that â in a group of patients who were deemed surgical candidates for knee OA with involvement of the meniscus â 60% to 70% of those who first participated in a physical therapy program did not go on to have surgery. One year later, those results were unchanged. This study suggests that physical therapy may be an effective alternative for people with knee OA, who would prefer to avoid surgery.
Sometimes, however, surgical intervention, such as arthroscopy or a total knee replacement, may be recommended. There are many factors to consider when determining the appropriate surgical treatment, including the nature of your condition, your age, activity level, and overall health. Your physical therapist will refer you to an orthopedic surgeon to discuss your surgical options.
Should you choose to have surgery, your physical therapist can assist you prior to and following your surgery. The treatment you require following surgery will depend on a variety of factors such as the type of surgery performed, your level of function, and fitness prior to surgery. Contrary to popular belief, surgery is not the easy choice you will still require treatment following your surgery to maximize your level of function.
Etiology And Disease Diagnosis
OA can be seen as a two-part degenerative, chronic, and often progressive joint disease. It is the most common musculoskeletal complaint worldwide and is associated with significant health and welfare costs. Within a joint such as the knee, there is a smooth fibrous connective tissue known as articular cartilage. This cartilage surrounds the bone where it comes into contact with another bone. In a normal joint, the cartilage acts as a shock absorber as well as it allows for even movement of the joint without pain. When cartilage degrades, it becomes thinner and may even disappear altogether leading to joint pain and difficulty in movement such as in knee OA. OA is characterized by a repetitive inflammatory response of the articular cartilage due to focal loss or erosion of the articular cartilage and a hypertrophy of osteoblastic activity or a reparative bone response known as osteophytosis. Both of these defining characteristics result in a joint space narrowing or subchondral sclerosis, leading to pain, immobility, and often disability. The symptoms of OA, such as pain and stiffness of the joints and muscle weakness, are serious risk factors for mobility limitation and lead to impaired quality of life for the affected population.
Can Physical Therapy Help With Arthritis
The short answer is Yes, physical therapy can make a profound difference for those suffering with arthritis. To get to the meat of why thats true we need to understand the types of arthritis, and what kind of physical therapy is right for each.
ProHealths owner and lead physical therapist is Dr. Karyn Staples, PT, PhD. She says that among the practices patients, about 60% are struggling with arthritis-related pain. I see it every single day, she says. Back pain is the number one reason patients come in. Then its knees and shoulders. The biggest reason, the underlying cause is for most of these conditions is arthritis.
As a modality, physical therapy is known to have patients walking out better than they walked in, and it can have a profound effect on arthritis. Those effects depend on what kind of arthritis the patient has.
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How To Practice Walking Or Running Up Stairs
Although walking up and down stairs may hurt, it can be a good strengthening exercise for your leg and hip muscles.
Theres another benefit to exercise, and thats having a protective effect on joint or articular cartilage. This is extremely important for slowing the onset of osteoarthritis.
Think of articular cartilage as a protective covering for your joints.
Articular cartilage functions as a shock absorber and also reduces friction between bones where they meet at joints. As a person ages, this cartilage can wear away, leading to joint pain and swelling, or osteoarthritis.
Research shows that loading of the articular cartilage maintains the health of the cartilage and that avoidance of loading, aka exercise, results in atrophy, or thinning of the articular cartilage.
To safely climb steps:
- Take your time. A slow and steady approach can help you maintain your stability.
- Use the railing for support. If you currently use a cane, talk to your physical therapist about how to best use it while on stairs.
For a low-impact alternative, try using a stair stepper machine. When using a stair stepper, keep the following in mind:
- Start with a shorter workout and increase the duration over time. Doing too much too quickly can be harmful.
- Adjust the height of the rise to suit your needs. Bell advises that you start small and gradually work your way up to a higher step.
- Use the railing for support, as needed. Be careful not to lean on the rails.
Exercising At Home Or Work
The best knee exercises may be the ones you can do at home or even during a break at the office. Theyre easy, effective, and convenient, and dont require any special equipment. Do them slowly and gradually increase the number of repetitions as your muscles get stronger.
Afterward, be sure to do a few gentle stretching exercises to help prevent your muscles from tightening up. Consider exercising your knees every other day to give sore muscles a rest.
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Symptoms Of Rheumatoid Arthritis Of The Knee
Knee rheumatoid arthritis symptoms include:
- Knee discomfort, pain or tenderness that worsens when exercising, standing or walking
- Reduced range of movement
- Stiffness that is worse in the mornings and during cold weather your knee joint may also become locked ie when you cant fully bend or straighten your knee joint
- Warmth in and around your knee
- Weakness in your knees when you bear weight on them
In addition to symptoms that specifically affect your knee, you may also notice other symptoms including:
- A dry mouth
- Warmth in and around your knee
- Weakness in your knees ie feeling that your knees will buckle
Three Ways Physical Therapy Can Be Helpful For Neck Arthritis
Physical therapists have an intimate understanding of the structures of your neck since they have spent years learning about this and other parts of the human musculoskeletal system. This knowledge allows them to offer physical therapy thats helpful for neck arthritis. A few of the benefits that physical therapy can offer for this condition include:
Physical therapists can use a technique called therapeutic exercise to help improve your neck range of motion . A study of this technique found that 10 days of it helped cervical spondylosis patients improve their:
- Right rotation by nearly eight degrees.
- Left rotation by more than six degrees.
Often, your specialist will use a therapy method called spinal manipulation to help treat neck arthritis pain. One study reveals that this technique helped reduce patients numeric pain rating scale scores by nearly three points on average after just two sessions.
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What To Expect From Physical Therapy For Knee Pain
If you are referred to physical therapy for knee pain, the initial visit is important to ensure correct diagnosis and proper management. During this visit, your physical therapist will interview you to gather information about the history of your problem, about the aggravating and relieving factors, and about any past medical history that may contribute the overall problem. From the information gathered during the history, a focused examination will be conducted. The examination may consist of several sections including, but not limited to:
How To Practice Deep Lunging
For people with knee osteoarthritis, lunging poses the same benefits and risks as deep squatting.
Lunges are a great way to improve your overall leg and hip strength, but they may cause unnecessary pain when practiced incorrectly.
The trick, Bell says, is to make sure your knee doesnt extend past your ankle.
You may also find it helpful to practice lunges while holding on to the back of a chair or table for added support.
To do a basic lunge:
During your practice, its important that you take note of any changes in pain or discomfort. If you begin experiencing more pain than usual, you should stop lunging for the day and move on to another form of exercise.
Running can increase your overall wellness and help control weight. This can reduce the amount of stress on your knees and lessen the overall effect of osteoarthritis.
However, some caveats do apply:
No one with arthritis should start running, she says flatly.
To minimize symptoms:
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Three Ways That Physical Therapy Can Treat Your Knee Osteoarthritis Symptoms
Physical therapy specialists are experienced at performing many beneficial therapy techniques. This wide range of treatment options is one thing that allows them to effectively treat knee osteoarthritis.
Your physical therapist will start by evaluating the movement and pain level of the affected joint. They may ask you questions about the activities you do daily. They may even ask you if youve injured your knee in the past or if other family members have arthritis. All this information can help your physical therapist choose the therapy methods that can be most effective for you.
Some of the physical therapy techniques that are commonly used to treat knee osteoarthritis include:
Treating A Meniscus Tear With Physical Therapy
Youâve developed some knee pain, and you are having difficulty walking and climbing stairs without pain. You visit your healthcare provider, and an MRI is done which shows a knee meniscus tear. Surgery is recommended. It seems reasonable, but is it absolutely necessary? Are there other alternatives to surgery for a knee meniscus tear?
Recent research indicates that a course of physical therapy can yield the same outcome as surgery for a torn meniscus in your knee.
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Arthritis: How Physiotherapy Can Help
Arthritis is a joint disorder, which features inflammation, pain and stiffness. There is also often a loss in movement with arthritis, as the joints are too inflamed to move. When only a single joint is involved its known as monoarthritis. If two or three joints are involved its referred to as oligoarthritis. To date there are over 100 types of arthritis. Osteoarthritis occurs due to wear and tear of the cartilage and Rheumatoid Arthritis results from an overactive immune system. Arthritis is the most common chronic illness in the nation. Many people cannot work due to arthritis and have to go on disability. And it affects men, women and children. Arthritic pain can impede ones mobility and quality of life. If you suffer from arthritic pain be sure to call us to schedule an appointment with one of our physiotherapists. Physiotherapy for arthritic pain has been proven by research to be highly effective.
Physical Therapy For Knee Arthritis Information Exercises And More
Knee stiffness, pain, and swelling. Youve been dealing with the symptoms for far too long and youve had enough. You want to get back to doing everyday activities without the pain.
Now, youre curious about the cause and how to make the constant discomfort fade, but without a proper diagnosis, it may be hard to find relief.
We understand and are here to help.
In this guide, were discussing everything you need to know about knee arthritis, from types and symptoms to treatment and everything in between. Keep reading to learn more.
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How Physical Therapy Helps Chronic Joint Pain
Physical therapy can be your first line of defense against chronic joint pain. Physical therapy can help to reduce the pain, swelling, and stiffness of joint pain and knee osteoarthritis, and it can help improve knee joint function. It can also make it easier for you to walk, bend, kneel, squat and sit. In fact, a 2000 study found that a combination of manual physical therapy and supervised exercise has functional benefits for patients with joint pain knee osteoarthritis and may delay or prevent the need for surgery.
A physical therapist implements both passive and active treatments for chronic joint pain. Passive treatments include cold therapy, heat therapy, and hydrotherapy. By reducing circulation, cold therapy reduces inflammation. Heat therapy increases blood flow and to decrease stiffness. Hydrotherapy is a gentle exercise in the water that helps facilitate motion. A physical therapist will also have you engage in specific strengthening and flexibility exercises during a session and at home. These exercises increase range of motion and make the joints stronger. They are very effective in reducing pain and increasing mobility.
Can Imaging Exams Detect Arthritis
Imaging exams can help your healthcare provider get a clear picture of your bones, joints and soft tissues. An X-ray, MRI or ultrasound can reveal:
- Bone fractures or dislocations that may be causing you joint pain.
- Cartilage breakdown around your joints.
- Muscle, ligament or tendon injuries near your joints.
- Soft tissue inflammation.
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Strength Train Without Weights
Some people arent up to pumping iron in the gym and thats totally fine there are lots of strengthening exercises you can do just with your body, Hirst says. Pilates is a gentle way to strengthen the muscles that stabilize arthritic joints while improving range of motion and flexibility, she explains. Other options are yoga, tai chi, or bodyweight strength workouts you find online. Just be sure to run it by your PT first so they can make sure they are appropriate for your arthritis, she adds.
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Pt For Rheumatoid Arthritis
What about the other kinds of arthritis? The next most common that Dr. Staples sees is rheumatoid arthritis, an auto-immune disease diagnosed by a blood test. Whats happening is that their body is attacking their own joints. So, the physical therapy we do is to teach patients how to protect their joints, especially during certain flares. The individual might have different management strategies depending on their activities, so we look to decrease the strain on affected joints so they can do those activities, says Staples. The physical therapy for rheumatoid arthritis is how to help not exacerbate problems.
Staples says that rheumatoid arthritis would be primarily managed through medication, But they still have these joints that have had potential damages. So, the physical therapy is really teaching them how to move better.
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Learn How Your Joints Work
Arthritis patients are often more committed to doing their prescribed physical therapy exercises when they understand how their joints work, says Lauren Peterson, a physical therapist and owner of FYZICALTherapy & Balance Centers. When your joints move they produce a liquid called synovial fluid, which reduces friction in your joints, she explains. This means that your joints might ache a little initially when you start moving the joint, but discomfort should improve with continued movement as you get more fluid to lubricate it. Your doctor or PT can show you a model or diagram of what your joints look like when they move and how arthritis can change that.
If Physical Therapy Isnt Changing The Structural Problem What Exactly Is The Benefit
People are more than pictures, and pain is far more complicated than what that picture shows. X-ray and MRI findings can absolutely be helpful in developing a plan of care however, they are only one piece of the puzzle. While physical therapy is unlikely to result in a change in the X-ray or MRI findings, it can identify and help modify factors contributing to your knee pain and functional limitations.
Focusing on your unique condition, a physical therapist can work with you to determine the following:
- Health and lifestyle factors contributing to your knee pain
- Activity modification so you can safely perform activities of daily living
- Stretches and strategies to improve motion and strength
- Swelling and pain control
- How and when to appropriately get back to activities that cause you pain/discomfort
This combination can help patients to better understand their condition and develop a plan that assists in recovery. Doing all of this may greatly enhance your quality of life and ease the pain and symptoms you are currently experiencing.
Now, if you and your doctor determine that knee surgery is necessary, remember, physical therapy is a vital part of preparing for your procedure and recovering after it. Before surgery, we will work together to get you as healthy and strong as possible, which will enable your post-surgical recovery to be that much more successful and faster. Following surgery, we will focus on helping you to restore your strength, balance and flexibility.
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