How your physio can help alleviate your knee osteoarthritis symptoms
September 10, 2021
Knee osteoarthritis (OA) is one of the most common presentations we as physiotherapists see each and every day in the treatment room. Put simply, osteoarthritis is a breakdown of the protective covering of our bones, our cartilage. This cartilage helps absorb the impact of everyday activities, and given the knees take our whole weight during standing, walking, running, jumping; they are one of the most commonly affected joints by OA. Once the cartilage begins to break down, we can begin to experience pain, swelling and clicks or clunks during movement. This occurs as our bones begin to lose their protective coating, and we can get inconsistent thickness of cartilage on the outside of the bone.
In our knees, this can occur in 2 different joints.
- Patellofemoral joint: Joint between our patella (kneecap) and femur (thigh)
- Tibiofemoral joint: Between our femur and tibia (shinbone)
The most common symptoms of knee osteoarthritis include:
- Knee pain that gradually increases with activity
- Stiffness, soreness and swelling in the morning
- Pain after long periods of rest
- Cracks, clunks throughout movement
- Persistent joint swelling
- Reduced range of motion
The true cause of knee osteoarthritis can be quite varied in origin, however the most common risk factors to developing this condition are:
- Increased joint mobility or instability
- High load and wear and tear from high volume of sport, running and other high impact activity over long periods
- Periods of immobilisation (surgery, chronic illness)
- Previous injury to joint surface
- Poor positioning of joint (one side of bone being worn more than the other)
Knee OA is graded according to x-ray or CT scan in its severity and ranges from Grade I to Grade IV. This grading is scored on amount of cartilage loss, amount of joint space narrowing and presence of osteophytes (bone spurs).
With a thorough understanding of knee OA, we can begin to discuss the optimal treatment and management of knee OA! With that in mind, the first step in any stage of arthritis should be physiotherapy treatment. This can either prevent, or at the very least delay, the need for any surgery.
Through physiotherapy we are able to assess your movement, range of motion and joint position as potential contributing factors to knee OA. Throughout this assessment we aim to find the muscles which need a bit more attention via exercise to provide support to your knees. We are also able to give some hands-on treatment to help stiff joints and release any tightness around the knee to improve your mobility. As an adjunct to this treatment, our physiotherapists aim to get you moving as much as possible (motion is lotion!) as movement is the best medicine for people suffering from knee arthritis. Performing physical activity may not only improve your joint mobility and strength, but it can also improve your overall quality of life, mood and help you lose those pesky kilos!
The gold standard of treatment is low impact exercise programs that focus on increasing strength around the knee, without causing increased stress and irritation on the joint.
If the above presentation sounds like something you are experiencing, try giving the following exercises a go to get you started:
Calf raise: stand on a step with your heels hanging off the edge. Raise your heel up as high as you can, putting your weight onto the balls of your feet then slowly lower back to starting position. To make this one harder, try it on one leg! Aim for 3 set of at least 15 repetitions.
Straight leg raise: Lying on your back with your legs out straight. Turn one of your feet out to about 45 degrees, tighten your inner thigh muscle and slowly lift your leg off the floor. Lift as high as you can then lower back down, ensuring your knee remains straight throughout the exercise. Complete 3 sets of 12 repetitions.
Bridge: Lie on your back with your knees bent and feet flat on the floor. Maintain a hip width distance between your knees and feet. Tighten your buttock muscles and lift your hips towards the ceiling until you have a straight line from your shoulders to your knees. Control the movement as you lower back down to the floor and repeat. 3 sets of 12 should be your goal here.
These exercises should start to build some strength around your knee and reduce your OA related pain. If your symptoms are more stubborn however, feel free to come through and let our physiotherapists have a look at your knee for you!
Anatomy of the lower back and pelvis explained