What is Knee Osteoarthritis and how can Physiotherapy help?

Knee pain is one of the most common pain symptoms encountered in a person’s lifetime. You may have noticed knee pain and stiffness becoming more common with some movements, such as squatting and getting up from the floor. You may even have been told by your doctor, or by well-meaning friends and family, that you likely have osteoarthritis (OA) of the knee. In this article, we will discuss what knee OA is, some common beliefs about knee OA, and how physiotherapy can help to manage the condition.

What is knee osteoarthritis?

Knee osteoarthritis is a condition where the articular cartilage in the knee joint gradually becomes thinner. The articular cartilage is a lubricating layer that covers the ends of the bones that form the knee joint. When this layer becomes thinner, more pressure is felt across the knee joint, making it easier to experience knee pain and stiffness.

Although some instances of knee osteoarthritis may be due to other health conditions such as gout or rheumatoid arthritis, the majority of knee osteoarthritis occurs without any clear cause or disease. It is also important to note that the majority of people who have osteoarthritic knee changes on x-rays or scans actually do not experience any pain or stiffness.

Having knee OA - What does it mean?

It is common to experience some amount of stress and worry when you have been told that you have knee OA. There are many different beliefs and advice regarding knee OA, some of which may be unhelpful. We will now discuss some of the more common beliefs about knee OA.

Knee OA means I have bone rubbing on bone in my knee. Although knee OA involves the thinning of the articular cartilage in the knee, it is usually a gradual process that initially presents with mild changes in the articular cartilage. Cases of knee osteoarthritis with bone rubbing on bone are rare, and usually a long-term result of ignoring symptoms or inadequate management. Most cases start gradually with minimal changes in the knee joint, and it is thus important to manage the condition well when the symptoms are mild.

There is nothing I can do about knee OA as it due to wear and tear. It is common to find articular cartilage thinning on scans due to everyday usage, or so-called “wear and tear”. However, it is important to understand that the majority of people with such findings do not experience any knee pain or stiffness. It is unlikely that everyday usage will damage the knee, or worsen knee OA in a healthy individual. Most cases of knee OA are often stable in their symptoms, and a large percentage show improvements in their pain and mobility if managed appropriately.

I need to avoid exercise to avoid further damage to the cartilage.This is a common misunderstanding that exercise will cause further damage to the knee cartilage, or worsen knee OA. It may be helpful to understand how exercise works and how it can affect the knee. All exercises do cause some strain to the muscles and tissues of the body, and it is this exposure to strain that causes the muscles to respond by growing stronger. Injury only occurs when the demand of the exercise exceeds the tolerance of the muscles and tissues. Avoiding exercise may help reduce knee pain in the short term by reducing sources of knee strain, but it will eventually lead to muscle weakness, joint stiffness and, in some cases, reoccurrence of knee pain.A graduated exercise program that keeps the difficulty of the exercise within the capacity of the muscles is not only safe, it also helps to maintain the long-term health of the knees by improving the strength and flexibility of the muscles and tissues around the knee.

How physiotherapy can help to manage knee OA?

Being diagnosed with knee OA is not the end of the world, especially when it’s managed early and well. Many people with knee OA can still lead active, satisfying lives. Here are some ways that physiotherapy can help:

Improve muscle strength through exercise

There is good amount of research to show that regular exercise is one of the most effective management for knee OA. A key component of an effective program would incorporate strength training. Strengthening the muscles of the leg not only provide better support and reduce strain around the knee, it also helps reduce knee pain and improves the function of the knee. Stretching exercises are also important in maintaining the flexibility of the leg joints, while balance exercise help reduce falls risk, which may be important in older adults with knee OA.

It is always important to consult a healthcare professional before starting an exercise program, especially if you have not exercised for a while. A physiotherapist would be able to provide you with a tailored exercise program to your condition and needs.

Provide water-based exercise

Exercising in water, or hydrotherapy, can be an alternative form of exercise if you are confident in the water. The buoyancy of the water helps float the body, making it possible to do some exercises that may be painful to do on land. It is also a fun and cooling way to exercise, especially in Singapore’s humid weather!

Activity modification and joint protection

Getting out of a chair, or in and out of a car, can be challenging when you have painful and stiff knees. Your physiotherapist would be able to help you with tips to change the way you move to reduce knee strain, and make it easier to move. Your physiotherapist would also be able to advice you on the appropriate use of walking aids and knee braces to manage your knee pain.

Knee OA is a common cause of knee pain and stiffness. It is important to understand that there are many ways to effectively manage knee OA so that you can still have an active and fulfilling life. If you are looking for help to reduce knee pain or manage knee OA, feel free to contact our team of dedicated therapists at info@prophysio.com.sg or 6581 9688.