Knee Osteoarthritis Part 3: Management


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Help, I've got knee arthritis!

Written by Mitchell Robinson

Many people over the age of 50 will experience the symptoms of knee arthritis.  The knee joint is the most common area of the body where people will experience arthritis pain.  As a lot of people will get their symptoms when being physical eg. walking, standing etc. there tends to be a common thought that exercise and movement are bad for the knees, leading many people to move less and stop doing the things that they really enjoy.

The idea that knees are like tyres and only have a certain amount of tread before they wear out is extremely prevalent.

"How many times have you heard it as "wear and tear"?"

But research is showing that movement and exercise, along with education regarding managing your knee pain are the most effective ways of managing symptoms of knee arthritis.

Exercise and education have shown moderate improvements in a person’s pain, physical function, physical activity, quality of life, as well as reducing the amount of painkillers needed and sick leave needing to be taken.

So, what type of exercise is helpful?

Physical factors – regarding history of previous use of knees, previous sports involvement, work etc., as well as information regarding structure and anatomy of the knee which may be adding to your symptoms

Weight loss – even a small amount of weight loss can significantly decrease arthritis pain.  This is thought to be due to increased inflammation with visceral fat.

Pain medication and supportive devices – sometimes short-term pain medication and use of supportive devices can be helpful for managing your symptoms

How do I get started?

Strengthening exercises – a lot of people with knee arthritis pain have weakness of muscles around the knees.  Strengthening of the legs can help the knees to become more tolerable to activities. Surprisingly, gaining strength doesn't have to be painful either. Many exercises can stress the muscle tissue without causing pain at the knee joint itself.

Cardio exercises – cardio exercise such as swimming, walking, bike riding etc. can also be very helpful for increasing the endurance of muscles in the legs. There's a lot of conjecture about "impact exercise" being bad for osteoarthritis, but new evidence is emerging that this is not the case.

Balance - improving your balance improves the ability to control forces around your knees. It also reduces unexpected "jarring" incidents from near-falls or missteps. It's important to train balance as apart of a comprehensive program for osteoarthritis.


Are you ready to break free of your pain?

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References:
1. Fransen et al., 2015: http://onlinelibrary.wiley.com/…/10.1002/14651858.CD004…/pdf
2. EULAR Guidelines: http://ard.bmj.com/…/2013/04/16/annrheumdis-2012-202745.ful…
3. OARSI Guidelines: https://www.oarsi.org/…/non_surgical_treatment_of_knee_oa_m…
4. NICE Guidelines: https://www.nice.org.uk/guidan…/…/chapter/1-recommendations…
5A. Ottawa Panel CPG (Part 1 - mind-body exercise programs): http://journals.sagepub.com/doi/abs/10.1177/0269215517691083
5B. Ottawa Panel CPG (Part 2 - strengthening programs): http://journals.sagepub.com/doi/abs/10.1177/0269215517691084
5C. Ottawa Panel CPG (Part 3 - aerobic exercise programs): http://journals.sagepub.com/doi/abs/10.1177/0269215517691085
6. Susko, A., & Fitzgerald, G. (2013).  The pain-relieving qualities of exercise in knee osteoarthritis. Open Access Rheumatology, 5, 81-91.
7. Skou, S., & Roos, E.  (2017).  Good life with osteoarthritis in Denmark (GLA:D): evidence based education and supervised  neuromuscular exercise delivered by certified physiotherapists worldwide. BMC Musculoskeletal Disorders, 18, 72.
8. Petrella, R. (2000).  Is exercise effective treatment for osteoarthritis of the knee, BMJ, 34, 5.

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