Knee osteoarthritis is a common degenerative joint disease, affecting millions globally. It involves the breakdown of cartilage in the knee, leading to pain, stiffness, and sometimes, reduced quality of life. Without proper management, it can become debilitating.
What Is Knee Osteoarthritis and What It Affects
Osteoarthritis occurs when the protective cartilage in the knee joint wears away. The knee is a hinge joint involving the femur, tibia, and patella, and depends on cartilage to cushion and allow smooth movement. With osteoarthritis, this cushion deteriorates, causing friction and “rubbing” between the bones. As a result, patients often experience pain, swelling, limited range of motion, and crepitus (a grating sensation). Over time, this can lead to bone spurs or joint deformities, exacerbating discomfort. The weight-bearing nature of the knee makes it highly susceptible to osteoarthritis. Furthermore, cartilage tissue cannot regenerate as well as other tissues in the body.
Populations at Risk of Knee Osteoarthritis
- Aging Population: As people age, joint wear and tear increase, making older adults the largest demographic affected by osteoarthritis.
- Athletes: Individuals engaged in high-impact sports like running or basketball may suffer from early degeneration due to repetitive stress on the knee without proper recovery.
- Obesity: Excess body weight exerts additional pressure on the knee joints, accelerating cartilage wear and contributing to inflammation.
- Post-Injury Individuals: Previous knee injuries, especially if untreated or improperly rehabilitated, can predispose individuals to early-onset osteoarthritis. Conditions like meniscal tears or ligament injuries also increase risk.
- Women: Although not guaranteed, the orientation of women’s hips to their knees can increase stress on the inner knee. Additionally, hormonal changes due to the menopause can have an influence on knee health.
Initial Treatment
Early treatment of knee osteoarthritis focuses on managing symptoms and slowing disease progression. This includes:
- Medications: Over-the-counter pain relievers like ibuprofen are often prescribed. In more advanced cases, corticosteroid injections can help reduce inflammation temporarily.
- Activity Modification: Low-impact exercises such as swimming, biking, or yoga can help maintain knee mobility without further damaging the joint.
- Weight Management: Reducing body weight can lessen stress on the knee, improving symptoms and slowing cartilage degradation.
- Physical activity: Maintaining movement helps preserve joint mobility and can reduce stiffness if load is managed correctly. Remember, “motion is lotion.”
Physiotherapy and the Importance of Exercise
Physiotherapy plays a key role in managing knee osteoarthritis by helping improve strength and mobility while managing and limiting pain. An individualised exercise plan can help strengthen muscles around the knee, particularly the quadriceps, hamstrings, calves and gluteal muscles. Strengthening these muscles helps stabilise the knee and absorb shock, alleviating pressure on the joint itself.
A critical aspect of treatment is progressively loading the joint – introducing weight-bearing exercises gradually. This builds muscle and strength without overwhelming the knee early on. For individuals with knee osteoarthritis, striking a balance between managing inflammation and soreness while working on muscle-building exercises is a hard task, but essential. A qualified physiotherapist can help.
High-intensity exercise is not necessary. However, moderate, non-weight bearing activity, such as cycling and swimming can be performed regularly. The key is consistency and a well-structured plan to progressively increase intensity as tolerated.
Striking a Balance
The challenge with knee osteoarthritis treatment is balancing inflammation control with muscle strengthening. Too much rest can weaken the muscles around the knee, worsening symptoms, while too much exercise can inflame the joint. A gradual, supervised exercise plan that carefully increases intensity is crucial for long-term success. Physiotherapy helps manage this balance by ensuring that exercises are appropriately performed, exercise load is managed, and pain is minimised, thus reducing the risk of injury or flare-ups. As discussed, a physiotherapist can discuss and come up with a plan with you to achieve this gradual progression.
Speak to one of the tfd therapy team if you’d like any extra advice and they’d be more than happy to help!