Published on Jul 27, 2018 and last reviewed on Mar 17, 2023 - 3 min read
This article talks briefly about knee osteoarthritis and stresses on how you can benefit from special physiotherapy exercises for the knee.
Osteoarthritis is a form of arthritis that features the breakdown and eventually, loss of the cartilage of one or more joints. Osteoarthritis occurs more frequently as we age, the common age group of onset being 40 to 50 years. Osteoarthritis is referred to as degenerative joint diseases (DJD). Osteoarthritis commonly affects the hand, feet, and large weight-bearing joints like hip and knee joints. Osteoarthritis is a chronic joint disorder of cartilage. It is not a systemic disease, unlike rheumatoid arthritis which is a systemic autoimmune disorder.
Osteoarthritis is partly a result of natural aging of the joint, where the water content of the cartilage degenerates as a result of biologic processes. The cartilage begins to degenerate by flaking or forming tiny crevasses. In advanced osteoarthritis, there is a total loss of cartilage cushion which causes friction between bones, leading to pain. There is then a limitation in the mobility of joints. Inflammation of cartilage can also stimulate new bone growth spur (osteophytes).
Signs of Joint Inflammation
It is very hard to diagnose OA until there is pain or debilitating symptoms.
For chronic osteoarthritis
The patient can do all activities except bending knees. Sitting on the floor is restricted. For pain relief, painkiller medicine is suggested.
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The exercises that are beneficial for osteoarthritis in the knees include:
- Hamstring Stretch: Stretching helps maintain flexibility and improves the range of motion of the joints in certain directions.
- Calf Stretch: A chair can be used for this exercise. Hold the chair for balance and bend the right leg. Then take a step back with your left leg, straighten it slowly and press the left heel onto the floor. This causes a stretch in the calf of the back leg. This position is maintained for 20 seconds and is repeated twice. The exercise is then performed with the other leg.
- Straight Leg Raise: It helps to build muscle strength to support weak joints. Lay down on the floor, and support the upper body with the elbows. With the foot on the floor, bend the left knee and make the right leg straight with toes pointed upwards. Raise the right leg and keep the thigh muscles lower the leg slowly to the ground. Touch the ground, repeat ten times, and then perform the same exercise with the other leg.
- Quad Sets: If it is difficult to raise legs, quad sets can be performed instead. In this exercise, raising the legs is not required. It just involves tightening the thigh muscles, or quadriceps, of one leg at a time. Lay down on the floor with both legs relaxed on the ground. Flex and keep the left leg tense for five seconds. Repeat ten times and then do the same exercise with the other leg.
- Pillow Squeeze: Lay down on the back with both knees bent and keep a pillow between the knees. Squeeze the knees together, pushing the pillow between them. Stay in this position for five seconds, relax and repeat the exercise ten times.
- Seated Hip March: It helps to strengthen the hips and thigh muscles. Take a chair and sit up straight. With the toes on the floor, kick the left foot back slightly. The right foot is then lifted off the floor with the knee bent. Keep the right leg in the air for three seconds. Then slowly lower the foot to touch the ground. Repeat the exercise ten times and then perform the same with the other leg.
The patient can control the progression of osteoarthritis by maintaining an ideal weight and following an exercise routine to strengthen the muscles that support the joint. The patient must avoid excessive use of the damaged joints and take the help of their physiotherapist to stop the progression further.
With severe knee arthritis, the patient is advised to perform aerobics or endurance to maintain adequate fitness. This help improves cardiovascular health, control weight, and enhance stamina and energy. Examples of low-impact aerobic exercises that are not harsh on the joints include walking.
High-impact exercises, like running and jumping, must be avoided strictly by people with knee osteoarthritis as such joints can further damage the joint. However, it is believed that in mild or severe cases, these exercises might be helpful in stimulating the cells that facilitate cartilage repair.
Knees can be lubricated naturally by consuming foods that are good for the joints and help produce more synovial fluid. Examples of such foods include dark, leafy vegetables
and omega-3 fatty acids commonly found in flaxseeds, salmon, and mackerel.
Foods rich in curcumin (found in turmeric) and high-antioxidant foods (onions, garlic, berries, and green tea) can also be helpful.
The food items that can trigger osteoarthritis include red meat and fried foods, as they contain high levels of AGEs (advanced glycation end products), which can stimulate inflammation. Red meat is also a source of saturated fats, leading to high cholesterol that can worsen joint inflammation. Other food products that may trigger osteoarthritis include sugars, dairy items, refined carbohydrates, alcohol, and tobacco.
Osteoarthritis can be worsened by obesity or being overweight, as it leads to extra pressure or strain on the joints. Consuming unhealthy food or a diet rich in food that causes inflammation can also be a contributing factor progression or worsening of osteoarthritis.
Studies have revealed that stair-climbing helps to build stronger lower limb muscles and decrease knee pain. Therefore for strengthening the knee and preventing knee pain, stair climbing is considered a simple yet beneficial method for knee osteoarthritis patients.
Viscosupplementation or hyaluronic acid injections (hyaluronan injections) are one of the best knee lubricants that involve injecting hyaluronic acid into the knees of patients with osteoarthritis. Hyaluronic acid is naturally present in the healthy joint, but its concentration is low in joints affected by osteoarthritis.
People with knee osteoarthritis can initiate a slow and manageable daily walk. The patient must walk regularly and lengthen it gradually. Walking poles, crutches, or a stick can be used for walking as it helps balance the posture and relieves pain.
Biking is more beneficial than walking. Cycling is helpful as it is less harsh on the hips, knees, and ankles in patients with osteoarthritis. The patients must include some form of exercise in their regular routine to control the progression of the disease.
Knees can be strengthened by performing exercises like knee extension, knee flexion (standing), heel and calf raise, wall squats, and swimming. These are strengthening exercises, and according to the American Academy of Orthopaedic Surgeons, it helps help decrease the stress on the knee joint and makes the hamstrings, quadriceps, glutes, and hip muscles strong.
Gel injections are administered in patients who do not respond positively to other treatments like Acetaminophen, exercise, or physical therapy. Hyaluronate or hyaluronan is similar to a substance that naturally occurs in the joints. It acts as a lubricant and shock absorber in the joint.
Osteoarthritis can be managed without surgery through regular exercises like walking, cycling, and knee exercises. Reducing weight also helps to control the condition as it decreases the pressure on the knee joint.
Osteoarthritis can be managed with medications like Acetaminophen and NSAIDs (non-steroidal anti-inflammatory drugs) like Ibuprofen. If the pain continues, weak opioids like Tramadol can be prescribed.
Intra-articular knee joint injections like corticosteroid and hyaluronidase injections are also administered into the knee joint. The corticosteroid helps in reducing inflammation, while hyaluronidase acts as a lubricant.
Another technique that can be used to avoid surgery is the radiofrequency ablation of the nerves supplying the knee joint. It is performed in refractory cases and provides pain relief for up to one year. This procedure benefits patients who are unfit or unwilling to undergo knee replacement surgery.
Last reviewed at:
17 Mar 2023 - 3 min read
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