Can physical therapy help knee arthritis?

What is knee arthritis?

Arthritis of the knee is a very common condition, affecting more than 1/3 of the population over the age of 65. Osteoarthritis of the knee results in the most symptoms and limitations in participation of everyday activities compared to osteoarthritis at other joints in the body. The condition is usually caused by a slow degeneration of the knee joint.  Wear and tear causes the cartilage at the knee to gradually wear away. This cartilage provides cushioning between the bones and acts as a shock absorber during activities such as walking or running. When the cushion gets worn away it causes the bones to rub closer together causing pain and inflammation resulting in osteoarthritis.

Increased age is the most common risk factor in developing osteoarthritis however there are a few other factors that can play a role in the onset of the condition. Increased weight puts more pressure through the knee joints, which causes wear and tear of the cartilage to occur faster.  Certain occupations and participation in athletics where individuals perform repetitive stressful motions on the joints also increase the risk of developing osteoarthritis. Genetic factors can also contribute to the development of the condition.

Signs and Symptoms

Symptoms generally do not occur suddenly but develop gradually over time.  Common symptoms include pain and stiffness for greater than thirty minutes in the morning or after periods of inactivity.  Decreased motion due to swelling at the knee joint is another symptom that can be observed in individuals with knee osteoarthritis.  Crackling or creaking sounds and sensations can also occur in osteoarthritis.  This is called crepitus and is experienced while an individual bends or straightens their leg at the knee joint. Certain activities that put increased stress on the knee joint can be painful for those with this diagnosis.  Squatting, kneeling, climbing stairs, running, and walking are all things that may be difficult for individuals with osteoarthritis to perform without pain.

Physical Therapy

Most individuals with osteoarthritis stop participating in exercise routines or other activities because of the pain.  This inactivity has been shown to increase stiffness, decrease muscle strength, and cause more pain in individuals with osteoarthritis.  Regular exercise at a moderate intensity has been shown to strengthen the knee joint and decrease the risk of osteoarthritis and decrease symptoms if the condition is already present. With physical therapy a therapist will prescribe an exercise program that will address any strength deficits that may be contributing to symptoms related to osteoarthritis.

The knee joint contains two types of stabilization from surrounding structures.  The knee has static stabilizers and dynamic stabilizers.  Static stabilizers include ligaments and cartilage while dynamic stabilizers include the surrounding muscles.  In osteoarthritis the static stabilizers of the knee are affected causing decreased stability at the knee joint.  Physical therapy will incorporate exercises to increase the strength of the dynamic stabilizers in order to improve overall knee stability.  Improved knee stability will allow individuals to perform more activities without pain and decrease the risk of injuring surrounding tissues.

Along with strength, stiffness and decreased motion are other impairments a physical therapist will address.  Stretching and other hands on techniques to mobilize the surrounding muscles and joints can be used to treat this decreased mobility.  Improving the amount of motion at the joint will decrease pain and allow individuals to perform everyday activities more easily.

Another form of therapy that is beneficial in the treatment of osteoarthritis is aquatic therapy.  Aquatic therapy is perfect for individuals who are unable to complete weight bearing activities without high levels of pain.  The buoyancy of water allows decreased loading and pressure to be placed on the joints while an individual is completing exercises. Aquatic therapy exercises can help improve the motion at the knee joint and decrease pain.  Once a patient is feeling better they can progress to weight bearing resistance activities in order to improve muscle strength during functional activities.

Every individual case is different and a physical therapist will complete an evaluation on your first visit to determine possible contributing factors to the condition. Your therapist will tailor treatment to address individual impairments such as decreased flexibility and strength deficits that may be contributing to the condition. Physical therapy can decrease your risk of developing accompanying injuries, allow you to complete everyday tasks more easily, and help you get back to activities you enjoy doing.

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