Knee Osteoarthritis: from feeling STUCK back to coastal hikes!

What is knee osteoarthritis (OA)?

knee OA is a very common degenerative joint condition which affects all joints in the body as we age. Most commonly, it is the knee and hips which can become problematic as they are our major weight-bearing joints when we undertake many activities such as walking and running.

The harsh truth is that as we age, the strength of our muscles and bones will reduce. By the age of 40, it is quite normal for scans to identify some degree of arthritic change in our knees, but does this necessarily mean we will experience pain in these joints because scan findings indicate so? The answer is no, and let us explain why! Physiotherapists here at our Adelaide based CBD clinic see a lot of this injury! Below we will use a metaphor to understand the best way to manage knee OA so you can enjoy your coastal walks for years to come!

What does the latest research show?

Let’s take a case for this example; a 65yo male is experiencing sharp knee pain on his left side but no symptoms on his right side. It is suspected he has knee OA, and he is referred for x-ray scans which confirm he has severe left knee OA. If he were to have scans of his right knee, there is a very high chance he will have almost identical findings compared to his left, but remember he doesn’t experience pain in this knee.

The gist is that scan findings do not always equal whether one will be experiencing pain, and recent research has also backed this up on multiple occasions. So why can this be? Let’s explore this together..

What else can cause painful knee OA?

Whilst it is still important to consider scan findings when considering one’s pain, there are many other factors which can lead to knee OA including weight/BMI, gender (women generally more likely to experience symptomatic knee OA), family history, any other previous joint injury (e.g. joint trauma playing sports in teenage years) and psychosocial factors (e.g. previous beliefs regarding OA and fears of doing further damage)

What do individuals usually report with Knee OA?

Stiffness in the knee which can last up to 20-30mins after waking up
Locking, crepitus, cracking sensations
Possible weakness in the knee
Symptoms fluctuating from day to day (i.e. unpredictable pattern)
Soreness over the inner aspect of the knee on palpation, possibly after a lot of activity
In more severe cases there may be swelling

How can knee OA be treated?

This might sound strange, but let’s use the analogy of a cleaning sponge to explain how OA can be treated (and no, this isn’t an advertisement for cleaning products..!).

On the inside of our joints, we have a smooth layer which lines the bones called cartilage. This cartilage is made up of mostly water and a protein called collagen.
When we put load through this joint, the forces push new water in and take existing water out of our cartilage to keep it healthy.
When we don’t load this joint, the water within our cartilage isn’t able to flush out, causing a build up of waste products.
Imagine using a cleaning sponge for weeks and weeks without squeezing it out with fresh tap water…
This is where Physiotherapy can help you to find ways to most effectively load this joint to continuously flush out waste products (like a clean sponge would – cue the photo below) without the risk of causing further harm.

Common physiotherapy treatments

Individualised treatment program and home exercises. This program is dependant on what you want to get back to doing more of (i.e. goals) and how you are moving functionally (e.g. going up/down stairs, bending/squatting, balancing). So in summary, treatment is not only based on what scans show!
Treatments such as bracing/taping, joint mobilisation, deep tissue release and dry needling can be very effective in settling down your pain on top of active exercise, and will help you get the absolute most out of your individualised program!
Our in-house Pilates program is a fantastic option for long-term management of OA, and many Pilates clients have had great results! Once again, your pilates program will be personalised towards your goals and where you are at in your rehab.