Knee pain is one of the most common diagnoses that I see in the clinic and more often than not it is due to arthritis.  One source states that up to 2 million of the 14 million people with knee pain from arthritis are UNDER the age 45 when diagnosed.  But getting that diagnosis doesn’t mean you have to stop walking, running, or living an active life, it means you have to be active to take care of your knee joints.  You have a lot of years of road life left on the knees and taking care of them now can prolong or avoid any future disability or discussion of surgery.  

So what exactly is Osteoarthritis (OA)? It is a progressive disease caused by inflammation and degeneration of the knee joint that worsens over time.  The inflammatory process affects the entire joint: bone, cartilage, and ligaments and muscles.  Progression of arthritis is affected by many factors: body weight, bone structure, genetics, previous injuries, muscle strength, and activity level.  I highlight the last two on the list because that’s how you (with the help of your friendly neighborhood physical therapist) can best manage the symptoms and progression of OA.  Weakness and inactivity only speed the progression of the joint degeneration and lead to more pain. 

Obviously, each person experiences pain differently, but there are a few common themes that I hear from our clients.  Pain is usually triggered with standing or walking for long periods of time,  stiffness after sitting in a chair or in the car for a prolonged period, or frequent popping or cracking when moving the knee.  Because the knee is a weight bearing joint, the pain is usually worse when going up or down stairs or standing on hard surfaces (think tile floor in the kitchen without shoes).  

Knee OA is diagnosed by imaging: X-ray or MRI, but a physical therapist or physician can identify the symptoms with a clinical exam and by asking about medical history, looking at your strength, flexibility, swelling, and performance of activities.  

So back to what you can do… strength is super important to manage the symptoms of OA.  Strengthening the muscles around the knee gives you better stability and less joint forces going through the arthritic areas.  Less joint pressure usually means less pain and more activity.  Many clients tell me “My knees are strong, they just hurt”, but when I test them I usually find weak hips, tight hamstrings, and tight ankles.  All those joints are essential to good movement mechanics and decreasing joint forces that can further progress OA.

The biggest challenge is getting started.  If your knee hurts, the last thing you feel like doing is exercising it, right?  That’s where a physical therapist can help.  We find the balance of exercises and activity duration that will begin to lubricate the joint, restore muscle activation around the joint, and improve muscle balance for more efficient movement without irritation and additional inflammation.    

We have many tools in our bag besides exercise to get you started without irritating the knee. We frequently use Kinesiotape to provide some extra support until your own muscles kick in.  We also use manual techniques, stretching, and all natural topical pain relievers to manage pain symptoms until tolerating strengthening exercises.  My favorite tool of course is the pool, where we can take away up to 90% your body weight off the knee and hip joints in order to allow for pain free walking and exercise.  

If you want more information about effects of OA, the basic exercises to start managing knee pain, and how to become active again, give us a call!
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