Here is what you need to know about knee arthritis and how you can manage it:
When our doctor tells us that we have arthritis in our knee. We may feel puzzled and confused about what that means for our future. You may be wondering “Will I be able to continue playing sports”, “Will I have to live in pain forever”, “Will I need a knee replacement”…
Let’s start from the beginning by finding out what knee osteoarthritis (OA) is?
A joint forms when two bones meet. In our bodies, joints are surrounded by cartilage which acts like cushion to absorb pressure. Weight bearing joints like hips, knees and ankles have to absorb forces when we do activities like walking, running, going up and down stairs etc. Due to aging, normal ‘wear and tear’ from daily activities or trauma to a joint we can develop osteoarthritis. Arthritis describes the wearing down of cartilage which can lead to us having pain, may affect our ability to walk, climb stairs or participate in sports.
Here is what the latest research is saying about what we can do manage symptoms of knee OA or prevent it1,4:
- Weight reduction
- Exercise!!!
- Strengthen muscles around your knee, like the quadriceps, hamstrings, glutes, adductors. (Ex. Wall squats, repetitive sit to stands, step ups, step downs)
- Aquatic Exercises (Ex. Forward/Backward/Side walking, squats, heel raisesin the pool)
- Aerobic Exercise (Ex. Walking, biking)
- Balance Exercises
- Eating healthy
- Proper footwear
Evidence:
- Many studies have confirmed that there is a direct relationship between obesity and having knee OA. Obese individuals are at a risk of knee OA progressing faster due to more than normal forces being exerted on the joint1.
- A study by Fisher et. Al suggested that increasing quadriceps and hamstring strength improved walking pattern in subjects2. Another study found that walking >6000 steps/ day decreased risk of functional limitations related to knee OA5. There is limited research that outlines the optimal dosage of exercise for people with knee OA but guidelines for management of knee OA usually recommend an exercise program consisting of strengthening and aerobic exercises 3x/week.
- Heel and sole insoles have proven to decrease reported pain in people with knee OA.3
What about a knee brace for knee OA?
According to two studies the group with knee OA who wore a knee brace were able to walk longer distances than the group with knee OA that didn’t wear a brace. These studies didn’t find a difference in reported knee pain, knee function or quality of life in the group that wore the brace.3
Do I need a knee replacement?
Individuals may need to get a knee replacement when there has been severe cartilage loss, when there is constant pain in the knee joint and functional limitations. It is still a good idea to make sure the muscles surrounding the knee joint are strong before the surgery. Rehabilitation post a knee replacement is very intensive but it does give people another opportunity to start or go back to an active lifestyle.
Before you begin an exercise program it is important to ask your doctor if it is safe, in case you have other illnesses. A physiotherapist can help you get started on a program that is tailored to your age, fitness level, disease severity, pain level and lifestyle. The most important thing you need to know about knee OA is that keeping active will help you manage your symptoms.
Reference:
1.Bennell, Kim L., Fiona Dobson, and Rana S. Hinman. “Exercise in osteoarthritis: moving from prescription to adherence.” Best Practice & Research Clinical Rheumatology 28.1 (2014): 93-117.
2.Fisher, N. M., et al. “Muscle function and gait in patients with knee osteoarthritis before and after muscle rehabilitation.” Disability and rehabilitation 19.2 (1997): 47-55.
3.Brouwer, Reinoud W., et al. “Braces and orthoses for treating osteoarthritis of the knee.” The Cochrane Library (2005).
4.O’Reilly, Sheila, and Michael Doherty. “Lifestyle changes in the management of osteoarthritis.” Best Practice & Research Clinical Rheumatology 15.4 (2001): 559-568.
5.White, Daniel K., et al. “Daily walking and the risk of incident functional limitation in knee osteoarthritis: an observational study.” Arthritis care & research 66.9 (2014): 1328-1336.