StemCell Therapy

Walk into any gym, step onto any basketball or tennis court, or even take a look at the person jogging or walking down your street, and youll likely to see an assortment of braces or support aids on older (and younger) individuals.

One of the most common areas youll see this equipment is on the knee.

Knee pain is one of the most common conditions I see as a physical therapist. Often I see people after knee replacement. However, I also see people with knee pain due to osteoarthritis before surgery.

Knee osteoarthritis is a common condition and is one of the five most disabling conditions in the U.S., affecting more than a third of people over 65 years of age. Sometimes, knee pain due to arthritis will lead to the use an assistive device, such as a cane or walker, and eventually knee replacement surgery.

Chronic knee pain due to arthritis is characterized by pain, cartilage degeneration and joint space narrowing. When patients are referred to physical therapy for arthritis relief, they often dont understand how physical therapy can help. After all, if there is cartilage degeneration and joint space narrowing, wouldnt more movement just make the arthritis worse?

Fortunately, as Ive discussed at length before, the body is much more complex than that. In fact, the 2008 guidelines from the American Academy of Orthopaedic Surgeons recommend exercise as the core treatment for osteoarthritis.

As the saying goes in physical therapy, "Movement is medicine."

The right type of exercise in the appropriate dosage and intensity can help "lubricate" the joint, improve muscle strength, improve joint motion and decrease joint pain. Osteoarthritis is associated with decreased muscle strength and abnormal joint mechanics.

A 2012 review in the journal Physical Medicine and Rehabilitation reviewed resistance training interventions on knee osteoarthritis and found some studies showing up to a 43 percent reduction in pain with appropriate resistance training.

Physical therapy, and specifically resistance training, works to improve joint mechanics and muscle activation patterns. In the physical therapy clinic, the typical culprits for weakness I see are the muscles of the thigh and the hips. So my treatment usually starts with exercises targeting the thigh muscles, both quads and hamstrings, as well as the muscles that move your leg back (hip extension) and to the side (hip abduction). The hip muscles actually help control the position of the knee during functional activities, so making sure your hips are strong is a good way to help improve knee mechanics.

I also will include some calf (lower leg) strengthening as well.

Next, it's important to help make sure that certain movements, such as squatting and going up and down steps, are performed with good mechanics. This usually means ensuring that when looking at the knee from the front that it stays in line with the second toe when climbing the stairs.

When bending down to sit in a chair or pick something up off the ground, it means that the knees stay outward to remain in line with the toes.

A good test to perform at home to check your mechanics is to stand sideways beside a step and perform a lateral step-up. Keeping the knee in line with toes is often difficult for most people. Often, when people have pain with stairs, fixing the mechanics helps their pain relatively quickly.

Lastly, I like to combine knee/hip strengthening and functional tasks focused on mechanics with a biking activity. It seems the continual motion of the bike helps to lubricate the joint and just helps things move a little better. If you have knee pain due to osteoarthritis, I recommend you get a bike, either recumbent or upright, and ride for 10 to 20 minutes a day to keep the knee joint loose and well-lubricated.

With the right exercises, individuals with mild to moderate osteoarthritis can experience symptom relief, decreased disability, improved function and overall improved health.

These recommendations also apply even if you dont have knee osteoarthritis. As we age, the prevalence of knee osteoarthritis increases, so its likely a good idea to perform biking, leg strengthening and biomechanics training as part of a comprehensive exercise routine.

Show caution when starting new exercises, and if you have any doubt about your mechanics, see your physical therapist for instruction. Dont push through pain with exercises. Start off slow, and progress in weight, reps and biking distance as you are able.

Nick McClary earned his doctor of physical therapy from the University of Tennessee. He is a Georgetown County native and lives and works in Pawleys Island. Send him your health and fitness questions at: nmcclaryDPT@gmail.com.

Originally posted here:
Nick McClary column: With arthritis, movement is good medicine - South Strand news

This entry was posted on June 2, 2017 at 4:44 am and is filed under Arthritis. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed. |