What is osteoarthritis of the knee?
What is the prognosis of osteoarthritis of the knee?
What about surgical and or knee replacements for severe OA?In more advanced cases of knee arthritis, where symptoms are severe, patients may require surgical intervention. This may involve a knee arthroscope or partial or complete joint replacement surgery. The treating physiotherapist or doctor can advise if this may be required and will refer to an orthopaedic specialist for an assessment and opinion. Following a total knee joint replacement, patients are normally in hospital for 5 to 10 days and require physiotherapy treatment and rehabilitation over the following months. Resumption of normal daily activity can usually be achieved 3 – 6 months following surgery.
How can physiotherapy and massage therapy help osteoarthritis of the knee?
Manual PhysiotherapyTypically knee flexion (bending) is lost as well as knee extension. This limitation in range of motion occurs with moderate to severe arthritis. Joint mobilization techniques work to decompress the joint and restore the gliding/sliding motion of joint surfaces to promote both flexion and extension of the knee joint. In addition, the kneecap movement will be assessed and treated for stiffness as well as the important musculature such as the quads and IT Band. General massage techniques, such as effleurage, can also be effective in reducing significant swelling and may be performed by your massage therapist and your physiotherapist. Whilst little can be done to reverse the degenerative changes to the knee associated with this condition, patients can generally remain active by modifying their activities appropriately. The primary goal of treatment is to remain as active as possible without aggravating symptoms in order to maintain strength and mobility and to avoid deterioration. Treatment should be directed at improving knee range of motion, reducing swelling and pain, and restoring normal function. In addition, establishing foot, knee and hip stability and strength is important to remain physically active. The exercises prescribed initially by your physiotherapist for knee arthritis will depend on whether you are acutely inflamed or not. When inflammation is high, exercises will focus on the restoration of range of motion and activation of the major stabilizers of the knee, such as the quadriceps, adductors and hamstrings. As range of motion increases, the bike will be introduced and there will be a focus on functional strengthening and transitional balance exercises. Examples of these types of exercises are weighted sit-to-stands, leg press, and body squats with emphasis on both technique and resistance. It is very important to attain sufficient strength in the major muscles to minimize torqueing, shearing, and compression inside the knee joint. You will be progressed through a personalized exercise plan over many months to reach a higher level of function and strength. Most minor to moderate cases of knee arthritis can be managed with an appropriate personal improvement exercise program so the patient can remain relatively symptom free and active. The success rate of this program is largely dictated by patient compliance. It requires flexibility and sometimes doing an activity that you may not enjoy. One of the key components is that patients understands what the aggravating activity and what the corrective activity and balance their weight bearing activity with periods of active rest (biking instead of walking) to keep symptoms to a minimum. This prevents further damage and deterioration and allows the body to clear any swelling or inflammation. Continuing to participate in painful weight bearing activity is likely to lead to a poor outcome. It is important, however; to keep as active as possible by choosing activities that do not increase symptoms. Better activities for knee arthritis include swimming, hydrotherapy or bike riding.
Massage TherapyThe goal of the Massage Therapist with Arthritis clients is to help improve joint stiffness, decrease pain and increase range of motion. During a flare up, the use of moderate Swedish massage techniques can affect the spasms in the supporting musculature, decrease stress and increase the production of naturally occurring pain killing endorphins. When the arthritis is not in a flare up deep tissue, myofascial and trigger point techniques are introduced to decrease adhesion in muscles and ligaments affecting the joint.
How can exercise and physical development help after osteoarthritis of the knee?
Exercise and Physical DevelopmentThe final step is to establish a personal improvement health plan to continue to develop physically throughout your life. This is especially necessary after injury or an accident when you have become deconditioned. All of our staff have a combination of health sciences and sports sciences training, having dual training in both kinesiology and physiotherapy and allowing us to provide a biomechanical focus. Once you have recovered from your painful arthritis, our therapists will perform a functional movement screen and analysis to identify individual muscle imbalances that are unique to your inherited structure, to your movement patterns, and to your goals and interests in living a healthy physical life. We develop a individualized program that focus on:
- Your specific imbalances and movement patterns at work, home, and those evident during the activities that you participate in.
- You structural and genetic posture and alignment characterizes and how they affect your interests to do activity etc.
- We look at the ergonomics specific to your workplace and home
How can low intensity laser therapy help osteoarthritis of the knee?
Physiological effects of Low Intensity Laser TherapyWith LILT there is an increased production and release of:
- Endorphins which - natural analgesics
- Cortisol – a precursor of cortisone
- Growth hormone – instrumental in tissue repair
- ATP – improves and regulates cellular metabolism
- An increase in protein synthesis – collagen, DNA, fibroblasts
- A facilitated venous and lymphatic flow
- Increased angiogenesis – the elevation of oxygen saturation
- Enhanced immune response
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