What is knee osteoarthritis:
It is a degenerative process of the cartilage that protects the ends of the bones that form the knee. The thickness of the cartilage becomes progressively thinner and protects the bones less and less. This degenerative disease is not reversible, but in most cases it is very manageable.
Osteoarthritis is the most common joint disorder in the United States. According to the scientific journal Clinics in Geriatric Medicine, symptomatic knee osteoarthritis occurs in 10% of men and 13% of women aged 60 or older. The number of people with symptomatic osteoarthritis is likely to increase due to the aging population and the obesity epidemic. Osteoarthritis has a multifactorial cause and can be seen as the product of an interaction between systemic and physical factors. For example, a person may have a hereditary predisposition to develop osteoarthritis, but only develop it if an injury to the knee causes, for example, a laxity of the knee and triggers the process of wear and tear of the knee cartilage (osteoarthritis).
Old age, female gender, overweight, obesity, knee injuries, repetitive joint use, bone density, muscle weakness and joint laxity all play a role in the development of joint osteoarthritis, particularly in weight-bearing joints such as the knee. Modifying these factors can reduce the risk of OA and prevent subsequent pain and disability.
What are the symptoms:
Symptoms vary depending on the severity of the level of cartilage wear, and will include some or all of the following: pain around the knee joint, reduced range of motion, swelling, difficulty moving the joint especially in the morning, pain that increases with prolonged activity, and a “cracking sound” felt in the knee.
Let’s look at what can be done to avoid or reduce the effects of knee osteoarthritis. We have stated above the factors that contribute to the development of osteoarthritis. We have no influence on some of these factors, of course, such as old age and gender, but we do have control over the other factors.
Following a knee injury, it is very important to have physiotherapy to restore maximum strength and stability. The use of a knee brace can also help to treat the injury.
Repetitive use of joints:
If we work in a job that requires us to kneel dozens of times a day, for example, well, this is likely to lead to osteoarthritis. Try to choose jobs that don’t require these kinds of repetitive movements or consult a physiotherapist or occupational therapist to see how you can adapt your workspace or work tasks to avoid overuse of your joints.
The higher the bone density, the stronger the bone. To improve or maintain your bone density, you need to do weight-bearing and strengthening exercises. The best thing would be to make an appointment with your physiotherapist so that he or she can set up a program that will maximize your bone density. I invite you to read my other blog post on physiotherapy and bone density. Nutrition also plays an important role and I invite you to discuss with your doctor whether or not you need nutritional supplements.
A sedentary lifestyle leaves you with, among other things, muscle weakness. Adopt a more active lifestyle. If you’re not sure what to do, visit your physiotherapist or sign up for an online fitness program such as the one offered at the AMS clinic (see our video in French).
The fact that the joint is not stable, the bone ends are subjected to excessive friction during regular daily movements. Physiotherapy can determine which exercises to do to stabilise the knee and, if necessary, which brace to put on as well.
In general, in the acute phase of knee osteoarthritis, treatment will be very gentle, with physiotherapy including education on relative rest, ice, electrotherapy, controlled movements without resistance. Use of a knee brace, use of a cane if necessary.
In the chronic phase, our goal in physiotherapy is to strengthen the affected leg and improve functional abilities. In this stage, the focus is on a stretching and strengthening programme, a gradual increase in activity level and proprioception and stabilisation training.
For even more severe cases – cortisone or Synvisc injections, for extreme cases a total knee replacement is the final solution.
When to ask your physiotherapist for help:
Unfortunately, rather than seeking help early, some people decide to see a physiotherapist only when the pain and swelling have become severe and disabling when their lives are disrupted and the pain prevents them from continuing their usual activities. The sooner you get help managing this condition, the better.