Osteoarthritis is the most common cause of arthritis. It can affect any joint in the body, however commonly affects the spine, knees, hips and hands. The process of arthritis includes inflammation of the tissues, damage to the bone and cartilage (cushioning between the bones), and bony spurs called osteophytes forming around the joint. It can occur at any age however generally occurs in those older than 40, particularly if they have a history of joint injury such as a knee or hip injury. Being overweight or having a family history of osteoarthritis can also be contributing factors.
Conservative management via physiotherapy and exercise has proven to be effective in the management of osteoarthritis. However as physiotherapists, a common complaint we hear is “my knee is too sore to do any exercise” or “exercise makes my hip feel worse” or “I need to rest as much as I can to manage this”. Contrary to what you may think, exercise actually helps manage osteoarthritis, and can often prevent or delay the need for surgery. The key is knowing the right kind of exercise to do… that’s where physiotherapy comes in!
Due to the reduction in cushioning between the joint, lower impact exercises are best. This is exactly as it sounds- exercise that cause low impact on your joints or gentle motion. High impact exercises should be avoided such as running, jumping, skipping (although may be possible once you have sufficient strength to allow for the impact).
The aims of exercise for osteoarthritis are to improve strength (to reduce load on the joint), reduce pain, improve mobility and walking, improve flexibility and to maximise function. Nothing makes it easier to stand up from a chair than to get stronger! We often hear patients say “my friend gave me some exercises to do but they didn’t help”. Unfortunately osteoarthritis management is not “one size fits all”. Everyone is different, every joint is different, and each individual has varying degrees of osteoarthritis, pain, restriction or deficits. That’s why an individualised program based on your needs is important.
As physiotherapists our role is to provide you with the necessary information and treatment pathway to get you on track to managing your osteoarthritis. Whilst manual therapy can help, we are experts in providing individualised exercise programs for those suffering from osteoarthritis, whether it be in your knees, hips, hands or back. This requires an individual assessment by a physiotherapist so we can determine your goals, deficits and devise a treatment program for you.
Common exercise programs include;
- Home Exercise Program. These low impact programs require minimal equipment and time and can be effective in improving strength, balance, mobility, flexibility and pain management
- Hydrotherapy. This is an exercise regime completed in water utilizing specialised equipment. Exercising in water has many benefits including reducing stress on joints, providing warmth and buoyancy to the body, increasing confidence, and is useful if exercising on land is too painful.
- Clinical Pilates. This involves the use of pilates equipment (reformers and trapeze table) to improve core stability, strength, flexibility, motor control and balance with lower impact exercises.
- Walking Program. The aim of a walking program is to improve mobility and reduce pain via a gradual progression of distance, pace and incline whilst monitoring for pain and symptoms.
The most important things to remember when exercising for osteoarthritis are;
- Ensuring you are completing the ‘right’ kind of exercise for your needs
- Gradual progressions to challenge and build strength without causing ‘flare-ups’ of pain
- Completing safe exercise at an appropriate level for your capabilities
- Avoiding “too much too soon”; find a baseline and gradually build up the exercise
- Avoid exercises that “my friend told me to do this exercise” as this can make your pain worse
- Avoid jarring movements (jump/run)
- Find an activity or exercise you enjoy (or you won’t have motivation to continue!)
- Track your goals so you can monitor your progress (Great for motivation!)
The mainstay of exercise for osteoarthritis management is that it needs to be specific to you. Physiotherapists are able to complete an assessment of your condition and needs, and provide a plan of action and advice as to what exercise is best, along with modifications or pain management strategies that can assist.
If you’d like to find out more or discuss your situation with a physiotherapist contact Seville Health on 5964 2393.