BMJ Physiotherapy answers the top questions we often hear from our patients.
Osteoarthritis of the knee is one of the most common causes of knee pain in people age 50 years and above. Such knee pain can be very debilitating, limiting a person’s function and levels of activity.
Osteoarthritis of the knee is a result of the wear and tear of the cartilage of our knee joint, which is the layer of cushioning that we have between the joints. When the cartilage gets worn out, the bones of our knee joint rub against one another resulting in pain, swelling and stiffness in the knee. Osteoarthritis develops slowly and the knee pain associated with it can increase over time.
How can physiotherapy my treat osteoarthritis knee?
Physiotherapy consists of a whole set of holistic management for osteoarthritis of the knee. First and foremost, a throughout assessment of the causes of your knee pain would be done to determine the management strategy for your condition. Your physiotherapist would also discuss the outcomes you would like to achieve and would plan the follow up sessions to help you achieve your goals. Pain relief methods and self-help techniques would also be suggested by your physiotherapist so that you will be able to manage your knee pain should it reoccur in the future.
Strengthening exercises to help build strengthen the muscles around the knee will also be taught. Activity modifications, as well as foot-wear modifications like insoles may also be suggested if required for your knee pain. Special knee bracing may also be recommended by your physiotherapist to help with your knee pain if required. So yes! Singapore physio sessions often can help if we treat your knees early. Often most patients leave it too late and surgery is the only option.
How can I prevent osteoarthritis knee?
Regular exercise (preferably low impact exercises)
Regular exercise has been shown to help with osteoarthritis knees. Regular exercise can help you to maintain a healthy weight which reduces the strain that is put on your knee joints. Regular exercise helps to maintain joint range of motion and improve muscular strength. Consider low impact exercises like cycling, walking, swimming and aqua aerobic are good options for exercise.
Strength/ Resistance training
Strength and resistance training help to maintain muscle strength and joint biomechanics. Stronger muscles surrounding the knee joint in particular, help to support and stabilize the knee during movement, assisting to take the stress off the knee during physical activities. Stronger muscles help to cushion the load and impact the knee joint undergoes to reduce the wear and tear of the joint surfaces.
Flexibility and stretching exercises help to prevent such stiffness and pain by stretching out the muscles and tendons within our body. Don’t neglect the flexibility of your hips and ankle joints! We find that often patients with OA knees has stiff hip and ankle joints, and this means that their poor knee was overwork and compensating for what the hips and ankles cannot do. So flexibility exercises are important! This prevents our joints from locking up and when done regularly throughout the day, will help the people with osteoarthritic knees move around better.
Do I need a brace for osteoarthritis knee?
The use of a general knee brace for OA knee is to provide support and stability of the knee, which helps to reduce pain and improve their functional movements. The brace helps to provide compression and support to the muscles and soft tissues around the knee and helps to improve the proprioception of the knee. This gives the wearer more confidence in performing activities with lesser knee pain.
OA knee often need another type of special brace called an Unloader.
Image taken from ossur.sg
An unloader knee brace can be very helpful, especially if the arthritic changes within the knee are worse on one side than the other. This kind of brace allows for adjustments to shift pressure and off load the stress from the affected side of the knee to the other side. For example, if the inner side of the knee is painful, the brace can be adjusted to shift more force towards the outer side of the knee, off-loading the inner side and vice versa. If worn consistently, the knee brace can offer some stability and improve one’s confidence in using their knee. However, maximal benefits can only be achieved if strengthening and flexibility exercises are included in the management of the arthritic condition.
Does supplements help OA knees?
There have been some researches that suggest certain supplements may help with pain-relief and improving the range of motion in people with arthritic knee conditions. Osteoarthritis is a result of the breakdown of the cartilage layer within the knee. Easy to find supplements like glucosamine sulphate have shown to help delay the wear and tear of the cartilage layer in OA knees. From our clinical experience, its helps early OA knees, if your OA knees are in the advance stage (stage 3 or 4), glucosamine has not shown to be of much help. Nevertheless, a combination of exercise therapy with the supplements taken would likely yield better effects over a period of time.
Should I ice or use heat on my OA knees?
Both heat and cold treatment methods are easy and relatively inexpensive methods to help with knee pain. Heat helps to relax muscles, improve muscle flexibility and increase blood circulation. On the other hand, cold helps to reduce swelling and help numb the area of pain. Choosing which method depends on the what you feel and when you feel it.
When your knee is feeling stiff, heat often helps to sooth the area and makes it less stiff. For example if your knee is feeling stiff after a long sitting trip, or on a cold morning, heat helps to warm and relax the muscles to ease the stiffness.
When your knee is sore after a unintended long walk, ice would be helpful to numb the pain. Also if your knee feels warm to touch, icing often helps to calm the angry knee down a touch.
Overall it may not be a bad idea to try both methods to see which one works better for the knee pain due to osteoarthritis.
Learn more about the top 5 signs of OA knees here
If you are starting to feel any of these signs, and especially over the age of 50 years old, do seek help early from our physiotherapist. Early detection will help delay the exacerbation of the symptoms. Early treatment can help to preserve the longevity of your knee joint. Leaving it too late often means that surgery may be the only option. Healthy and pain-free knees are important to let you continue to enjoy your long-awaited retirement holiday and to enjoy the times with your family, isn’t it?