Written by: Taylor Post BA-Kin, CAT(C)
While it may seem counterintuitive, maintaining an active lifestyle should be a priority for individuals with osteoarthritis (OA) of the knee. With an exercise program designed around “arthritis friendly” exercises, daily workouts can (and should) become a central part of the OA treatment program. In fact, exercise is considered by many to be the most effective non-drug treatment to reduce pain and improve mobility in osteoarthritis patients.
When selecting knee friendly exercises, it is important to look for movements that target the quadriceps, hamstrings and glutes. These muscles make up the main groups that support the knee. Exercises should also be low impact, minimizing excessive forces that will aggravate the knee unnecessarily. Here we look at a few key exercises to include in osteoarthritis rehabilitation programs:
Aerobic (cardiovascular) activities are key to improve endurance and maintain a healthy weight. The Canadian Physical Activity Guidelines recommend that adults (age 18-64) complete at least 150 minutes of moderate to vigorous activities per week. They also specify that sessions should last at least 10 minutes to achieve health benefits. Walking, swimming, and cycling are all great examples of low impact cardiovascular activities. Circuit training is another creative way to increase your heart rate during a workout. Select a number of multi-joint exercises and perform them in a series with minimal rest periods in between.
Strength and Mobility Training
• Leg Raises
While lying on your back with your legs extended, raise one of your legs approximately 6 inches off of the floor. Hold this position for 5 seconds before lowering the leg down. Be sure to contract the muscles on the top of your leg before starting this movement, to keep the quads activated throughout. Complete 3 sets of 10-15 repetitions before doing the other leg.
• Side Lying Leg Raise
Start in a side-lying position, keeping your shoulders, hips and knees in line. Using your arms for support, slowly raise your top leg into the air and then slowly lower it back down. Focus on leading with your heel, by pointing your toes toward the floor throughout the movement. Repeat 3 sets of 10-15 repetitions on both legs.
• Glute Bridge
Begin by lying face up on the floor, with your knees bent and feet flat on the ground. Keep your arms at your side with your palms down. Once you are comfortable, lift your hips and buttocks off the ground until your knees, hips and shoulders form a straight line. Squeeze your glutes hard and keep your abs drawn in, so you don’t overextend your back during the exercise. Hold this bridged position for 30 seconds before easing back down. Repeat 5-8 times and complete 3 sets of this exercise. If this is too easy, try performing this move one leg at a time.
• Mini Squat
Hold on to a chair or stable surface, with your knees about shoulder width apart. Bend at the hips and knees as if sitting down onto a chair, and then slowly stand back up. Repeat 10 to 15 times, for 3 sets. Make sure that your toes are pointing forward throughout the movement, and limit the depth of your squats to a pain-free range.
Lie on your side with your hip and knee bent to approximately a 90-degree angle, with feet together. While keeping your ankles together, raise your top knee up about 12 inches from the other, in a clamshell type motion. Repeat 10 to 20 times and switch sides. Perform 3 sets in total.
• Standing hamstring curls:
Holding on to the back of a chair or stationary surface, without moving hip, bend knee as far as possible, bringing your heel up towards your buttocks. Focus on a slow and controlled movement. Do 3 sets of 10 to 15 reps on each leg.
These are just a few examples of exercises that are considered knee friendly for individuals with osteoarthritis. It is important to note that just because an exercise doesn’t appear on this list, it does not mean that it is unsafe to include in your workout program. At the end of the day, each person is different, and any movement is going to be better than none. To start, choose activities that you enjoy, and that don’t increase your pain. The best exercises will be the one you are willing to do and will keep doing regularly.
It is important to remember, that while this article presents many helpful tools to get started, not every injury or rehabilitation process will be the same. Always listen to your body and be sure to consult a medical professional as needed. Your local Athletic Therapist is a great resource for injury advice, and will design a program to suit your needs and fitness goals!
Written by: Taylor Post BA-Kin, CAT(C)
Arthritis is a disorder involving painful inflammation of one or more joints. While the term arthritis represents hundreds of different conditions, there is one that is far more common, especially in adults over age 50. Today we focus on the signs, symptoms and treatment of osteoarthritis of the knee.
Osteoarthritis (OA) is the most prevalent form of arthritis. It is often described as a “wear and tear” or degenerative type of an injury, but this may not be completely accurate. Recent studies show that this painful condition may also be linked to the body’s failure to repair joint damage. In either case, osteoarthritis is characterized by the breakdown of the cartilage along the surfaces of the joint and the bone underneath. This causes the protective spaces between the bone surfaces to become very rough and increasingly narrow. If left untreated, the joint space eventually becomes so small that the bone ends up rubbing against bone. The knee is the most common lower-limb joint to be affected by osteoarthritis.
While each individual is affected differently, symptoms of osteoarthritis often include; knee pain, heat, swelling and stiffness. During an assessment, a physician or other medical professional will also assess joint range of motion, joint stability and gait changes (limping/ trouble bearing weight). X-ray’s are ordered to confirm the presence and location of OA within the knee(s). Degenerative changes are most commonly found on the medial (inside) of the knee or under the patella (knee cap). It is less common to occur on the lateral (outside) part of the knee.
Unfortunately there is no cure for osteoarthritis. However, there are a few treatment options that can help manage pain and help keep people active and doing what they love. Most treatments are non-surgical but more invasive procedures can be necessary in severe cases. Here we focus on lifestyle changes and options for bracing and supports.
- Lifestyle Changes
Some small changes in an individuals’ daily habits can help slow down the progress of osteoarthritis. Limiting certain activities that aggravate knee pain, such as running or stair climbing may be necessary. That being said, a person with knee OA should still be as active as possible without irritating the knee excessively. Low impact exercise (swimming, cycling etc.) can help lubricate the joint and maintain range of motion, while strength training can keep the muscles surrounding the knee strong.
Maintaining a healthy weight can also be beneficial. Due to the load bearing nature of the joint, any excessive body weight leads to increase deterioration and strain on the knee structures. A healthy diet and regular exercise are both great places to start for any weight loss program.
- Knee Bracing and Supports
Wearing a knee brace can help support the joint and even prevent osteoarthritis from getting worse. In most cases, an “unloader” knee brace is most appropriate. This type of brace shifts body weight away from the affected side of the knee and helps maintain joint space. With a prescription from a doctor, braces for OA can often be covered through Manitoba Health, or through private insurance plans. In addition to a knee brace, some people may use a cane or a walker for additional support while walking.
Several medications can help deal with the pain and inflammation that comes with knee OA. Physicians will work closely with patients to discuss the pros and cons of each one, and to determine what dose will be both safe and effective for them. Over the counter pain relievers and/or non-steroidal anti-inflammatory drugs (NSAIDS) are often the first option, for conservative treatment.
- Corticosteroid Injections
Oral medications may not always work or may cause too many side effects. In this case an injection of medicine directly into the joint may be more effective. Steroid injections usually only provide short-term relief, and more than one injection may be needed over the course of a year.
- Athletic and Physical Therapy
Both Athletic Therapists and Physiotherapists are great resources to help with knee pain caused by osteoarthritis. Manual therapy can help to reduce the pain, swelling, and stiffness in the joint. They can also prepare an exercise program with OA friendly exercises and stretching to keep the knee strong and maintain mobility.
Surgical intervention (arthroscopy, partial or total knee replacement etc.) is often seen as a last resort. Surgery is usually only recommended for individuals with severe osteoarthritis in multiple compartments of the knee, or for those whose pain causes disability and is not relieved with nonsurgical treatment.
If you have persistent knee pain it is important to seek medical advice, before it affects your quality of life. Osteoarthritis can be very painful and make certain activities of daily living seem almost impossible to perform. Without treatment it can lead to lost work time and a serious disability for many people. However, with the right knowledge and lifestyle it is a condition that can be managed. A diagnosis of osteoarthritis does not need to stop you from living a fulfilling and productive life.
To book an appointment with Taylor please email her at firstname.lastname@example.org subject: athletic therapy appointment.