Osteoarthritis

What you need to know about Osteoarthritis in the knee and basic exercises to help get you through the day and minimize the pain.

What is Osteoarthritis?
Osteoarthritis (OA) is the most common form of arthritis. This condition involves the cartilage, which acts as the cushioning between bones, being broken down in the joint over time, causing pain. This degeneration results in bone on bone contact and inflammation.

The most common site for OA is the knee joint because it is a major weight bearing area. Over the years knee OA has been the leading cause of physical disability, resulting in knee stiffness, swelling, and pain when performing daily activities such as walking, stair climbing, or pivoting motions.





What Can Cause OA? Cartilage "wear and tear" can be caused by but not limited to:

1. Micro damage accumulated over time = work or sports related injuries can add up
2. Inactivity = not enough lubrication to keep the joint from gliding smoothly
3. Overweight = putting stress on the joints
4. Genetic = family history of weak joints.

1. "Movie-Goer's knee"- Pain and stiffness after prolonged inactivity (a long car ride, sitting in the same position for an extended time period).
2. Signs of inflammation- Swelling, warmth, pain, redness, or loss of function.
3. Bony deformity- Sometimes bone spurs can form. (These can be detected by your doctor by using an X-ray)
4. Age and gender may be predisposing factors- As age increases individuals are at higher risk. Women are also at higher risk for developing OA in the knee.

Ways to relieve "Movie-Goer's knee"
It is important to remember regular moderate exercise is the key to a healthy body. Exercises will help you increase joint range of motion and reduce stiffness by providing lubrication. It also keeps you active and helps to take off some unwanted increased body weight. (Even a loss of 10 pounds helps take stress off your joints!)

Exercises to keep your joints healthy
Research has shown keeping an active lifestyle can significantly reduce the effects of OA from accumulating. This can be achieved by doing low intensity cardio machines such as riding a stationary bike, or by swimming if available to reduce the amount of weight bearing. In your workspace remember to take breaks to walk around frequently and keep your joints from stiffening up.

Further ways to alleviate the pain are to strengthen the muscles around the knee joint.

Quadriceps

1. Knee EXT in chair= when sitting in chair (especially after knee has been bent for long periods of time), extend knee as straight as possible and contract to make a muscle in the quad. This will reduce stiffness. (Use a ball and squeeze thighs together or adding ankle weights are ways to challenge yourself.


2. Terminal Knee Extension (TKE) = Lie on back and place a rolled up towel under your knee to act as support and pivot point. Raise your foot/lower leg to achieve full knee extension. Progress by using ankle weights.
3. Step Ups = Standing to the side of a staircase or sturdy box, place foot of injured knee on step and use that quad to drive your body upward causing your leg to fully ext. Slowly lower your body.



Leg Press = Machine at gym. Use moderate weight to do single leg squats not exceeding 90 degrees of flexion. (Or you can use a physioball behind your back against the wall and do squats. )

Hamstrings

1. Walking backwards on treadmill
2. Leg Curls = On a flat surface, flex your knee moving your heel towards your buttocks.
3. Stool Exercises = Sit on rolling stool and bring single leg out in front of you. Pull on the heel causing the knee to flex pulling the stool forward. Repeat several times.

Calf Muscles

1. Calf raises stand on flat surface with legs straight and raise toes so heel comes off ground.
2. Calf stretch = Stand facing wall about 1 to 2 feet away. Push both arms into wall while lunging with injured leg behind other leg. Hold stretch for 15 seconds.

Calf Stretch

All these exercises will help to strengthen the musculature and increase the range of motion for the knee joint. To reduce pain, avoid exercise positions that involve deep squats, kneeling, stair climbing. For more pictures of selected exercises see Rehabworks Website: basic knee and basic hip

Last Minute Tips

• Exercise is the best way to decrease symptoms of Osteoarthritis.
• Use ice for 20 minutes post exercise and strengthening to help reduce pain and inflammation.
• Take Nonsteriodal Anti-Inflammatory Drugs (NSAIDs) when you have increased pain. (Aleve has been proven to work best for joint pain and Ibuprofen for muscle and tendon soreness). See your doctor before taking any medications to see what is right for you.