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Have you started to notice knee pain/stiffness or swelling recently and are not sure why or how this started? Do you experience morning stiffness and have a difficult time moving/getting out of bed? Do you have pain in your knee(s) while getting up from a chair or while climbing stairs? Does your knee(s) bother you or limit your ability to be active or to complete your job demands?
Knee osteoarthritis can cause significant pain and stiffness, resulting in decreased strength and mobility. This often leads to many individuals becoming inactive, can limit one’s ability to complete daily tasks and even result in time missed from work. Below is some essential information to help you manage knee osteoarthritis.
First, let’s briefly discuss the anatomy of knee osteoarthritis.
In the knee, there are two common areas where osteoarthritis develops: the tibiofemoral and patellofemoral joints.
The tibiofemoral joint is the main connection between the big thigh bone (i.e., femur) and the leg bone (i.e., tibia) and is classified as a hinge joint.
The patellofemoral joint is the space between the kneecap and the thigh bone and is classified as a modified planar joint.
The tibiofemoral joint consists of two compartments: inner (medial) and outer (lateral) and the patellofemoral joint consists of cartilage behind the kneecap as it articulates with the femur bone.
Typically, arthritis can develop in either one or both compartments in the tibiofemoral joint and often develops behind the kneecap as well (in the patellofemoral joint). As a hinge joint, the tibiofemoral joint performs two motions: flexion (i.e., bending) and extension (i.e., straightening). Often times in knee osteoarthritis, flexion of the knee is typically more restricted as opposed to extension.
What is Osteoarthritis and What are the Risk Factors?
Osteoarthritis is a chronic, progressive disorder that results from repetitive flawed repair responses from the body. This results in the breakdown down of various cartilage and bone within a whole joint, causing narrowing of the joint space. Additionally, this increased bone breakdown can lead to the formation of osteophytes (i.e., bone spurs). All of this leads to restricted movement and pain within the joint. Osteoarthritis is more prevalent in weight bearing joints, which makes the knee joint one of the most commonly affected areas for osteoarthritis.
There are various risk factors in the development of osteoarthritis. While age is a risk factor, osteoarthritis should not be considered a normal part of the aging process. Other significant risk factors for osteoarthritis are:
Gender (women > men)
Being physically inactive
Previous history of injuries/trauma
Occupational: involving repetitive stress to the affected joint
Treatment/Management of Knee Osteoarthritis
While there is no cure for osteoarthritis, the symptoms can be managed through a variety of different methods. People suffering from osteoarthritis may be in significant pain/discomfort, however, it is essential to continue to move!
Some of these treatment methods include:
Regular involvement in a therapeutic exercise program
Physical activity (such as swimming, water aerobics, walking and biking)
Establishing proper/effective body mechanics while at work
Management of body weight to help reduce excess stress on the knees
Physiotherapy can help those suffering from knee osteoarthritis. This is achieved through establishing a safe and effective home exercise and physical activity program, utilizing manual therapy and soft tissue techniques, and providing education on ways to help with daily ergonomics and pain management. Physiotherapy can help delay or prevent the need for surgical intervention (e.g., a total knee replacement); however, there are cases in which the development of osteoarthritis becomes so debilitating that one may likely require surgical intervention.
In these cases, it is essential that those planning on having a knee replacement continue to participate in regular physiotherapy. Establishing a routine involving an exercise strengthening program, consisting of strengthening one’s hip abductor musculature, can help to decrease excessive load/force on the knees. These treatment strategies can significantly help with prehab and rehab post-surgery to facilitate one’s return to work/pre-injury activity levels.
If you are experiencing knee pain/stiffness as described above contact us to book an appointment, so we can help develop an individualized treatment plan for you.
1 Dodds, A. L., Halewood, C., Gupte, C. M., Williams, A., & Amis, A. A. (2014). The anterolateral ligament: anatomy, length changes and association with the segond fracture. The bone & joint journal, 96(3), 325-331.
2 McAlindon, T. E., Bannuru, R., Sullivan, M. C., Arden, N. K., Berenbaum, F., Bierma-Zeinstra, S. M., ... & Kwoh, K. (2014). OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis and cartilage, 22(3), 363-388.
3 Heidari, B. (2011). Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I. Caspian journal of internal medicine, 2(2), 205.
Daniel Folino graduated with his Master’s of Physical Therapy from the University of British Columbia. Prior to completing his Master’s degree, he graduated with a Bachelor of Kinesiology at the University of British Columbia. He is a member of the Physiotherapy Association of B.C. and the Canadian Physiotherapy Association. Book with Dan today.