How can Exercise Physiology help with managing your knee pain and arthritis?
Inertia Exercise Physiologists prescribe specific exercise programs to assist in managing and improving your arthritis effected knees. There is more and more evidence emerging that tailored exercise programs targeted at building up the lower limb strength and condition are extremely effective in helping patients manage and improve their knee pain and reduce need for surgery and total knee replacements.
What Makes up the Knee Joint & How does it Work?
The knee joint is a synovial joint with primary movements of flexion and extension (bending and straightening) and allows for some degree of internal and external rotation. The knee consists of the femur, tibia, patella and to some degree the fibula, there are several tendons and ligaments originating and inserted at the joint. A healthy knee joint consists of a layer of cartilage covering the two bony surfaces producing a special fluid (synovial fluid) that allows lubrication and free movement at the joint.
What is Knee Osteoarthritis?
Osteoarthritis (OA) is a progressive disease that can affect multiple joints of the body, with knee OA being most common due to the high demand and stress that the knee joint is exposed to. Knee osteoarthritis can affect 30-40% of the population at some stage during their life. There are various factors that can contribute to the progression of OA in the knee. These factors include cartilage degeneration, mechanical stress, inflammation, trauma, and biochemical reactions. As the disease progresses, it affects multiple structures of the knee joint including bone remodelling, formation of osteophytes (bone spurs), weakness/inhibition of muscles surrounding the joint, and synovial effusion. Knee OA can be characterised by cartilage deterioration, a reduction in muscle strength, and joint space narrowing. These can result in symptoms such as weakness of the knee joint, reduced mobility, and pain. Risk factors for knee OA include obesity, inactivity, a history of knee injury/trauma, and overuse.
Knee OA Treatment
There are several prevention and treatment strategies for knee OA. Exercise has many benefits for the prevention and management of knee OA and in much of the emerging evidence is showing very good results in pain reduction and delaying or avoiding need for Knee surgery. Inactivity and insufficient use of the knee joint through physical activity and exercise can increase the risk of knee OA. Regular light/moderate physical activity helps to maintain nutrient flow to the joint, muscle and cartilage strength, and correct joint mechanics. The aim of knee OA treatment is to improve knee strength, and neuromuscular control increase knee range of motion and reduce pain. Most guidelines strongly recommend exercise as an initial treatment modality. Depending on the severity of the case, surgical intervention and medication may also be recommended in the treatment of knee OA.
What Type of Exercise is Best for Knee Arthritis?
The great news is there’s lots! A suitable exercise program for the management of knee OA should be specific to the individual depending on the presentation of their knee OA and other relating health and lifestyle factors. In general, exercises prescribed should be low impact and focus on correct movement patterns and activation of muscles surrounding the knee joint including aspects of balance and coordination.
Both land-based and water-based exercise can be beneficial for the management of knee OA. Water-based exercise has benefits in severe knee OA or in the initial stages of management as it is very low impact and can promote confidence with movement and exercise in a range of knee positions.
Land-based exercise allows for more weight bearing though the joint which is important for the management of knee OA. Common land-based exercise programs include low impact aerobic exercise such as cycling and walking, and strength-based exercises using body weight and resistance bands and weighted programs.
The following are very simple general knee strength exercises that can easily started at home- For best results you should discuss with your physiotherapist or exercise physiologist about your specific prescription!
KNEE EXTENSION IN LONG SITTING
Sit on a surface such as a firm mattress or floor with legs fully extended. Place a rolled-up towel or pillow underneath the affected knee. Push the back of the knee down into the towel or pillow while lifting that foot up, extending through the knee. Hold this position for 5-10 seconds before returning to starting position. Add an ankle weight to progress the exercise as tolerated.
GLUTE BRIDGE
Lay down on your back with knees bent at 90 degrees and feet flat on a firm surface. Squeeze through your buttocks as you lift your hips towards the ceiling, keeping your knees hip width apart. Aim to make a straight line through your knees, hips, and shoulders. Hold this position for 5-10 seconds, then slowly return to starting position.
CHAIR SQUAT
Sit down on a chair with feet firm on the floor hip width apart. Shift your weight forwards and use stand up slow and controlled from the chair, keeping your knees hip width apart and relying on your leg strength rather than momentum to stand. Slowly return to sitting, maintain control throughout the movement.
These exercises are only an example of the sorts we can include in your programming.
Exercise can also improve the symptoms and quality of life of individuals living with knee OA through secondary modalities such as weight loss and improved mental wellness. Maintaining a healthy weight can reduce the amount of stress the knee joint is under which can reduce the symptoms of knee OA. Regular exercise also offers benefits to mental wellness through the release and uptake of endorphins and hormones, which can assist with the psychological affect of knee OA.
As every one can experience different symptoms and feelings regarding knee OA, seeking professional advice through an Accredited Exercise Physiologist can be beneficial for the management of knee OA. At Inertia Health group we offer individualised exercise treatment for knee OA to suit the lifestyle of the client.
Book in for an initial assessment to begin the management of your knee OA.
Group Exercise Classes at Inertia Health Group
At Inertia Health Group we also run supervised exercise classes to assist people in managing their knee OA and for people of various abilities. If you would like more information on our group exercise class options click here!
Useful Links
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3635671/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2667877/
Ram A, Booth J, Thom J, Jones MD. Exercise and education for knee osteoarthritis-What are accredited exercise physiologists providing? Musculoskeletal care. 2020;18(4):425-433. doi:10.1002/msc.1477
Exercise Right. 2022. The Cure for Knee Osteoarthritis – Exercise Right. [ONLINE] Available at:
https://exerciseright.com.au/cure-knee-osteoarthritis/
www.ncbi.nlm.nih.gov. 2022. No page title. [ONLINE] Available at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6179584/.
RACGP – Exercise for knee osteoarthritis . 2022. RACGP – Exercise for knee osteoarthritis . [ONLINE] Available at:
https://www.racgp.org.au/clinical-resources/clinical-guidelines/handi/patient-resources/managing-osteoarthritis/exercise-for-knee-osteoarthritis.
https://www.sheffield.ac.uk/medicine/news
https://theprehabguys.com/runners-knee-causes-and-treatment/