Been told you have arthritis or wear and tear in your hip or knee, or that your hips or knees are “bone on bone” ?
Are you lacking confidence in your knee or hip to be able to walk longer distances, go up or downstairs or put your shoes or socks on?
Been told to ‘just stop’ doing what you love and that you’re just putting off the inevitable of a hip or knee replacement?
Physiotherapy can help reduce osteoarthritic pain in the knees and hips and also improve range of movement in the joints involved. Unlike medication or surgery which seek to treat the condition only, physiotherapy takes a holistic approach to treatment by reducing pain and increasing function while also taking steps to prevent further degeneration of the joint.
Physiotherapy for Osteoarthritis of the Knee
You’re in the right place, and you’re not alone. Knee osteoarthritis is one of the most common causes of knee joint pain we see in the clinic and we’ve helped hundreds of people with knee pain get improvements in their function, reduction in their pain, rely less on joint-related pain killers and delay or even completely avoid hip or knee joint replacements. Let us help you do the same.
What is Hip and Knee Osteoarthritis?
One in 11 Australians experience arthritis, meaning it affects more than 2.2 million Australians – it’s a very common condition! It can be caused or influenced by risk factors including previous joint damage, being overweight, heavy physical work, weak muscles and irreversible factors such as age, sex and heredity.
Typically hip and knee osteoarthritis develops slowly over many years and affects articular structures like the knee or hip joint capsule, menisci, cartilage and ligaments. The final stage of OA is consistent with articular cartilage loss and changes in the underlying bone. Hip and Knee joints are most often affected and represent the largest population affected by OA.
Osteoarthritis can be diagnosed using certain criteria such as having physical activity-related pain, functional limitations (i.e. difficulty with daily activities), reduced range of motion and age amongst others. Importantly, you don’t need an x-ray to diagnose arthritis.
What symptoms might you have with knee osteoarthritis?
Difficulty and/or pain in the knee with the following things:
- Putting on shoes and socks
- Going up or down stairs
- Standing up from a chair
- Standing and walking for long periods of time
- Leisure activity and sport
- Swelling around the knee
- Reduced strength in muscles around the knee
- Crunching or clicking noises
- Feeling of knee instability, ‘looseness’ or giving way
What you might not know is that FIRST line treatment of knee osteoarthritis recommend patient education, exercise and weight loss before injection therapy or joint replacement. Why? Because it’s effective, research based and completely safe.
How can Physiotherapy management help for knee OA?
Physiotherapy for knee OA involves a combined approach of education and individualised exercises. These exercises focus on the control and strength of muscles around the hip and the knee. These have been shown to help the most whilst also being safe and without the added risk that other, more invasive treatments can have. It’s true what they say, motion is lotion, and it is not different for knee OA.
Other therapy options may include advice around weight loss which can be very helpful for those with knee osteoarthritis. This is because every kilo of weight loss results in a four-times reduction in weight-bearing force at the knee. Also according to the arthritis foundation, reducing body fat percentage can also reduce inflammation in your system, which can further reduce osteoarthritis symptoms.
Finally, some may find that braces that fit around the knee can be helpful in providing pain relief and support. However, they should never replace physical exercises, education and weight loss as a means of osteoarthritis management.
In a nutshell, the benefits of education and exercises for your knees are:
- Improved joint confidence and range of motion
- Reduced knee pain
- Improved quality of life
- Less sick days
- Less likely to feel the need for surgery
Hip Osteoarthritis Physiotherapy
Hip osteoarthritis is not as common as in the knee, however, it can be just as debilitating. The physiotherapy management of hip osteoarthritis is exactly the same as it is in knee OA, and starts with the safe first-line treatments of education and exercise.
Weight loss also has a significant impact on symptoms in hip osteoarthritis, again the arthritis foundation recommends at least 5-10% weight loss to see a noticeable change.
What symptoms might you have with hip osteoarthritis?
Pain sites may include:
- Often outer part of the hip or deep inside the groin
- Inner or outer part of the thigh
- Above or inside the knee
- May refer to ankle and leg
- Putting shoe/socks on
- Moving from sitting to standing
GLA:D Physio Program
How can the GLA:D Program and Physiotherapy help me achieve great results with hip and knee OA?
According to the official guidelines, the best management for hip and knee OA that you can receive is in accordance with the GLA:D program. GLA:D stands for Good Life with Arthritis in Denmark (that is currently being rolled out in Australia) and represents a nationwide evidence-based initiative that follows the best and most current recommendations for the treatment of hip and knee osteoarthritis.
This program helps with reducing pain and improving your quality of life through a tailored exercise program appropriate for YOUR joints and the severity of the symptoms you have.
What does it entail?
It’s a 6-12 week education and exercise program that has demonstrated fantastic results and had over 30,000 enrolled participants in Denmark. Due to its amazing success and great results, it’s now gone worldwide.
At this stage, you might be thinking…”But I can’t exercise, I can barely move!” We hear this a lot. No matter how sore, weak or poor your current function is, exercise is suitable for you. In fact, the research shows that rest and avoidance of activity and exercise for those with osteoarthritis will make your pain worse! We’re experts at utilising personalised exercises to help you feel and move better. Even for those with severe pain, there’s somewhere we can start and help you!
Here are some things you MUST know:
- The research shows exercise is safe and helps. Exercises has even been shown to thicken joint cartilage!
- Findings on your scans are poorly correlated to pain and disability. We’ve seen marathon runners with severe hip or knee osteoarthritis, who run long distances without any trouble! Just cause your scan says your knee is ‘buggered’, doesn’t mean it is.
- Your degree of arthritis on imaging DOES NOT predict your pain and disability levels
Lastly, the Royal Australian College of General Practitioners’ clinical practice guidelines state:
“We strongly recommend offering land based exercises for all people with hip and knee OA to improve function and pain regardless of their age, structural disease severity, functional status or pain levels”
What’s involved in the GLA:D hip and knee program?
- 2 x 1-hour education sessions.
- 6-12 weeks of 2 x 1 hour supervised exercise sessions at a minimum
- Outcome measures to track the progress of your condition
This is all made easy to digest and to get started with the support of your physiotherapist.
But I’ve been told I need an arthroscopy or joint replacement?
That’s fine, you may well need one of these down the track. Although many people delay and even avoid a joint replacement, we know some with moderate to serve osteoarthritis will need replacement at some point. We’re really passionate about ensuring you’ve exhausted your options and get the best result from your treatment no matter which option you choose.
It’s important to note that when considering more invasive, arthroscopy of the knee is no better than ‘sham’ surgery. Both feel 30% better! That means people who simply had only an incision but were told they had an arthroscope got exactly the same outcome as those who actually had the proper arthroscopy. In fact, Medicare is no longer funding arthroscopes because of this.
With joint replacement surgery, although 80% get a good outcome, 20% of people do not get any pain relief.
Lastly, if you do go ahead with a joint replacement after completing a 6-12 week Physiotherapy block, the research shows you’ll get a better outcome post-operatively than those who didn’t complete physiotherapy management. That means a quicker recovery and less pain after your replacement or arthroscopy!
To read more about the GLA:D program, the research behind it and any other information you might be seeking, hit the following link:
If you or a family member are struggling to find relief from hip or knee osteoarthritis and want to get back to your physical best health and do all that you love, call the clinic on 8490 0777 or book online for your initial consultation with our hip and knee osteoarthritis physios today to get started.
Alternatively, fill out the enquiry form below and we’ll get one of our experienced Osteoarthritis Physiotherapists to give you a call.