Knee and hip arthritis are common conditions we see at the clinic, occurring as a result of thinning or loss of cartilage in the joint over a period of time.
Even though an x-ray is the most reliable way to get a diagnosis, osteoarthritis diagnosis is primarily determined by the symptoms you feel, such as:
-
- Pain
- Swelling
- Stiffness – especially in the morning or after periods of inactivity
- Feeling unstable
- Clicking / grinding
Why am I getting pain?
As we age, our joints change. This, along with our hair going grey and skin getting wrinkles, is a normal and natural part of aging that we cannot reverse. Osteoarthritis has been previously referred to as a “degeneration condition”, however today as new research and evidence emerges, this terminology is changing to “normal age-related changes”.
If we take x-rays of 100 knees in people over 40, we will find arthritic changes in a majority of the population, however, many of these people will not experience any sort of pain. Conversely where some people experience a lot of pain and stiffness, their x-ray results may show only minor arthritic changes. What causes pain in some people and not others is when the joint itself gets sensitised or irritated.
This is why a diagnosis of arthritis is typically not made from the x-ray alone, but in combination with the symptoms that present.
There are many reasons why a joint gets irritated and causes pain. Most commonly either doing too much activity too soon, or not doing enough at all. Other factors that can have an influence include stress and worry about our injuries and conditions, having a poor night’s sleep, or even it just being in our genetics and chemical make-up to experience pain more or less intensely than someone else.
X-ray results and structural changes at the joint are just one piece in the puzzle of what creates pain in arthritis. And while we are unable to reverse the x-ray imaging, what we can do is focus on the pieces of arthritis and the presenting pain, which we can impact positively.
The benefits of exercise with osteoarthritis
Physical activity is so important in not only the prevention of osteoarthritis but as a way to manage symptoms. Gone are the days where we use the term ‘wear and tear,’ which creates the idea that if you use your body by exercising and being physically active, that eventually it will be overused and breakdown.
Just like muscles, bones, and ligaments, which adapt and get stronger when we use and load them, it is becoming clearer that joints work in the same way, by responding well and getting stronger when we exercise over time.
There has been a huge amount of research into looking at the safety and effectiveness of exercising, particularly with knee and hip arthritis. They show that not only is it safe and doesn’t cause damage, but also that pain can be reduced massively as joints and muscles adapt and get stronger, creating a desensitising effect! Exercise is essential if your goal is to avoid surgery for as long as possible. While it may cause some discomfort, especially at the beginning, it’s really important to understand that you are not causing damage to your knee.
The first-line treatment for symptomatic knee osteoarthritis includes education around the condition and physical activity. To continue to be active is not only good for the general benefits of exercise and positive impacts on joint health and pain, but to be able to continue living and doing what makes you happy.
What kind of exercise is best?
The best kind of activity that you can do to help your arthritis, is the activity that you enjoy the most! It’s also really important to gradually increase exercise over time, rather than overdoing it straight away. This reduces the chance of a big flare-up.
There are plenty of different types of exercise, so here are some ideas that can be put together into a programme:
Aerobic Activity: Getting your heart rate up! A few examples include walking, cycling, or rowing. At a minimum, a simple walking programme alone can have a positive effect on arthritic knees, as it stimulates the production of our natural anti-inflammatories, which as a result reduces pain.
Resistance Activity: Building strength through resistance exercise improves function and reduces pain. The resistance used could be weights, resistance bands, or even your own body weight. Floor and reformer Pilates is an amazing way to build strength and improve the function of grumpy knees and hips (here’s a link to great our Pilates programme at the clinic!)
Balance Activity: Balance is often a forgotten component of an exercise programme for arthritis. Just like a muscle, we can train our balance skills to adapt and improve them. Our balance abilities reduce as we get older, increasing our risk of falling and getting hurt. Training balance also improves our sense of joint stability, which has a positive impact on joint health.
Your physiotherapist is ideally placed to work with you and create the right programme for your specific requirements.
