Knee Osteoarthritis and Physiotherapy

Osteoarthritis is the most common form of arthritis in Australia. An estimated 2.2 million (9.3%) Australians have this condition, according to the Australian Bureau of Statistics (ABS) 2017–18 National Health Survey (NHS). Osteoarthritis represented over half (62%) of all arthritic conditions in 2017–18 (ABS 2019).

Although osteoarthritis affects people of all ages, the prevalence increases sharply from the age of 45 years. 1 in 5 individuals in the Sutherland Shire (22%) over the age of 45 have osteoarthritis. It is most common in adults aged 75 and over, with just over one-third (36%) of people in this age group experiencing the condition.

Osteoarthritis is also more common among females than males, affecting 10% of females compared with 6.1% of males (after adjusting for age). Those are some huge numbers and that is in line with what we see at Aevum Physiotherapy in the Sutherland Shire.

Although it is so prominent, most people don’t realise what can be done about it. Well from a Physiotherapy point of view, a fair bit actually.

Let’s start by defining knee osteoarthritis. Despite what people think when they think about osteoarthritis and “wear and tear”, it’s usually more the excessive build-up of bone around the joint line coupled with narrowing of the joint space that causes majority of the pain. This excessive build-up of bone or osteophytes will hit, clash and rub during day-to-day life creating inflammation, swelling and pain.

Biomechanically most people load the inside of their knee joints more than the outside, which is why 95% of people will present to a Physio in the Sutherland shire complaining of pain on the inside of their knee. 

How Can Physiotherapy Help

Now we come to the major part of this article which is how can Physio help?

When you present to your Physiotherapist for knee pain they will firstly examine the cause. This could be through varied musculoskeletal tests or through requesting imaging such as an x-ray or MRI scan to help identify the issues.

Once knee joint osteoarthritis is diagnosed as the major issue, in concert with your Physiotherapist you’ll need to come up with a game plan to reduce the symptoms and restore as much function as we can in the knee. Unfortunately, knee osteoarthritis can't be cured but it can definitely be significantly improved upon.

Your Physiotherapist will discuss the best options that are tailored to what you want to achieve, but these may include:

• Hands on therapy to increase knee joint range of motion and reduce pain

• Swelling management

• Knee strengthening exercises

• Hip strengthening exercises

• Footwear prescription

• Activity modification

• Medication management e.g Panadol Osteo or anti-inflammatories 

Let me elaborate on just a couple of points to further explain their utility.

1. Swelling management

Swelling causes increased pressure within the knee joint. This, therefore, reduces the range of motion in the joint, making it difficult to walk up/down stairs or simply complete normal day-to-day activities, while simultaneously increasing the pain due to the increased pressure. Putting in strategies to reduce the swelling and manage this well, means you will get better function out of your knee and also as a consequence less pain.

1. Activity modification

This refers to simply altering the things we do in order to get a better outcome. For example, I treat an excellent competitive mature runner who has bilateral knee osteoarthritis and also happens to be a doctor. They love their running and don't want to stop, and the arthritis isn't to the extent that they need to. I should also mention at this point that the presence of osteoarthritis in your knees doesn’t automatically exclude you from ever running again. You simply need to run well with good technique, strength and the right shoes… but back to my point, by a simple modification in their technique and also modifying the types of training they do we were able to achieve an excellent outcome as part of our overall strategy to manage their osteoarthritic knee’s.

1. Hip strengthening

While it is very important to strengthen around the actually affected knee joint, an often overlooked and integral part is the hip joint, namely the glutes. It is the glutes that control your knee from above and therefore why it is so important to address this. Effectively strengthening the glutes, if done correctly, will enable your knee to move in its most functional position i.e. not drop inwards while performing day-to-day tasks. This gives us the dual impact of rapidly reducing your pain while also creating a longer-term result.

1. Shoe prescription

As aforementioned the inside of the knee is often most affected and selecting the right shoe or wearing an orthotic may help to unload this area by altering the load across your knee joint while softening through better cushioning.

Undergoing Physiotherapy for knee pain and knee osteoarthritis can have huge benefits. To have a discussion and create an individualised strategy call or book online and speak to one of Aevum Health’s expert team to see how they can help.