Knee Osteoarthritis and Physiotherapy

Physiotherapy and Knee Osteoarthritis. What You Need To Know

We live in a quick and easy fix world. Something is broken, so let’s just do a quick fix to get a bit more time out of it, or better yet, if it’s cheap we can just replace it. This is a common mindset with a lot of things around the house such as electronics, tools, and even our vehicles, and it’s the mindset I hear too often when patients come in after being told they have osteoarthritis in their knee.

“If I have osteoarthritis in my knee why don’t they just go in a clean it up? Why don’t they just replace it!?” Sure, arthroscopic knee surgery or a total knee replacement may be what’s best in cases of severe osteoarthritis, but in mild-to-moderate cases, physiotherapy and other conservative treatments can have tremendous outcomes for patients as well!

Here are a few ways that physiotherapy can help…

Manual Therapy

  • Manual therapy is a hands-on treatment approach used to improve mobility and reduce pain. Research has consistently shown that physiotherapy management of an osteoarthritic knee that includes individualized manual therapy has improved outcomes in the short and long terms compared to exercise alone.

Functional Exercise

  • Physiotherapists are exercise experts. Being taking the time to complete a thorough assessment, a physiotherapist will be able to find strength, stability, and mobility deficits that can be addressed with exercise. Exercise programs should also be regularly evaluated and adapted to address the patient’s changing needs. Research also supports a combination of supervised in-clinic exercises and a home exercise program compared to only a home exercise program. In a 2005 study, at 4 weeks post-treatment, patient functional scores had improved by 52% in those that had supervised exercises compared to by 26% in the home exercise-only group. At 1-year post-treatment, the patients that were supervised with their exercises were less likely to be taking medications for their arthritis and were more satisfied with the overall improvement of their rehab.

Taping

  • Therapeutic taping is typically used to improve tracking of the kneecap and unload soft tissues to reduce pain. By incorporating therapeutic taping into a patient’s rehab, it can lessen pain and improve stability allowing the patient to stay active and continue their exercises with comfort.

Bracing

  • A variety of braces can be used to help manage an osteoarthritic knee, ranging in size, level of support, and cost. On one end of the spectrum, a knit compression sleeve that assists with tracking of the kneecap can help keep the joint warm and improve your sense of stability at a relatively low cost. On the other end of support, patients with moderate-to-severe osteoarthritis in one compartment of the knee can benefit from an unloader brace that serves to decompress the arthritic compartment and improve tracking of the knee.

Modalities

  • Treatment modalities are commonly used in physiotherapy to help reduce pain and improve function. Acupuncture, dry needling, low-intensity laser, neuromuscular electrical stimulation, ultrasound, interferential current, pneumatic compression, ice, and moist heat are all effective treatments of knee osteoarthritis when used in combination with manual therapy and an individualized exercise program.

One thing that should never be a part of your knee osteoarthritis rehabilitation program is complete rest. All joints and cartilage require 2 basic things to produce synovial fluid (our natural lubricant) and stay healthy, 1) movement, especially into end range, and 2) compression. Our joints aren’t like car tires that wear out with use. In fact, the more we move and use our joints, the healthier they are! That’s why it’s important to get moving and a physiotherapist can help you do so.

As always, it’s important to remember that no 2 arthritic knees are the exact same and I am not against knee scopes and replacements. Your doctor and orthopaedic surgeon are the experts in that area and will give you accurate information if surgery or other treatment options, such as anti-inflammatories or injections, are indicated. This post is just meant to make you aware that osteoarthritis doesn’t always have to mean surgery and that as little of 6-12 physiotherapy sessions can help.

If you’re wondering if physiotherapy can help your arthritic knee, give Peach Physiotherapy in Chatham-Kent, Ontario a call at 519-358-7342 to set up your 60 minute 1-on-1 assessment today!

Deyle GD, Allison SC, Matekel RL, Ryder MG, Stang JM, Gohdes DD, Hutton JP, Henderson NE, Garber MB. Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program. Phys Ther. 2005 Dec:85(12):1301-17.

Deyle GD, Henderson NE, Matekel RL, Ryder MG, Garber MB, Allison SC. The effectiveness of manual physical therapy and exercise in osteoarthritis of the knee. A randomized, controlled trial. Ann Intern Med. 2000 Feb 1;132(3): 173-81.

Page CJ, Hinman RS, Bennell KL. Physiotherapy management of knee osteoarthritis. Int J Rheum Dis. 2011 May;14(2):145-51.

Salamh P, Cook C, Reiman MP, Sheets C. Treatment effectiveness and fidelity of manual therapy to the knee: A systematic review and meta-analysis. Musculoskeletal Care. 2016 Nov 18.