Knee osteoarthritis: is it as debilitating as we think?
Osteoarthritis (OA) is the result of wear and tear of the joint cartilage. It can result in pain and stiffness when loading a joint. But is OA always a sign we need to protect our joints and stop certain activities? The answer may surprise you.
Osteoarthritis (OA) is the result of wear and tear of the joint cartilage. It can result in pain and stiffness when loading a joint. But is OA always a sign we need to protect our joints and stop certain activities? The answer may surprise you.
What is OA?
Osteoarthritis is a break-down of the cartilage in our joints. It mostly affects weightbearing joints such as hips and knees and these joints are subject to larger forces. It was previously thought that joints with OA were to be ‘protected’ by limiting how much we bend, move and load them. We now know this is not true – in fact exercise is one of the most effective ways of reducing osteoarthritic pain.
Knees in particular appear to have many connotations around them and it is widely (but incorrectly) thought that exercise is harmful to our knees. In fact it is quite the opposite – weight bearing exercise helps bone, muscles and other soft tissue adapt to make our knees stronger and more robust. This means an improvement in joint range of motion, muscle length and strength and functional capacity.
How much value should you place on a scan?
It is also important to know that while a scan may show significant osteoarthritic findings, this certainly does not correlate to pain, function or quality of life! Even with ‘severe’ osteoarthritic findings on a scan, very positive functional outcomes can be seen with the above program.
What will help?
The latest guidelines around osteoarthritis, show the most effective way to slow the progression of the pathology is to perform regular weight bearing, strength based exercise. There is good evidence to say this can also significantly reduce pain and improve function. Anti-inflammatories may also help pain and swelling, however you should always consult your doctor before using medication.
It is recommended to perform land based strength exercises 2-3x weekly, such as squats, steps up or leg press. The sets, reps and weight will initially be determined by strength, function and pain levels. This is nicely complimented by aerobic exercises such as walking, bike riding or pool based exercise, although aerobic exercise is not shown to have the same benefit as land-based strengthening.
Our physiotherapists can create a knee strengthening program you can perform at home, all tailored to your individual goals and ability.
Injury Prevention: Part ONE – Groin Injuries
Prevention of an injury can be difficult as injury occurrence is usually a multi-modal. Extensive research has gone into the development of programs designed to address contributing factors of certain common injuries. Two common injury sites in sport are; groin and hamstring and both have been the subject of research articles investigating the efficacy of specific exercise intervention on prevention of injuries to those areas.
Prevention is the best cure - Desiderius Erasmus
Prevention of an injury can be difficult as injury occurrence is usually multi-modal. Extensive research has gone into the development of programs designed to address contributing factors of common injuries. Two common injury sites in sport are; groin and hamstring and both have been the subject of research articles investigating the efficacy of specific exercise intervention on prevention of injury.
GROIN
Groin injuries are a common occurrence in change of direction sports like soccer, basketball (e.g Lebron James recent injury) and Australian rules football. With the highest paid player in soccer earning $111 million per year, you can see why prevention of these injuries becomes very important.
Haroy et al (2017) looked at the inclusion of the Copenhagen exercise in the FIFA 11+ program (used as a warm up for soccer players) on improving hip adduction strength.
The Copenhagen Adductor (CA) exercise is a partner exercise where the player lies on the side with one forearm as support on the floor and the other arm placed along the body. The upper leg is held at approximately hip height of the partner, who holds the leg with one arm supporting the ankle and the other supporting the knee (position A in figure 1). The player then raises the body from the field and the lower leg is adducted so that the feet touch each other and the body is in a straight line (position B in figure 1). The body is then lowered halfway to the ground while the foot of the lower leg is lowered so that it just touches the floor without using it for support. It is performed on both sides.
Figure 1 The Copenhagen Adduction exercise. A start/end-position. B mid-position.
The article found that the CA exercise delivered in the below protocol (figure 2) resulted in an increase in hip adduction strength and as this is a risk factor for groin injuries, should be included in the FIFA 11+ to try to reduce the incidences of these injuries.
Figure 2 The prescription parameters for the CA exercise.
The CA is a fairly safe and easy exercise to self- integrate into the pre-existing FIFA 11+ protocol. However, even with the diligent performance of the protocol, groin injuries can still occur. It is always best to be assessed by a physiotherapist to ascertain a correct diagnosis so you can receive the best treatment possible for your specific condition. Here at East Vic Park Physiotherapy, our physiotherapists are very experienced in assessing and treating groin pain. Additionally, if you would like to know more about the CA exercise or the FIFA 11+ program then click the link at the top of the webpage to book an appointment or call us on 9361 3777. Below is a quick link to review:
https://www.fifamedicinediploma.com/lessons/prevention-fifa-11/