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.

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.