Osteoarthritis

Osteoarthritis is the most common form of arthritis that people suffer from. It can affect any joint in the body but is most common in the weight bearing joints such as hips and knees. It is often seen as a result of wear and tear in the joint over a long period of time. It results in the breakdown of the cartilage lining of the joint which reduces the cushioning, lubrication, and stability of the affected joint. Osteoarthritis also can result from trauma to the joint such as a dislocation, infection, or fracture within the joint. Other factors, such as heredity, tend to increase the risk of osteoarthritis as well.

What are the symptoms?

Initially pain and swelling in the affected joint. It may hurt after activity and bother you at night as well.
As the condition progresses, there will be stiffness and reduced range of motion in the affected joint.
The joint may feel unstable at times.
The joint may look thickened or swollen all the time.
You may start to notice deformity such as you are becoming more bow legged at the knee.
The joint may be really stiff in the morning for a half an hour or so but then limbers up and feels better.

I think I have osteoarthritis. Does this mean I have to have my joint replaced?

While joint replacement is an option in treating severe osteoarthritis, there is a lot that can be done in the early stages to delay or eliminate the need for this in the long term. It is important to note that you can have acutely painful early osteoarthritis without a lot of joint damage. There is often a broad spectrum here.

What can I do?

One thing that has been shown to be effective over and over is the appropriate range of motion and strengthening exercises to support and protect the joint. Often people developing osteoarthritis have weakness in main supporting muscles that only increases the pressure on the joint and speeds up the wear and tear.
Often people who are developing osteoarthritis also become more sedentary. This, unfortunately, leads to weight gain, weakness, and deconditioning. Staying active with the appropriate activity and watching your weight help a lot. The average person absorbs 1.5x their body weight on each step at the knee. This means a 200 lb person absorbs 300 lb per step. If this person was now 225 lb, they absorb 340lb in a joint that cannot take the weight the way it once did. This is not great math over the long term.
Physiotherapy will help settle the acute joint reaction. It is the acute swelling and inflammation that erodes the joint tissue. The longer it is inflamed the more damage is done.
There are many ways to protect the joint from further damage:
- Use of a cane or brace can help reduced the weight bearing stress in the joint and improve balance and stability.
- Choosing the right activity that you enjoy and puts less compressive stress on the joint that is done regularly will help.
- Hit the pool!
- Keeping the joint from becoming inflamed after higher stress activities by using ice afterwards is beneficial.

What can physiotherapy do?

What can physiotherapy do for me?

A physiotherapist will assess your joint mobility, strength, balance, and level of irritability at the joint.
Educate you on the proper types of activity to safely perform, the amount and timing of activity as well as how to care for your joint after activity.
Provide specific exercises to work on elements of poor mobility, weakness and stability to keep your joint in the “sweet spot” where it is happy most of the time.
Work on settling down the inflamed joint. Using modalities that combat the inflammation and ultimately the pain to help you get to a point where exercise and activity are better tolerated.

I have severe osteoarthritis in my knee or hip and am waiting for joint replacement surgery. Can physiotherapy do anything for me now?

Yes! Physiotherapy prior to your surgery will ensure you are prepared in the best way possible by:

Helping manage your pain in the short term.
Teaching you the early post-operative exercises so you can get going right away and the exercises are not new to you in the days after surgery.
Teach you how to properly use crutches or a cane, the proper walking pattern, how to go up and down stairs etc.
We can talk about challenges you may face at home and how to set yourself up for success when you come home from the hospital.
Identify areas of weakness that you can address before the surgery to make your recovery easier.

We offer post-joint replacement physiotherapy in both one on one and group settings. We will get you ready for your surgery and get ready to see you afterwards.