Knee Osteo-Arthritis (OA) – Common Misconceptions and benefit of Physical Therapy

Knee Osteo-Arthritis (OA) – Common Misconceptions and benefit of Physical Therapy

For years we have just accepted that knee OA is just a byproduct of getting older and not much can be done for it until it’s time for a total joint replacement. Recent studies have shown this not to be accurate and we now have a much better understanding on one of the leading causes of disability in the United States.

OA is a condition in which the cartilage (aka articular cartilage) covering the surfaces of you bones becomes worn down and exposes the bone underneath that can lead to bony osteophyte formations (bone spurs). In your knee, the articular cartilage covers the end for your femur (thigh bone), tibia (shin bone) and the back of your patella (knee cap) and provides a frictionless surface for these joints to move over one another. This cartilage lives in what is known as ‘splendid isolation’ and has no blood vessels or nerve endings. When an area of this cartilage becomes damaged it will expose the bony surface which has nerve endings and will then send the pain signals to the brain and the symptoms appear to the patient. This can take up to 10-15 years to occur and a patient a lot of time will be asymptomatic until the bony surface is exposed. Symptoms of knee OA can include pain, swelling, loss of ROM and difficulty with normal levels of daily activities including prolonged sitting, walking and stair mobility. Unfortunately, when these symptoms do occur the damage to the cartilage has been done and due to the poor healing ability, it will not regenerate and it’s time to transition into management of the condition.

Common Misconceptions associated with OA:

As I get older my knee pain is from normal ‘wear and tear’.
Answer: False – Articular cartilage has the mentality of ‘use it or lose it’ and actually lives to have forces put through it which allows it to stay healthy and not deteriorate.

Exercise will make me worse
Answer: False – Exercise (land or water based) is the only treatment option that is ‘Highly Recommended’ by the American Academy of Orthopedics and the American College of Rheumatology – An exercise suitable for the individual would be recommended by a licensed Physical Therapist and would include low impact activities to reduce stress and pressure on the effected joint surfaces.

There is an association between weather and knee OA.
Answer: Depends. Rainy climates do not cause OA, but those with OA may have increased pain during rainy weather.

One is more likely to develop knee OA if a parent had knee OA.
Answer: Depends. One is at a higher risk of OA with a family history, but development is avoidable through a healthy lifestyle.

A diagnosis of OA does not mean that someone will just have to ‘live with it’ or ‘just wait as long as possible for a replacement’ which are both common phrases. Setting up an evaluation with a licensed PT is critical in the process of reducing pain, improving range of motion and strength and resumption of previous levels of activities including exercise. Typical treatments will focus on low impact exercise, education on reducing BMI if necessary, strategies to improve range of motion and reducing swelling and discomfort. We also recommend hands on physical therapy and the AlterG Anti-Gravity Treadmill. For more information about this service, click here.