Osteoarthritis Knees
Rehabilitation of Soft Tissues/ Joint Degeneration Problems
FAQ
OA knee is a progressive disease that wears out the joint cartilage. Pain results from contact of the bone surfaces when there is reduced or no joint cartilage. The pain is evident when pressure is created on the joint surfaces. This pressure can occur during simple daily activities such as walking, stair walking or squatting.
OA knee is the most common form of arthritis in Hong Kong. It affects up to 7% of men and 13% of women aged 50 years or above. Since there were 3,161,210 people in Hong Kong who were 50 years or older in 2020, about 110,000 men and 205,000 women were likely suffering from OA knee.
If you have at least 3 of the following symptoms, you are likely to be suffering from mild to moderate OA knee:
- Crepitus (grating sound created with movement)
- Morning stiffness <30 mins
- Bony enlargement
- No palpable warmth
- Age>50
- Bony tenderness
Radiological and physical examination will confirm the diagnosis.
Although OA knee is a progressive disease, it is a condition that often slowly develops over the years. However, if you are diagnosed with OA knee, there are still many ways you can control the deterioration as detailed in the following 5 measures.
Weight Management
Healthy weight means healthy knees. Being overweight puts increased stress on the joints in your body. When walking or going up and down stairs, for example, your knees are carrying up to 3 times your body weight. So, losing even a small amount of weight can greatly reduce the strain on your knees. Studies show that even a reduction of 5% of your initial body weight can improve function and reduce pain.- Exercise
Joints need movement to stay healthy, and this is especially important if you have osteoarthritis in the knee. By following the prescribed exercise routine given by your physiotherapist, exercise can significantly improve your function and reduce the pain in your knee joint. Remember, it is important to balance the amount of exercise and rest as too much or too little can increase pain and stiffness. In addition to prescribing exercise, your physiotherapist will help you find this balance.
Balance is crucial when it comes to exercise. Don’t get discouraged if you have a flare-up after exercising. Finding the right exercise and balance takes time.
We know that staying focused on your exercise routine can be tough at times, so we recommend spacing out some visits with your physiotherapists as booster sessions (e.g. weekly, monthly, quarterly) to keep you motivated in working towards a healthier joint.
How can a physiotherapist help you?
If you suffer from OA knee, simple daily activities such as walking, stair climbing or hiking could aggravate the condition and cause symptoms to arise. However, there is strong scientific evidence supporting the idea that exercise improves pain and function for mild to moderate OA knee. Currently, multiple international guidelines strongly recommend exercise as a conservative treatment for mild to moderate OA knee. At HKSH, our physiotherapists are trained in designing and implementing effective, scientifically proven exercise programmes according to your physical condition and any co-morbidities.
For patients who suffer from more severe pain, our physiotherapist-led aquatic exercises are another option that allows for strengthening with less loading on your knees.
In addition to exercise, our physiotherapists specially trained in pain management may recommend adaptive coping skills that can help you better manage your pain.
- Ergonomic Alternatives
Several epidemiologic studies have found a relationship between OA knee and functional activities in occupations that require kneeling, squatting, stair walking, and lifting or carrying heavy loads. Each of these activities increases the risk of OA knee more than 2.5 fold when performed daily3-5.
Therefore, it is important to manage the amount of time spent performing these tasks, especially if they are something you do regularly.
Some alternatives include taking an escalator or elevator rather than the stairs, using a small trolley when carrying goods, and sitting on a low stool instead of squatting.
When performing repetitive, high load activities, find alternatives to manage the load.
Sometimes it is impossible to avoid stairs. A helpful technique to go up and down stairs is to use the good leg to go up first followed by the bad leg onto the same step. Going down is with the bad leg first followed by the good leg onto the same step.
- Walking Aid
If necessary, our physiotherapist will prescribe a walking aid that is most appropriate for you. A walking aid is a great low-cost tool for reducing pain in knee arthritis and improving function. Some options include walking frames, crutches and different forms of canes6.
As a general guideline when adjusting the height of the cane for the first time, the cane should reach the crease of the wrist when the arm is relaxed by the side. When using a cane, remember to place it on the same side as your good leg.
- Brace
When a doctor has determined you have OA knee, find out which joint is affected. Not only will this give you a better understanding of your condition, it will help you choose the knee brace that is best for you. Purchasing the correct knee brace can lead to decreased pain and improved functional ability.
When affected by medial or lateral tibial femoral joint OA, select an unloading style brace that opens up on the affected side of the knee (as shown below). For a patellar femoral joint OA, choose a brace that provides dynamic support to the patella.
At HKSH we offer a variety of knee braces at our Prosthetist & Orthotist department. For more information, please contact them on 2835 8648 or visit their website.
If you have severe OA knee (knee joint deformity, severe swelling and pain), consulting a knee surgeon can help you decide whether you need a joint replacement.
