If arthritis is limiting your activities, a physical therapist can help. And with that said, I think there is a very important point here to make, which is that sometimes I see patients and the first thing they say is, I know, I know, I know, I have to lose weight.â¬ And while that may be true, to pin it all on that is a mistake, because it’s very difficult to lose weight when it’s hard to walk across the street because the pain is so bad. Exercise is such an important component of losing weight that sometimes you get yourself into a vicious cycle: your knee hurts so you stop moving, you put on weight so you put on more pressure on the knee, the knee hurts more and you move less. That can start spiraling downwards.
The meniscus (the shock absorber of the knee) may be involved in some cases of knee OA. In the past, surgery (arthroscopy) to repair or remove parts or all of this cartilage was common. Current research, however, has shown thatâ¬ in a group of patients who were deemed surgical candidates for knee OA with involvement of the meniscusâ¬ 60% to 70% of those who first participated in a physical therapy program did not go on to have surgery. One year later, those results were unchanged. This study suggests that physical therapy may be an effective alternative for people with knee OA, who would prefer to avoid surgery.
Individuals who develop knee OA may experience a wide range of symptoms and limitations based on the progression of the disease. Pain occurs when the cartilage covering the bones of the knee joint wears down. Areas where the cartilage is worn down or damaged exposes the underlying bone. The exposure of the bone allows increased stress and compression to the cartilage, and at times bone-on-bone contact during movement, which can cause pain. Because the knee is a weight-bearing joint, your activity level, and the type and duration of your activities usually have a direct impact on your symptoms. Symptoms may be worse with weight-bearing activity, such as walking while carrying a heavy object.
So the job of someone like me, with the kinds of interventions that I do with physical therapists and all the different healthcare professionals, one of the important things is to break that cycle. Sometimes just breaking the cycle (taking away the pain), allows the person to be more active, and a lot of the times the weight loss will take care of itself. Obviously, things like diet, nutrition, and overall exercise are very important, but if you can just take away the pain and break the cycle, the person will start moving better, the weight starts coming off and then you start spiraling in the right direction instead of the wrong direction.