How Physical Therapy Reduces Joint Pain and Stiffness

click Why Physical Therapy After SurgeryYour kids keep bugging you to come out and play basketball with them, but you keep using the same excuse: “I’m too busy right now.  Maybe later.” 

accutane uses A more truthful statement: “My arthritic knees won’t tolerate it, so I’d better not.”

buy levitra online with paypal Years go by.  Same excuse, except your kids are now adults who want you to play golf.  What’s worse is that golf is a lot easier on your knees compared to basketball, but your knees have continued to give you trouble.  Your fitness continues to spiral downward. Your doctor recommends steroid injections, which reduce pain temporarily but don’t do anything to actually address the problem.   Your orthopedic surgeon wisely recommends physical therapy before considering replacing your knee joints with titanium.

source site Why bother doing physical therapy for your knee arthritis?  It won’t improve the structure of the joint, as the cartilage has worn away over time and now the bones are rubbing together.  Kneeling is extremely difficult and walking longer than 20 minutes has become a chore.  Just moving around in bed can be difficult due to stiffness. If you have osteoarthritis, the most important thing to realize is this: muscles are the best shock absorbers for joints and if they are weak and/or stiff, joints will be exposed to greater forces and pain (J Applied Physiology 1998).  Thus, the question becomes: how can you strengthen and stretch the muscles affecting knee mechanics without increasing pain/swelling? Research shows that when performed carefully, strengthening and stretching can dramatically reduce knee pain caused by osteoarthritis (Lancet 2005; Arthritis Care Research 2008, 2011; J Science Med Sport 2011).  The key is to gradually increase muscle work and flexibility so that your muscles have time to adapt and get stronger/more flexible, which will then reduce forces in the knee joint. 

generic cialis P HS stretchTo reiterate, weak muscles fail to absorb forces before they reach the joint, so the joint will have greater forces imposed upon it during activity. Stiffness is also a major problem, as stiffness across the knee joint restricts surface area that the knee is able to move (i.e., range of motion), which translates to greater pressure on the knee joint because:

generic cialis sale Pressure = uk accutane Force

go to site Therefore, pressure goes up if surface area goes down. 

For example, the squat exercise is a common movement in people with knee osteoarthritis, as it strengthens multiple muscles (e.g., thighs, hamstrings) essential to reducing knee forces.  However, it must be done carefully to minimize pain and knee stress.  Notice the picture, which shows the follow url lowest position a person should move during the squat if knee stress is to be minimized.  Squatting deeper dramatically increases knee forces, as the contact area between the knee cap (patella) and thigh bone (femur) drops dramatically (J Bone Joint Surg 2009; Archives Physical Med Rehab 2006). 

Those with severe osteoarthritis often cannot perform a squat exercise to this point, so we often start them at much less of a knee bend to allow muscles to strengthen gradually.

Stretching is crucial and should be performed daily.  Research shows that stretching can reduce pain in people with osteoarthritis, although it also must be done carefully in order to avoid inflaming the knee joint (J Orthoped Sports Physical Therapy 2002, 2012).  For example, stretching the hamstrings is often a key movement as part of physical therapy programs for knee osteoarthritis, as it can help reduce knee forces during walking (Archives Physical Med Rehab 2008).  In the picture, notice that posture should be maintained while gently straightening the knee.  It’s perfectly fine to hold onto something while doing this stretch, as this may facilitate longer hold times. 

Finally, in all exercises, make sure that your physical therapist pushes you hard enough so that you’re not wasting your time.  This is called intensity.  With our patients, we use an intensity scale from 0 to 10, where 0 is nothing, 5 is hard and 10 is maximum.  During strengthening exercise, you should feel like you’re working at about a 6 to 8 to achieve strengthening benefits (Med Sci Sp Exercise 1998, 2006).

Right now, the most important part is to get started!  Find a physical therapist you trust who has advanced training in exercise therapy and will push you safely and effectively.

Your kids await…

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