Managing Osteoarthritis in your Knee
You are a “weekend warrior” who enjoys recreational activities to stay active and socialize with your friends. Maybe your sport of choice is golf or tennis or basketball. There is only one thing stopping you from playing… your “Arthritis.” You have become accustomed to dealing with the knee pain. With many trips over the years to the doctor, there is a growing concern that the arthritis in your knee will stop you from doing what you love most.
I have seen many of my patients in this situation over the years. The first thing I do is assess their current activity level. How often do they participate in activities and for how long? Then, I ask specific questions on the current pain location, intensity and frequency. When do they experience the pain? Is it constant or intermittent? Do they take medication in order for them to play? Have they tried injections, physical therapy, acupuncture or other treatment approaches?
I think it’s important that someone in this situation really takes a step back and looks at the things they can do to manage their pain. Osteoarthritis of the knee is a degenerative condition where the padding or cartilage in your knee is wearing down and you lose the “shock absorption” capabilities that allows your knee to take on increased joint compressive forces.
There are some very important aspects to consider when it comes to remaining active and avoiding a total knee replacement. When looking at the answers to the questions posed in my assessment above, no matter what the answer, I always educate the patient on the condition so they fully understand what it means.
For example, if a patient is a tennis player, a golfer or a basketball player, these are all high impact sports that can take a toll on your body. This is especially true if your knee has arthritis to begin with. Patients should be aware that there are alternatives to these sports that can help keep them active and may reduce pain. Activities like swimming and biking are two big aerobic activities I recommend switching to which can lower stress to the knees. These are both low impact exercises which provide minimal to no loading on the knee joint.
You don’t want to give up your favorite sport? There is a way to control the pain. If you play tennis four times a week then I would give the patient options like play two times a week. Then, bike or swim the other two days just to take some load off of your knee joint.
I place a strong emphasis on educating about the important benefits of proper stretching and strengthening of the lower extremity. Physical therapy will teach you the correct exercises that you can do at home, before and after your activity. With proper stretching and strengthening, you can improve your quality of life by doing everything you can to control the progression and even reduce your symptoms. By learning these exercises, it will benefit you by allowing you to continue with your activity or activities of choice, with or without lifestyle changes. It is so important to understand that osteoarthritis is not reversible, unless of course you decide to get a total knee replacement.
Lastly, I want to say that if you have tried physical therapy with a reputable therapist, tried injections, tried acupuncture, tried lifestyle and activity modifications, and you are unable to have a good quality of life because of unrelenting pain when walking, standing or getting up or down from a seated position then maybe it is time to think about surgery. That should be your last resort because otherwise there is no reason to consider surgery.
Author: Avi Bregman, PT, MPT
Avi Bregman is a licensed Physical Therapist in the state of Florida. He received his education at the University of Western Ontario in London, Ontario, Canada where he graduated with Honors with a Bachelor of Science Degree in Kinesiology. Later, he completed his Master of Physical Therapy Degree at Western University.
Avi holds a Manual Therapy Certification and has practiced in Florida for over 10 years in the field of outpatient orthopedics and neurological rehabilitation.
Avi is a Credentialed Clinic Instructor for PT and PTA students through the American Physical Therapy Association. He has also earned additional specialized training in Golf Rehabilitation, Acupuncture and is Mckenzie Certified. Avi’s love for the field of golf rehabilitation led him gain TPI Certified expert status through the Titleist Performance Institute.