Osteoarthritis, often referred to as degenerative joint disease (DJD), is the most common disease affecting weight-bearing joints like knee joints. Osteoarthritis causes pain, muscle weakness, and limits the joints range of motion which can lead to disability. Factors such as excess weight, joint trauma, misalignment (pinch knee, bow knee), weakness of quadriceps muscle and abnormal tibial rotation are identified as risk factors for developing OA.
Post traumatic arthritis in the knee occurs in response to ANY injury that affects the joint structures, but particularly following acute ligament and meniscal tears. Trauma, also including repetitive microtrauma, is a common cause of degenerative changes in the knee joint. The symptoms of OA include pain, limited motion, and muscle guarding.
Joint pain and stiffness also inhibit quadriceps muscle function which leads to a lack of joint control as well as problems with gait and balance. The limitation of a knee joint’s range of motion is also typical and usually occurs more often during knee flexion than extension.
Muscle support and strength
Muscle weakness is an important additional risk factor for knee OA development and progression. Muscular weakness and imbalance can have a significant impact on the ability to develop and withstand forces with compensatory movement patterns that increase force applied to the static joint structures.
The loss of quadriceps (knee extensors) strength and a loss of muscle mass (atrophy) have commonly shown impairments associated with knee OA. Much emphasis has been placed on the quadriceps; however, impairment of other muscles have also been documented. For example: hip rotators, hip abductors & adductors, hip extensors and knee flexors.
The main muscular contributors to knee joint anteroposterior stabilization are quadriceps, hamstrings, gastrocnemius, and popliteus muscles. New studies have also shown that glutealis muscles, especially, gluteus medius have an important role in stabilizing knee joint.
Joint stabilizing muscles and muscle strength around the osteoarthritic knee joint offer the support and shock absorption that takes away excess pressure from the painful joint. Also, all the joints in our body require synovial fluid and lubrication to stay mobile. So, muscle condition and exercise are essential treatment for knee OA.
Move it or Lose it
Exercise is a well documented management for those suffering from knee OA. It is common sense that you want to do something low-impact instead of overload your joint (i.e. running or playing tennis). Too much of a wrong kind of exercise can load up the affected joints by causing more pain and stiffness. However, too much rest is not good either because it makes joints stiffen up and weakens the muscles around the joints.
The suitable low-impact exercises for OA are swimming, water-aerobic, biking (flat surface), pilates and yoga. Physical therapy may help those with Osteoarthritis because physical therapists usually give you home exercises which emphasis the strengthening of your weak muscles (quadriceps, gluteus muscles) and the stretching of any tight ones (hamstrings, hip rotators, it-band and calves muscles).
As a Physiotherapist and certified Pilates Instructor, I work weekly with people with knee injuries and Osteoarthritis. My program combines together therapeutic exercises, balance training and pilates. Pilates exercises with a reformer and trapeze table are very suitable and recommended for people with OA. These exercises are low-impact and gentle for your joints, they reduce pain and stiffness by strengthening and stretching the muscles around knee joint. Also, Pilates one-on-one training improves your overall posture and body awareness which helps correct your muscle imbalances and faulty movement patterns (compensatory movement because of pain). For more about PhysioWise in Carlsbad, California please visiti http://www.physio-wise.com