Senior Physiotherapist Chris Barrett discusses why exercise is important for patients with Osteoarthritis.
Osteoarthritis (OA) is a term that we often hear, you may have been told by your GP that you have it, or you may have diagnosed it yourself by reading up on the internet and talking to friends or relatives. The truth of it is that Osteoarthritis sounds scary. Patients sometimes have pain, sometimes they don’t, sometimes they need surgery, often they don’t. This article will explore a few of the issues around this common but misunderstood condition.
“I can’t continue to exercise because I have Osteoarthritis”. This is a very typical comment that I hear. In fact, I heard it again only last week. Let’s look at this phrase a little closer. We had someone who clearly didn’t understand their condition and who was frightened to do any exercise. Exercise to him was counter-intuitive. Why would I want to move my stiff and painful knee?
So what is Osteoarthritis (OA)? Osteoarthritis affects 8 million people in the UK (Arthritis Research UK). We often talk about OA being similar to grey hair and wrinkles – it’s describing an aging process which may or may not include pain. OA is a condition whereby the surfaces of your joints become altered. Cartilage at the end of the joints become roughed and thin. As with many injuries, imaging for OA can sometimes be helpful. However, you can look at results from a scan and think the patient is bound to have pain, swelling and struggle with daily activity. However, in reality they were actually doing really well. Essentially there is a poor relationship between findings on x-ray and MRI, versus functional pain and problems with daily activities.
What can I do about OA? Exercise and movement is key. Many people perceive that once diagnosed, their symptoms will only ever get worse. This however is false as the majority of individuals actually report an improvement of symptoms after starting exercise. The National Institute for Health and Clinical Excellence (NICE) recently reviewed its advice on OA. They recommended access to appropriate information, activity and exercise. If anyone is overweight, they should be offered advice to lose weight. Looking at the exercise, this should include local strengthening and general cardiovascular exercise. They also advocated the use of heat/ice therapy, manual therapy and specific strengthening exercises. The amount and type of exercise you do will depend on many factors. It depends on your individual capabilities, your personal circumstances and what you enjoy. We see many people at Physiotherapy Matters who want guidance to ensure they get the most out of their exercise.
Physiotherapists often use complicated terms like manipulation and mobilisation. Effectively we are talking about “hands on” treatment. For many people, this can be useful to kick-start their rehabilitation. Because all our appointments are 30 – 40 minutes, we can really make the most of your sessions. The physiotherapist may also advocate some stretching. This may help with keeping the joint mobile. It is important to be realistic and find exercises that suits you and your routines. I tend to only give a couple of exercises and get my patients doing them correctly.
You may have heard of acupuncture and injection therapy as a possible treatment. Many of our physiotherapists have had some really good responses from treatments like acupuncture and injection therapy to help settle a patient’s pain.
So can you just start exercising? Firstly, if you are concerned about your health, you should always seek advice from a physiotherapist or GP before commencing an exercise programme. As an experienced physiotherapist, I use specific pacing strategies with my patients to ensure they are eased into a strengthening programme appropriately. The benefits of exercise in OA are numerous. Exercise will help to increase circulation around the area and can reduce swelling around the joint. This can often increase comfort and mobility within a joint. Similarly, I sometimes use massage techniques to help keep joints mobile and loose. Patients can then really work hard with stretching techniques to keep the joint moving freely. Don’t just think that by going to see a physiotherapist, all you will get is a list of exercises. For example, for hip and knee OA we use a combination of techniques ranging from hands on manual therapy to specific taping techniques to improve muscle activation. Also don’t be surprised if we start looking at the strength of your hip even if you have knee pain -the body works in wonderful ways!
The purpose of what I do with anyone with OA is to keep their joints moving freely, keep joints as strong as possible and encourage exercise. Ultimately I want to ensure you can do as much appropriate exercise as possible. People are often surprised because I often encourage them to continue what they enjoy doing but make some small but important alterations.
If you have any queries, please contact Chris Barrett at Physiotherapy Matters on 0191 2858701. Physiotherapy Matters have clinics at Darras Hall, Gosforth and Newcastle Upon Tyne.