Monday, March 23, 2009

The role of exercise

Unfortunately, once your knee is worn, it will stay that way or get worse unless it is surgically replaced.

So do you just give up and accept things are going progressively worse?


Although you're stuck with the amount of wear that has occurred to date, the amount of pain that wear gives you is changeable.

This is a very important point.

As soon as osteoarthritis walks into your life you need to focus on the variables that you can change, and accept those you can't.

You can't change the fact your knee is worn.

You can change your weight.

You can change the strength of your muscles.

Studies have shown that most treatments are more effective when the patient understands the rationale behind the treatment. So why exercise?

The weight issue is an easy one. Osteoarthritis is a disease of weight-bearing joints. This is why it is common in the hips, knees and lumbar spine, but less common in the elbow and shoulder.

High school physics teaches us that Pressure = Force x Area.

Once our bones stop growing, the area of our joints becomes fixed. Any increase in weight directly increases the pressure on the joint surfaces and therefore increases the rate of wear. The good news is that this is totally reversible. Any weight lost means less pressure on the knees.

What about muscles strength?

Our joints are supported by the muscles that cross over them. The knee by the quadriceps at the front and the hamstrings at the rear. The stronger these muscles are the more support they offer.
Inactivity caused by increasing levels of pain results in weaker muscles. Weaker muscles support the joint less effectively and result in more pain - the result is a vicious cycle.

Activity and exercise can break this cycle, and reverse it. Increasing strength can lead to decreasing pain and a better quality of life.

The two key factors here are motivation and guidance. A physiotherapist can help you develop an exercise program to both strengthen the appropriate muscles and lose weight. This must be achieved without exacerbating the symptoms and patience is required as it typically takes 4 -6 weeks to feel the benefits of a strengthening program.

The important thing to remember is that you can have a say in how much pain your knee gives you.

You can lie down and take it..........

or stand up and fight.

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