Physiotherapeutic Options for Management of Knee Osteoarthritis

Knee osteoarthritis is a common joint degenerative disease wherein the knee joint becomes inflamed and deteriorates over time. How it progresses is influenced by advancing age, patient's BMI, activity levels, strength, genetics and bone structure. There are surgical treatment options, such as knee replacement and knee arthroscopy, but these should only be used in more advanced cases where milder interventions have failed. If you have knee osteoarthritis (KOA) and don't want to go for surgery, below are a few lower-risk interventions to discuss with your physiotherapist.

1. Weight loss

When you are heavier, your knee joints support a heavier load and this predisposes you to development of KOA and faster progression upon development. Overweight and obese people with the condition should therefore discuss weight loss options with their physiotherapist, including diet and lifestyle changes. Studies shows that losing just 5 to 10 percent of weight can improve your knee function and reduce pain.

2. Physical activity

Exercise is not only important for weight management and general health benefits; keeping your knee joint active will strengthen, stabilise and lubricate the joint. The physiotherapist can recommend general exercises that can be handled given the progression of your knee, as well as specific exercises to strengthen your knee musculature, tissues and cartilage for better mobility.

Focus on core muscle (muscles of the lower back, pelvis and abdomen) and hip-strengthening exercises to increase your stability and balance the force applied to your knee when you move. The therapist will give you a list of personalized exercises – type, intensity, duration, frequency and resting times between exercises – as well as a progression schedule so that you don't do too much and negate the benefits accrued.

3. Knee braces

There are different kinds of knee braces, and the choice of brace will be prescribed according to the specific part of the knee most adversely affected. Patients with patella femoral arthritis (behind the kneecap) do well with braces that support the kneecap and apply gentle pressure sideways to straighten the knee. Such patients complain of pain at the front of the knee which worsens when going downhill. Patients with tibio femoral arthritis (between shin and thigh bones) will have a different brace prescribed. Unloader braces offer significant relief for patients whose arthritis is on the inner or outer knee.

4. Manual therapy

Physiotherapists can perform manual physiotherapy several times a week depending on severity. During these sessions, the therapist gently mobilizes and moves joints and muscles around the knee to increase flexibility, motion and strength. He/she targets specific areas that are hard for you to reach or exercise on your own. These complement your own exercise regimen to provide incremental benefits in pain reduction and increase of mobility.