Physical Therapy in Venice for Knee

Welcome to FYZICAL Venice's patient resource about Osteoarthritis of the Knee.

Osteoarthritis (OA) is a common problem for many people after middle age. OA is sometimes referred to as degenerative, or wear and tear, arthritis. OA commonly affects the knee joint. In fact, knee OA is the most common cause of disability in North America. In the past, people were led to believe that nothing could be done for their problem. Now there are many ways health professionals like Physical Therapists can treat knee OA so patients have less pain, better movement, and enhanced quality of life.

This guide will help you understand:

• how OA develops
• how OA of the knee causes problems
• how doctors treat the condition

Which parts of the knee are affected?

The main problem in OA is degeneration of the articular cartilage. Articular cartilage is the smooth lining that covers the ends of the leg bones where they meet to form the knee joint. The cartilage gives the joint freedom of movement by decreasing friction. The layer of bone just below the articular cartilage is called subchondral bone.

Subchondral Bone

When the articular cartilage degenerates, or wears away, the bone underneath is uncovered and rubs against bone. Small outgrowths called bone spurs or osteophytes may form in the joint.

Bone Spurs/Osteophytes

Related Document: FYZICAL Venice's Guide to Knee Anatomy

How does knee OA develop?

OA of the knee can be caused by a knee injury earlier in life. It can also come from years of repeated strain on the knee. Fractures of the joint surfaces, ligament tears, and meniscal injuries can all cause abnormal movement and alignment, leading to wear and tear on the joint surfaces. Not all cases of knee OA are related to a prior injury, however. Scientists believe genetics makes some people prone to developing degenerative arthritis. Obesity is linked to knee OA. Losing only 10 pounds can reduce the risk of future knee OA by 50 percent.

Scientists believe that problems in the subchondral bone may trigger changes in the articular cartilage. Normally, the articular cartilage protects the subchondral bone. But some medical conditions can make the subchondral bone too hard or too soft, changing how the cartilage normally cushions and absorbs shock in the joint.

What does knee OA feel like?

Knee OA develops slowly over several years. The symptoms are mainly pain, swelling, and stiffening of the knee. Pain is usually worse after activity, such as walking. Early in the course of the disease, you may notice that your knee does fairly well while walking, then after sitting for several minutes your knee becomes stiff and painful. As the condition progresses, pain can interfere with simple daily activities. In the late stages, the pain can be continuous and even affect sleep patterns.

When you visit, FYZICAL Venice, our Physical Therapist will take a history and do a physical exam. The diagnosis of OA can usually be made on the basis of the initial history and examination.

Some patients may be referred to a doctor for further diagnosis. Once your diagnostic examination is complete, the Physical Therapists at FYZICAL Venice have treatment options that will help speed your recovery, so that you can more quickly return to your active lifestyle.

Non-surgical Rehabilitation

OA can't be cured, but Physical Therapies are available to ease symptoms and to slow down the degeneration. Recent information shows that mild cases of knee OA may be maintained and in some cases improved without surgery.

Medication

Patients may also want to consult with their doctor or pharmacist regarding the use of pain relief or over-the counter anti-inflammatory medication. Acetaminophen (Tylenol) is a mild pain reliever with few side effects. Some people may also get relief of pain with anti-inflammatory medication, such as ibuprofen and aspirin. Talk to your doctor or pharmacist if you have questions or concerns regarding these medications.

Medical studies have shown that glucosamine and chondroitin sulfate can also help people with knee OA. These supplements seem to have nearly the same benefits as anti-inflammatory medicine with fewer side affects. Many therapists feel the research supports these supplements and are encouraging their patients to use them.

Physical Therapy

Your Physical Therapist plays a critical role in the nonoperative treatment of knee OA. Physical Therapy may be needed to ease pain and improve mobility, strength, and function. Our primary goals are to help you learn how to control symptoms, maximize the health of your knee and prolong the time before surgery is needed. Although the time required for recovery varies, you will probably progress to a home program within two to four weeks

We begin by recommending ways to calm pain and symptoms, which might include the use of rest, heat, or topical rubs.

Our Physical Therapists then teach patients how to protect the arthritic knee joint. This starts with tips on choosing activities that minimize impact and twisting forces on the knee. People who modify their activities can actually slow down the effects of knee OA. For instance, people who normally jog might decide to walk, bike, or swim to reduce impact on their knee joint. Sports that require jumping and quick starts and stops may need to be altered or discontinued to protect the knee joint.

Our Physical Therapist may suggest that shock-absorbing insoles placed in your shoes to reduce impact and protect the joint. In advanced cases of knee OA, or when the knee is especially painful, we may recommend a cane or walker to ease joint pressure when walking. People who walk regularly are encouraged to choose a soft walking surface, such as a cinder or grass track.

A new type of knee brace, called a knee unloading brace, can help when OA is affecting one side of the knee joint. For example, a bowlegged posture changes the way the knee joint lines up. The inside (medial) part of the knee joint gets pressed together. The cartilage suffers more damage, and greater pain and problems occur. The unloading brace pushes against the outer (lateral) surface of the knee, causing the medial side of the joint to open up. In this way, the brace shares the pressure and unloads the arthritic medial side of the joint. A knee unloading brace can help relieve pain and allow people to do more of their usual activities.

For mild cases of knee OA, our Physical Therapist may give you a heel wedge to wear in your shoe. By tilting the heel, the wedge alters the way your knee lines up, which works like the unloading brace mentioned above to take pressure off the arthritic part of the knee.

We will use range-of-motion and stretching exercises to improve your knee motion. Our Physical Therapist will also show you strengthening exercises for the hip and knee to help steady you knee and give additional joint protection from shock and stress. People with knee OA who have strong leg muscles have fewer symptoms and prolong the life of their knee joint. Your Physical Therapist will also suggest tips for getting your tasks done with less strain on the joint.

Post-Surgical Rehabilitation

Physical Therapy treatments after surgery depend on the type of surgery performed. Rehabilitation is generally slower and more cautious after knee replacement procedures and certain types of tibial osteotomies. After simple procedures such as arthroscopy, you may begin fairly aggressive exercise therapy immediately.

Your Physical Therapy treatments usually begin the next day after surgery. Our first few rehabilitation sessions are used to ease pain and swelling, help you begin gentle knee motion and thigh tightening exercises, and get you up and walking safely. You may need to use either a walker or crutches after surgery. We may instruct some patients to limit how much weight they place on the knee for about four to six weeks.

After going home from the hospital, a Physical Therapist may see you for a short period of home therapy before beginning outpatient Physical Therapy. Our outpatient treatments are designed to improve knee range of motion and strength and to safely progress your ability to walk and do daily activities.

At FYZICAL Venice, our goal is to help you keep your pain under control, maximize knee mobility, and improve muscle strength and control. When your recovery is well under way, regular visits to our office will end. Although we will continue to be a resource, you will be in charge of doing your exercises as part of an ongoing home program.

FYZICAL Venice provides services for Physical Therapy in Venice.