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Knee osteoarthritis – smart approaches for a long term fix
Knee osteoarthritis (OA) is a pain and stiffness of the knee joint caused by degeneration of joint cartilage
It is classified from grade 1 to 4 depending on the number of features of OA present on imaging and the depth of the cartilage loss
Risk factors for knee OA include excessive body weight, previous trauma (such as ACL rupture) and chronic hip or ankle stiffness. Note that distance running and sports with repetitive joint loading do not cause knee OA
Most of the pain associated with knee OA comes from the swelling, which causes a loss of joint range and puts pressure on the soft bone underneath the cartilage defects
Compressive knee braces can be helpful to manage swelling as well as improving control of the knee, both of which will reduce pain. A simple knee brace made of a firm but elastic material is all that’s required, such as this one with Velcro straps for adjustable pressure and fit. Hinges or metal struts don’t assist knee movement for OA and should be avoided
Strength training is the most effective long term management strategy for both prevention and resolution of episodes of pain and stiffness. It should focus on leg strength generally and related to common functions rather than focusing on one muscle group
Consistent and regular exercise is needed to maintain joint movement and cartilage quality. Walking every day, even multiple short walks per day, is preferable to walking every 2nd day
Knee OA is not as steady decline nor is it a guaranteed road to joint replacement. Although the cartilage degeneration is not reversible, the pain and stiffness are almost always reversible
Running is not the enemy. Running has been proven to NOT cause knee OA – in fact it can actually improve joint quality and maintain strength. You just need to ease back into it slowly after an OA flare up. Start with a run:walk approach and only after you’ve started your strength training
Avoid being reactionary with your management of knee OA. Don’t wait for it to swell to start meds, use them as soon as you think you’ve overdone it. Don’t wait for pain and stiffness to start strength training, make it a weekly routine to maintain joint function and cartilage quality
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