HIP AND KNEE OSTEOARTHRITIS: EXERCISE YOUR WAY INTO ACTIVITIES

by DR JASPREET KAUR TALWAR (PT) CLINICAL PHYSIOTHERAPIST

Osteoarthritis occurs due to wear and tear of the cartilage in your joint. This causes the bones to get closer together and the joint does not absorb shock (i.e., when walking) effectively. The bone thickens in an attempt to protect the joint, during this pain, swelling (inflammation) occurs.

How my pain can be managed?
Active lifestyle! The symptoms have a higher probability to get worse if you sit and do nothing, however with regular gentle movement you can help reduce stiffness, protect the joint and strengthen the muscles.

Aerobic exercises: It includes walking, cycling and swimming. Exercise hard enough to get out of breath, yet be able to have a conversation. Try to do 2 hours and 30 minutes of aerobic exercise each week, you can spread this out over the week with 30mins session each day, instead of all in one go.

Medicines: A very important part of managing your symptoms. Talk to your doctor for proper guidance.

Hot fermentation: Use a hot water bottle for 15-20 minutes twice a day around the aching area.
You may find it helpful to relax the muscles around the joint.

Footwear modification: Wear good shoes. Well-cushioned, supportive shoes can reduce the pressure on joints by effective shock-absorption. Try to avoid wearing high heels, shoes that have hard soles or are excessively worn.

Walking Aids or supports: Walking stick when held in the on the opposite side to your painful joint (if your right hip is affected, use the walking stick in your left hand) can help reduce the pressure on the joint during activities.

Weight management: Being overweight increases the stress on your joints, especially your hips and knees. Thus, losing weight could reduce your pain and other symptoms. No specific diet is recommended for people with osteoarthritis. However, if you need to lose weight, try to follow a reduced calorie, balanced diet, with regular exercise. Your doctor should be able to give you advice on diets and exercise.

Aquatic Exercises: The buoyancy of the water takes pressure off your hips and knees making you move more easily than you can on land.

Benefits of exercises in OA.
Regular physical activity can:

• Release chemicals in your brain that reduce pain and boost your mood.
• Help you sleep better and makes you feel more energetic.
• Enhance joint mobility.
• Improve nutrition to the joint.
• Stretch and strengthen muscles that help support and move your joints.
• Boosts overall fitness.
• Make your heart and lungs stronger.
• Help you to reach and stay at a healthy body weight.

Joint protection tips

• Use large joints for big jobs: When lifting, carrying or pushing, use your largest and strongest muscles in your arms and legs.
• Pace your activities: If you know that 30 minutes walking increases your pain but you can manage 15 minutes comfortably then stick to 15 minutes, but may be do it more regularly. Alternate periods of heavy activity with periodic rest.
• Practice good posture: Stand and sit up erect.
• Regularly change Positions: To avoid stiffness, move around frequently.
• Listen to your body: Increased pain or swelling after activity may indicate you overworked your joints. Reduce your activities and take more breaks.
• Ease into it: When starting a new task, take it slow until you know how your body reacts.
• Ask for help: Don't try to do a job that is too big all alone.

These are some exercises you can practice at home. Do the exercises 2-3 times daily up to 10 repetitions per exercise. You can hold each position for 5-10 seconds and gradually return to the rest position. Stop if exercises aggravate symptoms and consult your doctor/physiotherapist.

1. Sit with your leg straight. Keep a towel roll under your knee and press your knee down on it.

2. Stand holding a support squeeze your buttock muscles together and take the affected leg back with your knee straight.

3. Stand hold a support squeeze your buttock muscles together and take the affected leg out to the side. Keep the knee straight.

4. Lie on your good side bend the underneath knee. Lift the leg a few inches off the bed, keeping the knee straight and toes facing forwards.

5. Laying on your back slide the heel of your foot in order to bend your and gradually straighten it again.

6. Laying on the back lift your painful leg up while keeping the knee straight.