KNEE OSTEOARTHRITIS AND PHYSICAL THERAPY BASED

SOLUTIONS

DR. KUNJAL SHAH GADAM.P.TH (SPORTS)

OBJECTIVES

• What is osteoarthritis of knee and how it affects us.

• Explain physical therapy approach towards knee problem

• Teach preventive strategies

• Details of physical therapy treatment options available.

INTRODUCTION

• Osteoarthritis (OA) is the most common disease affecting weight bearing joints. It gradually leads to a disability restricting the individual from various daily functional activities.

• It is currently a very big concern and slow growing disability causing disease in our society which requires awarness and preventive management.

• This condition does not follow the same course in everybody and there are certain things that you can do to help yourself and prevent problems in the future.

OA KNEES

• TIBIOFEMORAL JOINT

• PATELLO FEMORAL JOINT

• LINKAGES

THE KNEE JOINT ANATOMY

THE PATELLOFEMORAL JOINT

EFFECTS OF OSTEOARTHRITIS ON

THE KNEE JOINT

EFFECTS OF OA KNEEThe cartilage becomes thin and worn away especially where more weight is borne

EFFECTS OF OA KNEE

• The joint space becomes narrower allowing less space between the bones for movement.

• Increased stress/load on the ligaments and muscles and the capsule may lead to inflammation (swelling). The capsule may become thickened.

EFFECTS OF OA KNEE

• New bone forms at the edge of the joint which can be quite rough (osteophytes).

EFFECTS OF OA KNEE

• Cartilage may fragment to give loose pieces causing symptoms of locking or giving way of the knee.

EFFECTS OF OA KNEE• The inflammation and

swelling may cause pain. • Decreased mobility due to

pain/ aching and fear of making the knee worse may lead to muscles wasting and weakening, therefore causing more stress and decreased protection to the knee joint.

• The knee becomes stiff as it is moved less through its available range of movement.

Grades of OA KNEE

OTHER CONDITIONS ASSOCIATED WITH OA KNEES

• PATELLOFEMORAL PAIN SYNDROME• SCIATICA• FLAT FOOT/ PRONATED FOOT• TRAUMATIC ARTHRITIS• MENISCAL/ ACL/PCL LIGAMENT TEAR.• OBESITY• FAULTY POSTURE.

PHYSIOTHERAPY ASSESMENT IN

OSTEOARTHRITIS OF KNEE

PHYSIOTHERAPY ASSESMENT

o Chief Complains (Functional Problems)

o Tightness / Weakness

o Hip Musculature Tone / Strength

o Foot posture

o Gait Problems

o Proprioception

o Daily functional activity restriction.

BIOMECHANICS

CHIEF COMPLAINS

Area of Pain

Pain Scale

What Activities Cause/ relieve Pain

Problem since how many Days / Months / Years

Daily Routine (Job / Housework)

Clicking / Locking of Joint

Swelling / Temperature

BIOMECHANICS-(TIGHTNESS/ WEAKNESS)

• When muscles around knee & thigh are tight they

are not able to contract to their full capacity, as a

result over a period of time the become weak as

well…hence the term tight / weak muscles

• Such problems in turn results in deformities and

other complications like knock knees, bow legs,

abnormal gait

BIOMECHANICS (HIP MUSCULATURE / TONE)

(BIOMECHANICS)FOOT POSTURE

BIOMECHANICS (ABNORMAL GAIT)

PROPRIOCEPTION

DAILY FUNCTIONAL ACTIVITIES

• Squatting• Climbing up.• Descending stairs• Getting in and out

of the car• Walking or

standing for log time

• Sitting cross legged.

• Early morning stiffness.

POSSIBLE TREATMENTS

• Physiotherapy rehabilitation• Aids• Medication• Surgery

Physical Therapy Treatment Options

• Preventive Strategies • Joint Mobilizations• Taping• Knee Braces & Stick• Foot Posture Corrections & Footwear Change• Gait Rehabilitation• Accupuncture / Soft Tissue Release• Ergonomic Analysis & Correction• Basic Rehabilitation (4 Weeks)• Advanced Rehabilitation (8 Weeks)

PREVENTIVE STRATEGIES• Any kind of physical activity (Climbing Stairs / Walking /

Jogging / Cycling / Yoga / Gym / Swimming / Sport)• Use good footwear with arch support• Avoid roaming around bear foot in house• Every time you want to pick something from ground, try

and squat in a right manner• Whenever a tiring day in office / house…. stretch your

body before going to bed• Use a stool / small table to alternate weight shift if u have

to stand for long hours• Consult a physical therapist whenever minor / major

problems

JOINT MOBILIZATIONS

• Improve Joint Mobility• Improve Blood Flow In The Joint

TAPING• Helps in Improving

Alignment

• Used in Pain Relief

• Reduces Swelling

• Prevents Excessive Movement

Knee Braces & Stick

Foot Posture Correction

GAIT REHABILITATION

Accupuncture / Soft Tissue Release

Ergonomic Analysis

BASIC REHABILITATION PROGRAMME

FOR 1 MONTH /FIVE TIMES A WEEK/ TWICE A DAY

FIRST WEEK

• NON WEIGHT BEARING EXERCISES• STRETCHING• JOINT MOBILIZATIONS• FOOT POSTURE CORRECTION• WEIGHT CONTROL MEASURES• ORTHOTIC AID/ TAPING• ACCUPUNCTURE/ SOFT TISSUE RELEASE

2ND WEEK

• STRENGTHENING EXERCISES• STRETCHING• ACCUPUNCTURE/ SOFT TISSUE RELEASE• CARDIO (SWIMMING/ CYCLING)• FOOTWEAR ASSESMENT AND MODIFICATION

3RD & 4TH WEEK

• STRENGTHENING AND WEIGHT BEARING EXERCISES

• FUNCTIONAL REHABILIATATION• ACCUPUNCTURE/ SOFT TISSUE RELEASE.• CARDIO EXERCISES• POSTURE ASSESMENT AND CORRECTION

ADVANCED REHABILITATION(2 MONTHS/ 3 DAYS A WEEK)

• STRENGTHENING WITH WEIGHTS• BALANCE TRAINING• GAIT REHABILITATION• CARDIO (SWIMMING/ CYCLING)• REGULAR STRETCHING• FULL BODY MASSAGE (ONCE A WEEK)• ACCUPUNCTURE/ SOFT TISSUE RELEASE

Any Questions ?