KNEE OSTEOARTHRITIS PHYSICAL THERAPY

Our knees get a lot of wear and tear, so here are some exercises and information about osteoarthritis in the knee by Ashley Misitzis PT, DPT. If you have any questions, come to San Diego Sports Physical Therapy today for help!

Knee osteoarthritis is one of the leading causes of disability among adults.

Osteoarthritis, known as OA, is characterized by degeneration of cartilage and bone, which cases pain, stiffness, decreased motion and weakness that can lead to difficulty with daily activities. There is no cure for OA, but effective treatment involves managing symptoms and addressing functional limitations. Physical Therapists are licensed health care professionals who are experts in the way the human body moves. Physical therapy uses researched treatment techniques to improve mobility, reduce pain, restore function and prevent disability. Want to improve your health? Learn more about LIVESTRONG.COM’s nutrition and fitness program!

RANGE OF MOTION
According to the CDC, Approximately 80 percent of patients with OA have some degree of movement limitation. Normal knee range of motion is zero to 135 degrees, though there is some variation from person to person.

Your knee must get all the way straight for typical walking mechanics, and must bend normally to allow for sitting and going down stairs. A Physical Therapist will improve your range of motion through direct measures, such as bending and straightening your knee, and will give you home exercises to focus on movement. Indirectly, helping to decrease pain and restore normal joint mechanics also improve your range of motion.

STRENGTHENING
When your joint is damaged, your body needs as much support as it can get from muscle strength. The first step is making sure the muscles directly surrounding the affected knee joint are strong. If you only have arthritis in one knee, then it is also important to strengthen the muscles in the other leg to help support the injured side and to prevent excess force on the healthy knee.

Your hip and ankle strength is also important to provide support to the knee with OA. During your physical therapy evaluation, your physical therapist will determine what muscles need strengthening. The earlier you seek treatment, the less likely you will have muscle strength changes, which improves the outcome.
STRETCHING
Many muscles in the leg cross over the knee joint, so ensuring they are flexible is an important part of the physical therapy process. When pain causes a decrease in your range of motion, it is normal for your body to change how it moves in order to compensate for weak muscles or lessen the pain. This compensation can cause tightness in muscles surrounding the knee including the calves, hamstrings, and quadriceps.

Other muscles may also need stretching depending on what the physical therapist finds during her evaluation.
MANUAL THERAPY
Manual therapy is a physical therapy treatment that involves skilled, specific hands-on techniques that mobilize the joint. These can be used to decrease pain, increase range of motion, lessen soft tissue swelling and improve tissue extensibility. In recent studies, the addition of manual therapy to an exercise-based physical therapy program resulted in dramatically improved function and less pain.
MODALITIES
According to the Arthritis Foundation, both heat and cold treatments are effective for pain management. Heat is best before an activity or in the morning to increase blood flow and decrease stiffness. Use cold treatment after exercise or at the end of each day to lessen swelling and pain. Use each modality for 10 to 15 minutes at a time.

REFERENCES
Centers for Disease Control and Prevention: Osteoarthritis Arthritis Today: Osteoarthritis: Using Heat and Cold for Pain Relief Move Forward PT: Facts Annals of Internal Medicine: Article by Deyle, G. American Academy of Family Physicians: Physical Therapy and Exercise for Osteoarthritis of the Knee
Article reviewed by Helen Holzer Last updated on: Aug 16, 2013

Read more: http://www.livestrong.com/article/178813-knee-osteoarthritis-physical-therapy/#ixzz2e88YONSq

Exercise for Osteoporosis

Bone health is an important aspect to healthy living! Look at this article featured in WebMD reviewed by James E. Gerace, MD to learn more about exercising for Osteoporosis. Visit us at San Diego Sports Physical Therapy for more PT information today!

One of the best ways to strengthen your bones and prevent osteoporosis is by getting regular exercise. Even if you already have osteoporosis, exercising can help maintain the bone mass you have.
Super Foods for Your Bones

The Reason for Exercise for Osteoporosis
Why do health experts recommend exercise for osteoporosis? When you exercise, you don’t just build muscle and endurance. You also build and maintain the amount and thickness of your bones. You may hear health professionals call this “bone mass and density.”
Three types of exercise for osteoporosis are:
• Weight-bearing
• Resistance
• Flexibility
All three types of exercise for osteoporosis are needed to build healthy bones.
Weight-bearing Exercise for Osteoporosis
Weight-bearing means your feet and legs support your body’s weight. A few examples of weight-bearing exercise for osteoporosis are:
– Walking
– Hiking
– Dancing
– Stair climbing
Sports like bicycling and swimming are great for your heart and lungs. However, these are not weight-bearing exercise for osteoporosis. That’s because you are being held up by something other than your feet and legs, such as the bicycle or the water.
Walking as little as three to five miles a week can help build your bone health. For general health, most experts recommend that everyone get at least half an hour of moderate to vigorous exercise five times a week. Forty-five minutes to an hour is even better.
Resistance Exercise for Osteoporosis
Resistance means you’re working against the weight of another object.Resistance helps with osteoporosis because it strengthens muscle and builds bone. Studies have shown that resistance exercise increases bone density and reduces the risk of fractures.
Resistance exercise for osteoporosis includes:
• Free weights or weight machines at home or in the gym
• Resistance tubing that comes in a variety of strengths
• Water exercises — any movement done in the water makes your muscles work harder.
You can find instructions for safe exercises online. Once source is the CDC http://www.cdc.gov/nccdphp/dnpa/physical/growing_stronger/). Another source is the National Institute on Aging (http://www.niapublications.org/exercisebook/chapter4_strength.htm).
For best results, do resistance exercises two or three times a week. Make the exercise more challenging by gradually adding weight or repetitions. Work all your different muscles — including arms, chest, shoulders, legs, stomach, and back. Be sure not to do resistance training on the same muscle group two days in a row. Give each muscle group time to recover.
Flexibility Exercise for Osteoporosis
Flexibility is another important form of exercise for osteoporosis. Having flexible joints helps prevent injury.
Examples of flexibility exercise for osteoporosis include these:
• Regular stretches
• T’ai chi
• Yoga

Making Exercise for Osteoporosis Safe
Many people worry about the safety of exercise later in life. You may be concerned if you already have osteoporosis or osteopenia. Perhaps you have never been very physically active. Whatever your concern, you can choose from a range of safe exercise options.
To ensure your safety during exercise for osteoporosis, keep these guidelines in mind:
– Talk to your doctor before beginning any exercise program. This is especially important if you know you have bone loss or osteoporosis.
– Weight-bearing exercise does not have to be high impact. Running, jogging and jumping may put stress on your spine. These high-impact activities may lead to fractures in weakened bones. If you already have bone loss, choose gentler weight-bearing exercise like walking, dancing, low-impact aerobics, and gardening.
– If you already have osteoporosis, be careful of exercises that involve bending and twisting at the waist. This motion can put you at risk of fracture. Exercises that involve waist twisting include sit-ups, toe touches, and rowing machines. Golf, tennis, bowling, and some yoga poses also include some twisting at the waist. Talk to your doctor before choosing any of these activities.

Bone Health

Whether or not you know this, bone health has a lot to do with mobility! Take a look at this article from MoveForwardPT to learn more about the different aspects of bone health and how to prevent injury.

Physical therapists are experts in improving and restoring mobility and play an important role in ensuring optimal bone health. Healthy bones can help you stay strong and active throughout your life. If good bone health is achieved during childhood and maintained, it can help to avoid bone loss and fracture later in life. For healthy bones, it is important to maintain a physically active lifestyle and eat a balanced diet with plenty of calcium, vitamin D, and perhaps other supplements as needed. Physical therapists can design a unique program for you to help keep your bones healthy.

Osteoporosis is a common bone disease that affects both men and women (mostly women), usually as they age. It is associated with low bone mass and thinning of the bone structure, making bones fragile and more likely to break.

Some people are more at risk for osteoporosis than others. Not all risk factors can be changed, but healthy habits and a proper exercise routine designed by your physical therapist can keep bones healthy and reduce risk. Risk factors* include:

Age: More common in older individuals
Sex: More common in women
Family History: Heredity
Race and Ethnicity: Affects all races. In the US, increased risk for Caucasian, Asian, or Latino
Weight: Low body weight (small and thin)
Diet, especially one low in calcium and vitamin D
History of broken bones
Menopause
Inactive lifestyle
Smoking
Alcohol abuse
Certain medications, diseases, and other medical conditions

Physical therapists can help prevent osteoporosis and treat its effects by designing individualized exercise programs to benefit bone health, improve posture, and enhance core stability and balance. Most of these exercises are simple and can be done at home with no special equipment.
Fight Fracture with Fitness

Inactivity is a major risk factor for osteoporosis. The right exercises and good habits can keep bones strong and prevent or reverse the effects of osteoporosis. Weight-bearing exercise, such as walking, is an important way to build and maintain healthy bones. Muscle strengthening exercises have been found to stimulate bone growth and can help prevent and treat osteoporosis. These types of exercises are best if started early in life and done regularly. However, it is important to remember that you can begin exercising at any age and still reap great benefits.

If you have osteoporosis, are at high risk for a fall or fracture, or have a medical condition, affecting your ability to exercise, do not begin an exercise program without first consulting your physician and a physical therapist.

Avoid exercises and daily activities, which round the spine, such as sit-ups, crunches, bending down to tie your shoes, exercise machines that involve forward bending of the trunk, and movements and sports that round and twist the spine.
Benefits of Good Balance

Preserving balance and stability with exercises can help reduce falls and resulting fractures. Exercises that improve posture, core stability, balance, and coordination, can also protect the spine against compression fractures. An individualized program may include a walking regimen, Tai Chi, and other exercises geared toward conditioning, balance, and coordination.
Bone Health Begins With Good Posture

Physical therapists recommend good posture and safe movements to protect bones from fracture during daily activities. Using proper posture and safe body mechanics during all activities protects the spine against injury. Here are some tips:

Keep your back, stomach, and leg muscles strong and flexible.
Keep your body in alignment, so it can be more efficient when you move.
Do not slouch. When sitting, keep your spine and head straight. Put a small pillow behind your waist to keep your spine in a good position.
Use good body positioning at work, home, or during leisure activities.
When lifting or bending forward, bend your knees, keep your back straight, bend forward at the hip crease, and lift with your legs. Keep the load close to your body.
Ask for help or use an assistive device to lift heavy objects.
Maintain a regular physical fitness regimen. Staying active can help to prevent injuries.

*National Osteoporosis Foundation

Acknowledgements: APTA Section on Geriatrics