This week on the blog, we’re discussing something I see VERY often working with seniors in the community: osteoarthritis (also known as OA) of the knees or hips.
When I meet someone who has experienced years of struggle with OA, I wish I could have reached them when their pain first started. There are some big mistakes that almost client with OA I see has made. If these mistakes were avoided, clients could have helped themselves significantly by more effectively managing their pain, reducing the amount of further joint degeneration, and maintaining their strength, mobility, and function.
An excellent resource for information about OA is the Arthritis Society. Check out their site here for background including risk factors, diagnosis, and treatment for OA
Mistake #1: Wait for an MRI and/or specialist appointment to take action
Most of my clients are diagnosed by their family doctor when their OA is in the mild-to-moderate stage. Sometimes, your family doctor will order some tests (Xray, diagnostic ultrasound, or MRI) and/or make a referral to a specialist such as a rheumatologist or orthopaedic surgeon.
Ideally, the family doctor would make the first referral to a physiotherapist, but this doesn’t always happen. And so often people tell me “I will start physiotherapy once I see the specialist/get my MRI” which, in Canada, can take months.
There is a huge advantage, however, to starting physiotherapy as soon as possible. A tailored exercise programme will help prevent muscle atrophy and the progression of joint stiffness. And your physiotherapist may also apply treatments such therapeutic modalities, hands-on therapy, or acupuncture, to reduce your pain. Why wait??
Mistake #2: Stop all exercise
This is one time human intuition can get things dead wrong. On the surface, I can understand your thinking: if it hurts to move, stop moving… right?
WRONG. While overdoing things isn’t the right way to go (see mistake #3) it is essential that you continue moving your joints and muscles as much as possible.
Joints require movement to be healthy. Without regular movement, joints stiffen, connective tissues tighten, and muscles start to atrophy. All of these changes will serve to worsen inflammation and joint degeneration.
Additionally, when arthritis pain limits activity, people usually start to gain a little “extra” around the middle. Carrying excess weight on your frame will exponentially increase the amount of stress on your load bearing joints (hips, knees, ankles).
I empathize with clients caught in this vicious of weight gain and increasing pain. My advice and start a gentle exercise programme (ideally under the supervision of a physiotherapist) as soon as possible. A physiotherapist can help you, at whatever your stage of OA, develop a safe exercise programme for joint mobility, strength, and weight management.
Mistake #3: Push through the pain
Conversely, continuing all usual activity and exercise while ignoring pain is a recipe for disaster. “Pushing through” pain is a sure way to exacerbate your joint inflammation and degeneration. If you have OA and are working with a health or fitness professional who uses the phrase “No Pain No Gain”- find yourself a different professional!
Listen to your body! Often by changing one or more aspects of the activity (type, intensity, duration, frequency, footwear, etc) you can continue on, pain-free.
Pursue a routine that incorporates cardiovascular exercise, gentle strengthening, and light stretching. Doing 3-5 gentler workouts per week will be easier on your joints that 1 or 2 intense sessions.
Mistake #4: Expect surgery to be a quick fix
This common mistake is closely related to mistake #1. Many people decide to skip the whole physiotherapy route, wanting to wait to see a surgeon who will “fix the problem once and for all.”
I understand this thinking. I do. However, I have some news that may come as a surprise. Having hip or knee surgery is not a shortcut to avoid physiotherapy. Quite the contrary. Proper rehabilitation from joint replacement surgery requires many months of dedicated daily exercise.
A relatively new concept, embraced by many specialists, is “prehabilitation,” a course of physiotherapy BEFORE surgery to maximize strength and flexibility. Studies show a compelling link between rehabilitation and better surgical outcomes. And, you’d be surprised at the number of clients I see who, after 6-8 weeks of “prehabilitation,” lose a little weight, build up some strength, and end up cancelling their surgery. And those who do go end up having surgery certainly reap the benefits of their hard work.
By avoiding these 4 common mistakes, you can more effectively manage your knee or hip OA in the long term. Please feel free to leave a comment if these suggestions are helpful to you!