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Non-Operative Management of Arthritis with Dr. Ronald Hillock- Part Three

Ronald W. Hillock, M.D.

Non-Operative Management Option 3: Exercise through Physical Therapy

Osteoarthritis is one of the most common conditions I am asked to evaluate and treat. It is estimated that 27 million Americans are currently living with the pain of osteoarthritis. Patients seeking treatment for the arthritis represent about 25% of all visits to primary care clinics 3. Globally there are about 250 million who live with the daily pain of Osteoarthritis (OA), which is roughly 3.6% of the world’s population 4. If you or a loved one has been diagnosed with Osteoarthritis of the knee or hip (or both) there are several non-operative medical treatment options that should be used before considering surgery.

Exercise is key to our overall health in all phases of our lives 3. In the face of arthritis we can achieve several goals through the use of a therapeutic exercise program 4, 5. The goals of physical therapy when treating arthritis focus on the following areas: flexibility, strength, endurance, and education.

Flexibility

Increasing range of motion is key to improving the symptoms of arthritis. Through exercises like stretching large muscle groups like the hamstrings, calf (gastrocnemius and soleus), and quadriceps, flexibility can be improved. It is important to have these stretches demonstrated my a professional before trying them on your own to ensure proper execution.

Strength

It is important to provide joints with balance and strength. Increasing the strength of the muscles surrounding a joint will help to provide support with the goal to decrease pain and force to the joint. Ways to improve strength of the hips and knees are utilizing strengthening exercises like the straight leg raise, quadriceps sets, seated hip marches, pillow squeeze, heel raise, and side leg raise. Like flexibility exercises, strengthening should also be monitored by a professional to ensure proper mechanics.

Endurance

The goal of endurance is to improve your stamina. By improving your endurance, daily activities can become easier to perform. Physical therapy will use exercises like moving from a sitting position to a standing position, balancing on one leg, step ups, and utilizing activities like swimming, water aerobics, and biking to improve your endurance.

Education

While visiting physical therapy, you can learn to properly utilize assistive devices like a cane, walker, or crutches. The purpose of these devices is to help alleviate pressure and force to your joints while assisting with balance. However; if these devices are used incorrectly they have an opposite effect of potentially causing discomfort to your body. It is vital to learn the proper use of these devices and education in physical therapy will help to identify proper use.

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References

1. “Table 9: Estimated prevalence of moderate and severe disability (millions) for leading disabling conditions by age, for high-income and low- and middle-income countries, 2004”The Global Burden of Disease: 2004 Update. Geneva: World Health Organization. 2008. p. 35.

2. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M et al. (December 2012). “Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010”. Lancet 380 (9859): 2163–96. doi:10.1016/S0140-6736(12)61729-2PMID 23245607

3. http://www.webmd.com/osteoarthritis/knee-pain-14/slideshow-knee-exercises

4. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2743580/

5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3568719/

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