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  • Writer's pictureMatt Kurz PT, DPT

Get Ahead of your Knee Pain

Exercises for Osteoarthritic Changes in the Knee


Amidst the coronavirus pandemic, there is more need than ever to find ways to manage your knee pain at home and without surgery. Knee Osteoarthritis (OA) can cause chronic pain, reduced function, and diminished quality of life. While there is no cure for knee OA, it is absolutely manageable through individualized and specific exercise programs. Through regular exercise, you may be able to limit the effect OA has on your life.


 

What is Knee Osteoarthritis?

Osteoarthritis can affect any joint. OA progressively wears away the amount of the cartilage within the joint. The cartilage in your knee provides cushion and support, helping to evenly distribute the load transferred through the knee during various activities. When the cartilage is worn, it causes rubbing of the femur (thigh bone) and tibia (shin bone) sometimes stimulating the bone to grow as the body tries to repair itself. This however does not always work, and often the new bone in these joint spaces grows abnormally and becomes misshapen, making the joint even more painful.



Why Should I Exercise if I have OA?

Exercise can improve or maintain muscular strength and body weight. Improved muscular strength can help control forces around the joint, creating stability and decreasing the negative stresses or loads which elicit a pain response. Exercise can also help keep us achieve or maintain healthy body weight. Being overweight or obese creates an excessive load on joints, accelerating the degenerative changes and exacerbating pain. It has been shown that exercise in the setting of OA provides similar pain relief as simple analgesics and non-steroidal anti-inflammatory drugs.



What Muscles Should I Target?

While it may seem counterintuitive, the first muscles that should be considered when trying to alleviate knee pain are actually located in the hip. This includes your “butt muscles” or the gluteals (hip extensors, hip abductors, and hip external rotators). The hip extensors, when firing properly, are some of the strongest muscles in the body. As we age, we tend to underutilize this muscle group while simultaneously over-developing our hamstrings. Relying on the hamstrings rather than the glutes to create hip extension can alter the forces in the knee, which can progress or initiate the osteogenic processes. The glutes are also important in reducing medial forces in the knees (knock knees). Strong hip abductors and external rotators prevent abnormal forces on the joint surface and help to evenly displace weight and load through the knee, resulting in a reduction of the negative stress on the joint surface.


The second muscle group to focus on to reduce knee pain are the “thigh muscles” or quadriceps. The quads have been shown to be important in prevention and alleviation of osteoarthritic knee pain. The quadriceps cause extension (straightening) of the knee and eccentric flexion of the knee or the gradually lowering when sitting or squatting. The quads are responsible for controlling your body weight as your foot strikes the ground when walking or going down stairs. Having strong quads will allow the muscle to control and alleviate excessive forces on the knee while walking or performing stairs.


 

The Exercises

These three exercises are classics as they are simple, effective, and easy to progress. Check out our instagram (@wmphysicaltherapy) for easy progressions. As always, muscular change takes time and some dedication. Don't expect these exercises to change your symptoms over night. We encourage you to get in touch with us for a fully customized plan to improve your knee health!



1) Supine Bridge

Setup: Begin by lying on your back with knees bent and feet firmly planted on the floor.


Movement: Contract your core (see previous blog post for techniques for this contraction) and slowly lift your hips off the floor into a bridge position, keeping your back straight and squeezing your

glutes (butt muscles). Hold for a moment then slowly lower down.


How much and how often: Start with 2 sets of 10 repetitions daily.







2) The Clamshell

Setup: Begin by lying on your side with your knees bent and your hips and shoulders stacked.


Movement: Contract your core and raise your top knee up toward the ceiling. Hold for a brief moment than slowly bring the knee back to the starting position and repeat. Try to keep your hips "stacked"

not allowing the pelvis to roll backwards or forward as this will shift the focus of the exercise to different musculature.


How much and how often: Start with 2 sets of 10 repetitions daily.






3) Eccentric Sit to Stand

Setup: Begin standing upright in front of a chair or bench.


Movement: Engage your core and tighten your gluteals (butt muscles). Slowly lower your body over a count of 5 seconds to a seated position. During the lowering movement, your weight should be focused over your heels, keeping the knees behind the toes, and the back straight with your chest up. Then return to the standing position.


How much and how often: Start with 2 sets of 8-10 repetitions daily.




























 

*Disclaimer: This is general information. No guarantees of results are made without the supervision and direction of a physical therapist. We encourage you to get in touch with us for a specific home program tailored to your individual needs.

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