Physical Therapy for Knee Osteoarthritis

Physical therapist-guided exercises are best for patients with knee arthritis

Osteoarthritis (OA) is a condition in which cartilage—the natural cushioning between joints—gradually wears away. Over time, this causes the bones of these joints to rub more closely against one another and leads to symptoms like pain, stiffness, swelling, and a decreased ability to move the joint normally.

OA is the most common form of arthritis, and although it can occur in any joint in the body, it’s seen most often in the knees. Knee OA can also occur at any age, but the risk for developing it increases with older age because the body gradually loses its ability to heal the damaged cartilage. This is why about 10% of men and 13% of women over the age of 60 have knee OA. Being obese or overweight also increases the chances of developing knee OA, since the additional weight puts added pressure on the knees and accelerates the damage to cartilage.

Unfortunately, there is no cure for knee OA, but treatments like physical therapy are strongly recommended to reduce patients’ symptoms and help them function better in their everyday lives as a result. Physical therapy treatment programs typically consist of a number of components, such as education, manual (hands-on) therapy, and pain-relieving interventions like heat/ice and ultrasound, but the most important part of treatment is structured exercises.

Since the muscles of the leg affected by knee OA tend to become weaker and less flexible due to symptoms, a specific set of exercises are needed to target these areas. In particular, stretching and strengthening exercises should be performed for muscles of the calves, hips, and those in the front of the thigh (quadriceps) and the back of the thigh (hamstrings). Completing these exercises will help to better support and stabilize the knee, reduce stiffness, and increase fitness levels, which will allow patients to do more and improve their quality of life in the process.

For these reasons, doctors like general practitioners should be referring patients with knee OA to physical therapy for an appropriate treatment program, which research has shown to be a beneficial approach. But according to a recent study, this is not always the case. The study examined the attitudes and beliefs of 5,000 general practitioners regarding the use of exercise for knee OA patients, and it concluded with the following:

While general practitioners’ attitudes and beliefs regarding exercise for knee OA were generally positive, initiation of exercise was often poorly aligned with current recommendations, and barriers and uncertainties were reported.

These results suggest that although most doctors regard exercise and physical therapy in a positive light, many of them are not referring patients to receive these treatments. The reasons for this are not clear but may be related opioids and other treatments being prescribed, which can actually serve as a barrier to knee OA patients’ road to recovery. This is why individuals who are currently dealing with knee OA should see a physical therapist first, as doing so will lead to a faster start to treatments that are intended to help them improve, without delays or obstacles to their care.

Meniscus Tear Treatment in Visalia

If you recently suffered a meniscus tear, and are looking for knee treatment in Visalia, recent research shows we can help.

If you have a meniscus tear and have been told that surgery is the only answer, that’s not accurate.  Surgery is not always necessary after a meniscus tear.  In fact, specific types of tears, called non-obstructive tears, often don’t need any surgery at all.

Background Information About the Knee Menisci

The meniscus is a tough, rubbery, C-shaped piece of cartilage that rests between your shinbone (tibia) and thigh bone (femur) in the knee. Each knee has two menisci (plural of meniscus), with one on the inner and the other on the outer side of the knee. These menisci both serve the same purpose: to absorb shock and stabilize the knee.

Meniscus tears are among the most common knee injuries in sports. Athletes, especially those that play contact sports like football and soccer, have a higher risk of sustaining a tear to the meniscus, but the injury can occur in anyone at any age. In most cases, the meniscus tears as the result of twisting or turning quickly on a bent knee, often when the foot is planted on the ground. Older adults, on the other hand, are more likely to have degenerative meniscus tears after the cartilage weakens and wears thin over time.

Whatever the cause, the symptoms of a meniscus tear are usually quite similar. Some patients experience a “pop” or tearing sensation immediately after the tear, and there will usually be some sharp, intense pain either right away or soon after. This is typically accompanied by stiffness and swelling, an inability to move the knee normally and difficulty walking.

The Knife Is Not The Only Option

If a meniscus tear occurs, many people assume that surgery will be needed to repair it. Although this may be accurate for certain tears and for certain patients, it is not always the case. Treatment for these injuries depends on the size, type and severity of the tear, and in many cases, a patient can recover with conservative (non-surgical) treatment. A major component of conservative treatment for meniscus tears is physical therapy, which usually consists of the following:

  • Ice and compression to control pain and swelling
  • Laser therapy in increase blood flow and to facilitate healing
  • Exercises to strengthen the quadriceps, hamstrings, calf and hip muscles, such as quad sets, heel raises, hamstring curls, knee bends and straight leg raises
  • A home-exercise program consisting of a variety exercises and educational advice to avoid aggravating your knee
  • An optional treatment called neuromuscular electrical stimulation, which applies an electrical stimulus to improve muscle strength of the quadriceps
  • Instructions on how to maintain your fitness and activity levels, and guidance on when you can return to full activity

A recently published study shows how physical therapy compares to surgery and why it should be regarded as a strong alternative option when patients are making treatment decisions. The clinical scientists concluded in their research publication:

Among patients with nonobstructive meniscal tears, physical therapy was not inferior to surgery for improving patient-reported knee function over a 24-month follow-up period. Based on these results, physical therapy may be considered an alternative to surgery for patients with nonobstructive meniscal tears.

Meniscus tears are serious injuries, but as you can see, they do not always require surgery. If you have a meniscus tear and would like to know more about your treatment options, contact us here at Bacci & Glinn Physical Therapy and schedule an appointment.  We are the conservative choice for meniscus tear treatment in Visalia.

Looking for a Knee Pain Specialist in Hanford

If you’re currently dealing with knee pain, you may find yourself in a difficult predicament. Sometimes you need some guidance from a knee pain specialist in Hanford.  If so, this article and a visit with one of our physical therapists can help.

The best—and worst—types of physical activity for your knee pain

You probably want to continue doing the things you love, but when you do, your pain holds you back, and you might be concerned that you’re damaging it even more when you exercise. This situation is common, but as physical therapists, we can assure you that staying active is still very possible and strongly encouraged.

Knee pain is actually the second most common musculoskeletal condition in the general population behind back pain, and its prevalence is increasing as a result of the obesity epidemic and our aging population. Some cases of knee pain develop over time and are classified as overuse injuries, such as runner’s knee and iliotibial band syndrome. In others, though, knee pain results from traumatic injuries sustained in sports, usually as the result of a sudden change in direction or quick weight shift. This can lead to a tear of the meniscus, ACL or some other soft tissue within the knee.

But whatever the cause of the knee pain, it doesn’t have to put an end to your participation in physical activity. All it means is you’ll need to switch to exercises that have less of an impact on your knees while still working out the rest of your body. In turn, strengthening the muscles around the knee joints will protect you from injury by decreasing the stress and protecting them from normal wear and tear.

So if you’re trying to stay active while rehabilitating your painful knee, this list should serve as a great starting point for you:

  • Swimming: any type of water activity, including swimming, is ideal for the knees since it’s low impact; however, the butterfly stroke should be avoided
  • Brisk walking/biking/elliptical machine: the elliptical is a great alternative to jogging, while brisk walking and biking are always smart low-impact option
  • Yoga/Pilates/Tai Chi: if you’re able to get a personal class, tell your instructor about your knee pain, and they’ll be able to personalize your program for you
  • Stretching: the hamstring stretch, quadriceps stretch and iliotibial band stretch all target muscles in your thigh that help stabilize the knees
  • Wear a brace: you should also consider wearing a quality knee brace while performing these activities, which is designed to protect an injured knee and ensure the knee moves in a controlled manner without being constricted; consult with a doctor or physical therapist for help picking out a brace
  • Use insoles: cushioned insoles are also helpful in shoes to reduce stress on knees
  • Avoid: any high-impact exercise or any physical activity that involves sudden stops, starts, pivots or jumps and landings, including jogging, basketball, tennis, soccer, football and racquetball; these activities can make knee pain worse

Physical activity is just one part of the equation, and a comprehensive physical therapy program is also needed to properly rehabilitate most knee conditions. This is why we strongly recommend giving us a call to set up a consultation that will determine the best path forward for you based on your situation and personal goals.

For More Information You can Contact Our Hanford Office at (559) 582-1027

If the the Visalia Office is More Convenient, You can Call Us at (559) 733-2478

Physical Therapy After Knee Replacement in Visalia

Physical therapists play a vital role throughout both before and after knee replacement

Are you looking for physical therapy after knee replacement in Visalia?  If so, this information below might help.  We summarize why seeing a physical therapist pre and post knee replacement is a good idea.

Your knees take on a great deal of impact, especially if you’re actively involved in sports that consist of lots of running, jumping and/or cutting. As a result, the knee is one of the most commonly injured regions of the body, and the most commonly replaced joint. If you’re considering knee replacement surgery, it’s important to realize that physical therapy is a crucial part of the entire process.

Knee replacement surgery—or total knee arthroplasty—is a very popular procedure, but deciding to have it performed should only come after all other options have been unsuccessful. Almost all sources of knee pain should be treated conservatively (non-surgically) first with physical therapy and certain lifestyle modifications. If knee pain continues to be bothersome after attempting various types of conservative treatment, patients should evaluate the option of surgery with their physical therapist and an orthopedic surgeon.

If you’re found to be a good candidate for knee replacement surgery, your surgeon will explain the procedure itself, as well as the preparation and recovery process that will come with it. Physical therapy is integral at all stages, and your physical therapist can help ensure that the surgery is successful by providing evaluation and treatment before and after the procedure.

Before Surgery

  • Your physical therapist will teach you a number of exercises and show you how to walk with an assistive device (e.g. cane or crutches) after the procedure
  • They will also discuss important precautions and adaptations to make at home

Immediately After Surgery

  • Most patients will stay in the hospital for 2-3 days following surgery, and rehab typically begins almost immediately after waking up: your physical therapist will attempt to have you standing up and walking around within 24 hours
  • Your physical therapist will help you with the process of walking with an assistive device again and begin some range of motion exercises

After Being Discharged From Hospital

  • This is when the bulk of your rehabilitation will begin with a program that includes range of motion and strengthening exercises, and body awareness and balance training
  • As you gradually regain your physical capacity and motion, you will start an active recovery process that includes exercises that help will help improve activities of daily living

The benefits of physical therapy after total knee replacement surgery are frequently identified in related research, and in one recent study, it was found to reduce the amount of time patients spent in the hospital after their procedure. The conclusion states:

After total knee replacement, there is low-level evidence that accelerated physical therapy regimens can reduce acute hospital length of stay.

Making the decision to have surgery for your knee pain is a difficult one, and with it, you’ll probably want to do everything you can to ensure a positive outcome and quick return to the things you love. Physical therapy before and after this procedure is one of the best ways to increase the chances of a successful recovery, and this is why we strongly encourage you to contact us for a consultation if you’re considering knee replacement surgery.

If you have any questions about physical therapy after knee replacement in Visalia or Hanford, we can help.

Click here for the phone and address information for each of our clinics.

Runner’s Knee Treatment in Visalia and Hanford

 

We hear it all of the time.  I didn’t know that PT is an excellent option for runner’s knee treatment in Visalia and Hanford.  It’s true…yes, active individuals are at a higher risk for runner’s knee, but also true that physical therapy can address symptoms before they get worse.

If you run or participate in other sports that involve lots of running on a regular basis, you’re putting yourself in a good position health-wise to maintain adequate fitness.  Unfortunately, you’re also placing yourself at an increased for a number of running-related injuries, and a condition called patellofemoral pain syndrome (PFPS) is high on that list.  PFPS can truly dampen your ability to keep staying active, but help is on the way in the form of physical therapy.

The knee consists of two major joints: the tibiofemoral joint, which connects the shinbone (tibia) to the thighbone (femur), and the patellofemoral joint, which connects the kneecap (patella) to the femur.  PFPS—also known as runner’s knee—is essentially an umbrella term used to describe any type of pain that arises from this patellofemoral joint or the area directly surrounding it.  Another way of explaining it is pain at the front of the knee, in and around the patella.

Runner’s knee is regarded as an overuse injury, which means it usually develops due to excessive or repetitive movements that require the use of the knee.  This is why the condition is most common in individuals who are physically active with running or other sports, especially when someone suddenly increases the amount or type of training in their routine.  Other contributing factors include weakness, tightness or stiffness in the muscles around the knee, or an abnormality in the way the lower leg lines up with the hip, knee or foot.

Together, these conditions can interfere with the ability of the patella to glide smoothly on the femur during movement, and this increased friction is what is responsible for the pain and other symptoms associated with runner’s knee.  Patients with runner’s knee typically report feeling pain in or around the patella when walking up or down stairs/hills, after long periods of activity or sitting, or when spending time on uneven surfaces.

These symptoms can certainly make it difficult to keep active or even get through the day without issue, and many patients with runner’s knee have to take time away from their routine as a result.  But physical therapy can actually address these symptoms as soon as they begin and help patients recover before their condition gets any worse.  A typical physical therapy program will include the following:

  • Strengthening exercises
  • Stretching exercises
  • Sport-specific training
  • Taping or bracing if necessary
  • Cross-training guidance to avoid too much time in one sport

Results from a recent review of several studies illustrate just how effective a physical therapy program can be for patients with PFPS:

The studies indicated that manual therapy combined with physical therapy has some effect on reducing pain and improving function in PFPS, especially when applied on the full kinetic chain and when strengthening hip and knee muscles.

So if you’re an active individual and you’ve recently noticed some pain developing around your patella, it could be runner’s knee, and the best way to prevent it from getting any worse is to see a physical therapist right away.

 

Osteoarthritis Treatment in Visalia – Who Should You Call

Wear-and-tear arthritis can be a burden on your daily life, but physical therapy can help.  The evidence is clear.  If you have osteoarthritis and are looking a conservative care, look no more.  For osteoarthritis treatment in Visalia, Bacci & Glinn Physical Therapy is an outstanding choice.  Here’s why.

Many natural changes occur to our bodies as we age, and in most cases, there is not much we can do to stop this process.  Unfortunately, some of these changes make getting around in our everyday lives more of a challenge than we’re used to, and a condition called osteoarthritis (OA) is one prime example that can result from these changes.

OA, also known as wear-and-tear arthritis, is a progressive disease that can affect any joint in the body.  Joints are the area where two bones come together, and the end of each joint is surrounded by a protective layer called articular cartilage, which cushions your bones and protects them from rubbing against one another.

Arthritic Wear & Tear of Your Cartilage is Part of the Aging Process – But There is Hope

During the natural aging process, this shock-absorbing cartilage gradually begins to break down over the course of time.  With less protection, bones come closer and closer together, until eventually they are so close that the joint starts to swell and symptoms begin to develop.  Although OA can occur in any joint in the body, it is by far most common in the knees and hips, since both of these joints bear a great deal of our body weight.  Other factors that are involved in the development of OA are being overweight or obese, bone structure, genetics, strength and physical activity level.

OA affects every part of the joint, including the bone, cartilage, ligament and muscle.  Symptoms vary from patient to patient, but usually consist of the following: pain, stiffness, tenderness and/or swelling, a popping, cracking or crunching feeling, and difficulty getting out of bed, standing up or performing many daily activities

Osteoarthritis is Common in Older Individuals and Here’s How to Overcome It

OA of the hip and knee is quite common in older individuals, but that doesn’t mean you should just live through the pain and allow your life to be affected.  Instead, pursue a course of physical therapy that will target your arthritic joint and teach you how to make changes in your life that will help you overcome your OA.  A typical physical therapy treatment program will include:

  • Stretching exercises
  • Strengthening exercises
  • Manual, or hands-on therapy
  • Pain-relieving modalities like ice, heat and ultrasound
  • Activity recommendations and modifications

To illustrate just how effective physical therapy can be for OA, consider the results from this recent study, which evaluated the use of resistance exercise, an intervention commonly used by physical therapists:

Data from 17 randomized clinical trials including 1705 patients were integrated. The main source of methodological bias in the selected studies was lack of double blinding. The meta-analysis results suggested that resistance exercise training relieved pain (standard mean difference, alleviated stiffness, and improved physical function .

This study restates the same conclusion of many others about of the benefits you can expect when you see a physical therapist for any type of OA.  So if your joints are ailing you and it may be OA, contact one of our physical therapists here in Visalia for an appointment as soon as possible.

Knee Pain Treatment In Visalia

Physical therapy is an ideal approach for any condition that’s causing your knee pain.  Below is a summary of why you might consider our experienced clinicians if you are looking for knee pain treatment in Visalia.  Please read more to find out.

There are Many Options for Knee Pain Treatment in Visalia – Here We Make the Case to See One of Our PTs First

There are certain areas of the body that are just more prone to pain than others, and the knees are one of them.  Ranking behind back pain, knee pain is actually the second most common musculoskeletal condition, and it’s the single greatest cause for disability in people aged 65 and older.  This bothersome pain can interfere with your daily life, make it difficult to complete certain activities and negatively affect your mood.  But just because knee pain is common doesn’t mean there’s nothing you can do about it.

Knee pain can arise from several conditions and may be the result of an overuse injury over time or a single injury.  Knee osteoarthritis (OA) is a degenerative condition in which the protective cartilage surrounding the ends of bones in the knee gradually wears away, causing bones to rub against one another.  Runner’s knee is another overuse injury that’s common in runners, while jumper’s knee tends to affect athletes involved in sports with lots of jumping.  Other examples of overuse injuries that develop over time include iliotibial band syndrome, quadriceps tendinitis and bursitis.

In other cases, knee pain is due to a traumatic, one-time injury.  Athletes involved in sports that require cutting movements like basketball, football and soccer are particularly vulnerable to these types of injuries because they often push the knee to its limits.  Sprains and strains are the most common types of traumatic knee injuries that cause pain, and in extreme circumstances, tears are also possible and require more intense treatment.

The good news is that whatever its cause, most cases of knee pain can be treated non-surgically with a comprehensive physical therapy treatment program.  These programs are designed to reduce pain, restore strength, regain function and make mobility easier, and usually consist of the following:

  • Strengthening exercises to build back the strength of weakened muscles
  • Stretching exercises to increase flexibility of the knee and surrounding structures
  • Ice and/or heat therapy, which will help reduce pain
  • Manual therapy, in which the physical therapist uses their hands to perform a series of techniques to improve the mobility of the knee
  • A home-exercise program to help you retain your improvements

There is a great deal of research that supports the benefits of physical therapy for a range of conditions that cause knee pain.  In one recent study, non-aerobic exercise was used to treat patients with knee OA, and researchers concluded with the following:

 The results showed that the patients with knee OA (osteoarthritis) in exercise group had significant improvement in pain, disability, walking, stair climbing, and sit up speed after treatment at first and second follow-up when compared with their initial status and when compared with non-exercise group.
Reference: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4431424/

Instead of letting your knee pain interfere with your daily life, why not do something about it?  Contact one of our physical therapy clinics for an appointment and you’ll be taking the first important step on your way to a successful recovery.