Knee OA is commonly referred to as a condition resulting from “wear and tear”, due to the loss of articular cartilage; the smooth gliding surface between bones. However, it is important to note that changes to the joint itself are a normal part of the ageing process and having knee OA doesn’t mean you need to limit your activity levels.
How will exercise help?
Contrary to what you may think, regular movement is effective at reducing pain and improving function related to knee OA. The reason? Well, our cartilage is mostly made up of water, and regular movement allows for the removal of “dirty water” and the absorption of “fresh water” which helps our joints stay hydrated and healthy. Furthermore, strengthening the muscles surrounding the knee joint is like adding another layer of protection which not only makes us stronger but helps us move more efficiently when performing everyday tasks.
Patellofemoral Pain Syndrome
What is it?
Patellofemoral pain syndrome or PFJPS as it is commonly termed, is anterior knee pain that is often seen amongst active adolescents and adults who are involved in running activities. Other activities that may aggravate symptoms include, but are not limited to, stair climbing and squatting. The diagnosis of PFJPS depends on a combination of both subjective and objective information; for a comprehensive assessment and accurate diagnosis it is recommended that you see a Physiotherapist.
What will help?
Typically, the initial stages of rehabilitation will involve a reduction in workload (running) and modifying some of the irritating movements (squatting, stair climbing). Once the irritation around the knee has settled, a progressive and graded exercise program can assist with returning to the activity or end goal of the individual. PFJPS results from an inability of the supporting structures around the knee to cope with the demand being placed on them (excessive running or other activity). Thus, it is integral to commence exercise rehabilitation to help improve the strength and integrity of the musculature surrounding the knee. This will allow us to return to meaningful activities and our body will now be able to cope with the demands being placed on it thanks to a graded and progressive exercise program.
What is it?
Patellar tendinopathy involves injury to the patella tendon, which connects the knee cap (patella) to the shinbone (tibia). Pain, swelling and stiffness are common symptoms associated with patellar tendinopathy. These symptoms will often present after a dramatic increase in an individual’s training/workload. The recreation of pain is common with movements that involve the quick storage & release of energy such as jumping; hence, the reason behind patellar tendinopathy often being referred to as “jumpers’ knee”. Patellar tendinopathy almost always results from an acute increase in training load.
What will help?
Much like PFJPS, patella tendinopathy results from an inability of the supporting structures around the knee to cope with the demand being placed on them (excessive jumping or other activity). In this case, the structure of interest is the patella tendon. Whilst tendinopathy may be the result of an acute increase in workload, it is important to mention that tendons are responsive to load and they must be loaded in order to strengthen them. A tendon which is shielded from load is actually more likely to become injured than one that is exposed to proper loading.
Because of the pain, swelling, and stiffness that is often present in the early stages of patellar tendinopathy, a reduction in workload and some isometric exercises are commonly prescribed. Isometric exercises (muscle length/range remains the same) are important because they allow for safe loading of the tendon without putting undue stress on the tissue itself. Furthermore, isometric exercises have been shown to elicit an analgesic effect.
Once the pain and inflammation has settled a graded exercise program involving resistance training can be prescribed to assist with improving the integrity of the unaffected regions of the tendon. The exercise program itself will progress according to the pain-limiting symptoms experienced by the individual. After a block of strength training, the final phase involves returning to the previously aggravating activities, such as jumping, in a graded fashion so that we can allow time for the tendon to adapt. Thus, it is important to participate in a graded exercise program to assist with improving the integrity of the patella tendon. Doing so will allow you to return to meaningful activities with greater confidence.
Authored by Bailey Hunt - Accredited Exercise Physiologist