Exercises Continued. What is Osteoarthritis (OA)? Causes of Osteoarthritis. Symptoms

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1 What is Osteoarthritis (OA)? You have been diagnosed as having osteoarthritis of the knees. This is a disease where the cartilage surface of the joint it damaged and the bone around the edge of the joint becomes thicker. This can cause pain, swelling and restriction of movement. It is a common disease and other joints can be affected. Causes of Osteoarthritis Osteoarthritis can develop as a result of trauma to a joint; it is common in the elderly and can run in families. If you are overweight you are more likely to develop osteoarthritis. Excessive high impact exercise and repetitive activities can injure joints and may lead to osteoarthritis. Normal activity and exercise is good for joints and not the cause of osteoarthritis. Exercises Continued Knee Extension 1. Stand with one foot on a step 2. Raise your body up pushing with the leg on the step, straightening your knee 3. Do not raise the other foot onto the step 4. Lower yourself down slowly from the step again Symptoms The symptoms may build up over many months. They include: Pain Stiffness: especially after resting, but wears off once you get moving Grating and grinding : when the joint is moving Muscle weakness: can make walking and stair climbing more difficult Swelling These symptoms vary in intensity for each individual. The symptoms can be limited or improved by exercise and some simple lifestyle changes.

2 Osteoarthritis of the Knees Exercises reprinted from Therapy Skill Builders: A division of Communication Skill Builders, Inc. Patient Information Leaflet \\bedford\data\ghh\physio PC 2\LEAFLETS\anterior knee pain.doc

3 Exercises Continued Isometric Knee Flexion 1. Sit on a chair with your back supported 2. Place one foot against the leg of the chair 3. Push your foot against the leg of the chair, tightening the muscles in the back of your thigh Prevention of Symptoms There is not a cure for osteoarthritis, but the symptoms you get from it can be improved by the following: Fitness By doing simple exercises to strengthen the thigh muscles you can prevent too much stress going through the knee joint by improving its support. Exercises may have already been given to you by your physiotherapist, it is important that you continue them on a regular basis. Taking regular exercise to improve your general fitness will help your general well being and prevent stiffness. However, this needs to be exercise that is not high impact. Exercises are included in this booklet. Weight reduction Hip Adduction 1. Sit on a chair with your back supported 2. Place your knees and feet together 3. Squeeze your thighs together (if you find the side of your knees are sore place a small towel between your knees 4. Hold for 5 seconds the relax If you are overweight you are putting more loading through the joint, for some this can make osteoarthritis of the knee worse. Walking aids Walking sticks can offer good support and relieve pain when weight bearing. You will need to be shown the correct way to use it and have the stick adjusted to the correct height for you. Footwear Flat shoes with support at the top and back of the foot with thick, soft, shock absorbing soles are ideal.

4 Protect your joints Avoid the unnecessary activities that excessively stress the knee joint(s). If needed an Occupational Therapist can advise you on protecting your joints during activities of daily living. Avoid sitting for too long. Little but often is a good policy for pacing activities. Medications Exercises Continued Hip Adduction 1. Sit on a firm surface with your hands behind you for support 2. Straighten both legs and place a rolled towel between your knees 3. Squeeze the towel roll between your knees 4. Hold for 5 seconds and relax Your doctor may prescribe Painkillers, Non Steroidal Anti-Inflammatory Drugs (NSAIDs) or NSAID creams and gels for osteoarthritis. With these medicines you should follow the instructions you have been given by your doctor and not take more than the recommended dose. Injections of Steroids into the joint may be given by your doctor for very painful osteoarthritis. If you are unsure about the medication you are taking you should discuss it with our GP or Pharmacist. Ice Pack/Heat Ice can be applied to the knee to relieve pain and swelling. Wrap some ice or a bag of frozen peas in a damp towel and apply to the knee for minutes. Check the skin regularly and beware of ice burning. Heat can also be applied in the form of a heat pad or hot water bottle. Never use boiling water and always place a towel between the heat source and the skin. Beware of burning. People with diabetes, circulatory problems or those taking anticoagulants (e.g. warfarin) should not use ice or heat. Active Knee Extension 1. Stand at the back of a chair, holding onto the back 2. Bend your knees halfway, taking care to keep your back straight 3. Slowly rise to knees straight again Surgery For severe osteoarthritis, where pain and disability is affecting mobility, knee joint replacement surgery may be considered.

5 Exercises Continued Static Quadriceps 1. Sit on a firm, flat surface with the knee of your uninvolved leg bent and your hands behind you for support 2. Straighten your involved leg as much as possible, tightening the muscles on the top of your thigh 3. Hold for 5 seconds and relax 4. Repeat on the other leg Exercises Continued Hip and Knee Flexion 1. Lie on your back with your legs out straight and relaxed 2. Keep your kneecaps pointed toward the ceiling throughout the exercise 3. Slide one foot toward your buttock, bending the knee and hip 4. Slowly return to starting position Inner Range Quadriceps 1. Sit on a firm, flat surface with your hands behind you for support 2. Place a rolled towel under one leg to bend it about 6 inches 3. Raise the lower part of your leg until your knee is straight Static Hamstrings 1. Recline on your back, resting on your elbows 2. Keep one leg straight, and bend the other to a height of about 6 inches 3. Tighten the bent leg by digging down and back with the heel

6 Exercises Continued Long Arc Quadriceps 1. Sit on a sturdy surface high enough that your feet don t touch the floor 2. Grip the sides of the surface for support 3. Straighten your knee completely 4. Return to starting position and relax Further problems Improvement will take time. It is up to you to make lifestyle changes and continue with your exercises. If, after a period of time, you feel your symptoms are becoming worse, with loss of mobility, pain increasing or your sleep is disturbed, consult your GP. Your GP will advise you on what further action to take. Likewise if you are having problems with regards to your medication you should also see your GP. Useful Addresses Arthritis Research UK Copeman House St Mary s Gate Chesterfield Derbyshire S41 7TQ Gluteal Strengthening 1. Recline on your back, supported by your elbows 2. Keep both legs straight 3. Squeeze your buttocks together as tightly as possible Arthritis Care 18 Stephenson Way London NW1 2HD

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