Physical Therapy For Knee Pain That Also Helps Arthritis

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Physical therapy is the safest, lowest risk and most cost effective treatment for knee pain and arthritis.

A recent study questions the efficacy of arthroscopic surgery for osteoarthritis of the knee. This is encouraging to patients and they should seek physical therapy for their condition, which is an effective non-surgical treatment choice for arthritis of the knee and knee pain. The study, titled “A Randomized Trial of Arthroscopic Surgery for Osteoarthritis of the Knee” was published in the September 11 issue of the New England Journal of Medicine (NEJM).

The study found that physical therapy, combined with comprehensive medical management, is just as effective at relieving the pain and stiffness of moderate to severe osteoarthritis of the knee as surgery.

This study offers hope and encouragement to persons with osteoarthritis who would like to avoid the pain and emotional toll of surgery. Many times the first option presented is surgery when there are other less invasive and more conservative options available. Physical therapy can be equally effective and should be the primary treatment option considered by not only patients, but also primary care and orthopedic physicians.

Many times knee pain is associated with a movement dysfunction at the hips or foot/ankle and these abnormal movement patterns can cause increased stress on the knee joint. Arthroscopic surgery does little to correct the dynamic factors that may be contributing to knee pain and pathology. These findings reinforce the need for a comprehensive, whole body, treatment approach for such patients.

This recent study in the NEJM adds to the growing body of evidence supporting physical therapy for treatment of osteoarthritis of the knee, including:
* A report published in the January 2008 issue of the journal Physical Therapy that reviewed research on osteoarthritis of the knee from 2000 to 2007 and found “high-quality evidence that exercise and weight reduction reduce pain and improve physical function.”
* A study published in the Feb 1, 2000 issue of the Annals of Internal Medicine that concluded “a combination of manual physical therapy and supervised exercise yields functional benefits for patients with osteoarthritis of the knee and may delay or prevent the need for surgical intervention.”

A physical therapist will perform a thorough examination, including hands-on assessment, and design an individualized plan of care that may include:
* Passive soft tissue and joint mobilizations, including myofascial release, to release restrictions that create an unbalanced postural alignment.
* Evaluation of the foot and ankle to determine if prescription orthotics to wear in your shoes
* A series of exercises designed to help improve motion and improve muscle strength. Including walking, swimming, flexibility exercises and a functional progression of activities to simulate normal stresses on the knee.
* Most importantly you should learn self-treatment techniques so you can extend the benefits of your sessions by taking care of the whole body independently. Learning to reduce and minimize symptoms at home is an important aspect of physical therapy.

A knee’s tolerance for stressful activities often decreases with age and loss of conditioning. As a result, stresses that would not have caused pain or injury to the knee last year could today. A decrease in levels of activity over a period of time may also contribute to the vulnerability of knees.

There are steps one can take to help prevent injury and continue to enjoy participating in sports and exercise. Participating in a regular exercise program designed by a physical therapist can be one of the best ways to prevent injury.

The first step in designing your exercise program is an evaluation by your physical therapist. He or she can identify your predisposing factors, those body traits that may make you more or less at risk to a knee injury. Based on this evaluation, your physical therapist can create a customized routine that will help you reach your optimum levels of function, strength and conditioning.

In many states you can see your physical therapist directly, without a referral from your physician. This is called Direct Access, and allows you to seek treatment for your condition today, get better faster, spend less money, feel great and return to the activities you enjoy. You can search for a manual physical therapist at http://www.apta.org or when you call the physical therapy practice of your choice, ask if they provide hands-on manual physical therapy.

Physical therapy plays a key role in treating and rehabilitating the knee, and the patient’s participation in their own recovery plays a big factor in achieving a successful outcome. For more information on taking care of your knees, visit http://www.moveforwardpt.com

Aaron LeBauer PT, DPT, LMBT is a Doctor of Physical Therapy and a Licensed Massage and Bodywork Therapist. He owns LeBauer Physical Therapy with his wife Andra in Greensboro, NC and specializes in treating people who want to return to a pain free and healthy lifestyle. Visit www.LeBauerPT.com
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