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Osteoarthritis of the Hip or Knee
Osteoarthritis is the wearing away of the cartilage that covers the end(s) of the bone(s) that form a joint. As our baby-boomer generation ages it is inevitable we will show some wear and tear on our joints. One of the most common ways this will appear is through pain in our hips or knees. These two joints take a significant portion of our body's weight and are highly used for many daily, work, and leisure activity's. At times the source of this pain can be a trauma such as a fall, but more often it may be due to recent overuse through too much activity or exercise. It can also just be the accumulation of years spent doing sports or work that may have abused the hip and knee joints.
Quite often people suffering with these issues will see their primary care doctor or even a specialist such as an orthopedist. X-rays will be taken and findings often show a mild, moderate or even severe osteoarthritis of the joint. Typically upon hearing this news the sufferer feels shock and dismay that their once active life is now doomed to relative inactivity or the worst thought.. joint replacement.
This is a time to keep a cool head and realize one thing. If the affected hip or knee didn't't hurt one week, one month, or six months ago, how could it have become arthritic so quickly. The answer is, it didn't't become arthritic and worn down quickly. If an x-ray had been taken 6 months previous it is highly likely that it would have looked exactly the same as it does present day. The pain being felt is due to inflammation of the joint not due to the changes in the x-ray.
The important thing we can take away from this is the following. "If my knee was arthritic months (or more likely several years earlier) and I did not feel any pain, it should be possible to reduce the inflammation enough so that my pain decreases to the point where I can once again do the things I enjoy doing". This is absolutely true, but takes some expertise to achieve.
And that's where we come into the picture. The first step is to have a thorough evaluation done. We need to know what the joint is able to do or not to do. For example, can it move through a normal range of motion, (if the opposite hip or knee is unaffected that is our measure of normal). Secondly, what structures of the knee or hip are limited or involved? Is it the cartilage, ligament, muscle bone, bursa? It could be one or more of these. Third and very importantly with these joints specifically, how much weight can they comfortably take with a limited amount of pain.
Getting this information gives us a starting point that we can use for future reference. A way to gauge the joints' improvement.
A normal hip and knee has basically two important functions. First it must move through a normal amount of motion. Second it must be able to bear a normal amount of weight to make daily activities and sports pain-free.
A physical therapy program for this type of problem must be individualized for each patient in order to not do too much or too little. In addition, there should not be any significant pain associated with the treatment or exercise portions of physical therapy. And, the pain should not be felt either during therapy or even for 24 hours after therapy.
If the program has been optimally designed and the patient compliant, typically, in a matter of weeks improvements should be seen in the knee or hip in terms of pain, motion, and amount of exercise (weight-bearing) tolerated. Once this has been achieved a specific home or gym exercise program is then prescribed in order to maintain this function and prevent future re-injury.
The hip and knee are beautifully constructed joints that are able to do huge amounts of work over the course of our lives. Although wear and tear over the decades will occur for many, a diagnosis of osteoarthritis does not have to mean a rocking chair existence. Today, with physical therapy, medication, and education, most if not all osteoarthritis sufferers can move past the pain and back into active, productive lives.
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