Patient education

complete patient education about osteoarthritis.

Introduction: It is the diseases of joint that occur as the result of unwanted stress on weight bearing joint of the body. It is characterized by erosion of the articular cartilage and erosion of the bone beneath the articular cartilage(subchondral bone).The most commonest joint it can affect is your knee and hip because these are the weight bearing -0joints in the body and are very much prone for the degeneration.







How it can happen in your joints?

When these joints are under the repetitive stress(prolonged heavy weight bearing),the cartilage(connective tissue) present on contacting surface of the bones forming the joint under goes the process of degeneration(damage) making the contacting surface of two bone rub each other. Rubbing produces a type of friction in between yours bones causing the microfracture. This microfracture heals thus resulting the abnormal bony out growth which is called as osteophytes or spurs.


What sign and symptom you may have?

Pain around your joint that is involved.

Swelling around your joint involved

You may feel instability around your joint involved.

You may feel a grating sensation while moving your involved joint.

There can be stiffness on your joint.

There is decreased range of motion on your involved joint and joint above and below.



Our suggestion to our beloved patients.
Although the sign and symptom are less in the early course of diseases, if it is not taken into account seriously it can completely damage your joint hamper your activities of daily living. Therefore our suggestion to you is that its earlier the care you receive, better the you and your carrier will be.
What the physical therapist can do?
We appreciate that whatever the medicine you take, it can make you better but we are the one who can bring back your strength whatever you lost before. We don’t add years to life but we add life to years.



Why electrotherapy and exercise therapy?


(1)Electrotherapy

ICE: It is used in the acute stage(inflammatory phase) because ice prevents the swelling by constricting your blood vessels. Ice decreases the pain signal from affected area because ice slows the nerve conduction velocity. But is absolutely contraindicated on peripheral vascular diseases. For how much time and what method to be applied, we choose that according to your tolerance and severity of your condition.

Rest: When your joint is under the stress you shouldn’t do such an activity that can further stress your joint. Here the rest means avoiding the weight bearing activities on your joint. You should completely avoid when the condition is too severe. Rest (unloading the joint) also helps to heal the inflammatory process more faster.


Ultrasound: Ultrasound used in physiotherapy is not the ultrasound that is applied to scan the organs of your body. What we physical therapist use is a therapeutic type (Treatment purpose).It has two affect that is thermal and non-thermal. Non thermal affect is used in the early stage of inflammation because it has pro inflammatory influence(healing faster),whereas thermal affect is used in the remodeling or chronic stage of your inflammation(end stage inflammation) just to improve the extensibility of the tissue(ligament, cartilage, muscle that were affected).The dose and time duration is determined by our physical therapist according to your condition and area of the treatment.


Electrical stimulation: The osteoarthritis is also a inflammatory condition. When there is inflammation pain will be there. Pain produces the spasm ( reflex sustained contraction of muscle to resist the motion just to avoid the pain) Spasm is normal phenomenon in body elicited by the muscle after injury or pain to avoid the further movement. But if it occurs for a long time it can result adaptive shortening and atrophy of muscle around the involved joint. Electrical stimulation can produce a painless contraction of muscles and thus prevents the atrophy. Quadriceps (muscles in front thigh) are the muscle that are prone for atrophy (decrease in the muscle size).we concentrate our therapy on this group of muscle.



TENS and IFT: Theses are the modalities we use for pain reduction. Electrode are placed on the area to be treated. Pain reduction also reduces the spasm on your muscles.



Exercise therapy

What ever the electrotherapeutic modalities we discussed creduce your signs and symptoms. Once the signs and symptoms get slower we prescribe you exercises. Only exercises can make you potent enough for activities of daily living. Exercises are not specific and limited and there is no particular exercise for particular exercise in fact exercise are dynamic. Exercises are designed according to patient condition, tolerance, vital signs, occupation and so on. Two person with osteoarthritis can be prescribed different exercises though they have same problem .Its only the physical therapist who can design and prescribe the exercises by using his\her biomechanical knowledge(study of human motion).so we request our patient and their family members not to believe on those person exercise prescription who do not have the knowledge of biomechanics. As we have already mentioned that exercise science is dynamic and one can not directly prescribe without a detailed examination. However there are few important exercises that we can present here.




Isometric quadriceps


This exercise is prescribed by therapist when patient is under the rest and cant move the joint due to pain or spasm on muscles of front thigh.you should lie on your back on the comfortable platform placing the small towel roll under the back part of your knee.Then just try to press that towel by your knee but don’t over press it or use your maximum strength.once your press the towel hold that press for 6 to 10 second .fell the contraction of your front thigh muscle while you press.duration and repetaion of this exercise is prescribed after we under go a detailed examination.


Multiple angle quadriceps:Once you can do a little movement on the knee(bending),then you can progress to multiple angle isometric exercises.At first you have to bend your knee up to the point of tolorence,then stop the movement.Try to press your sole of the foot away from you.hold a press for 6 t0 10 sec then gently release.


Isometric hamstring:hamstring is the group of muscle located on back thigh.Its action is to bend your knee joint (opposite of your quadriceps).There should balance on strength on hamstring and quadriceps because they are opposite in action(as per as Newton 3 law of motion,to each and every action there is equal and opposite reaction).At first you should matian the position like what you did in isometric quadriceps exercise.But the towel roll should be placed at the back of heel and you should press the towel down through your heel.


Free exercises : once you complete most of your range of motion ,we prescribe you a free exercises.These exercises maintain range of motion,promotes the joint nutrition and improves your strength.


Progressive resistive exercises:Here we add heavy weights on against your movements inorder to improve your strength completely.what weight for how long is determind after your detailed examination by our physical therapist.





Home advice


Do not stand for prolonged time period.If you have to stand use the support of the wall or any assistive devices.

Always elevators rather thatn stairclimbing.

Support to the railing and try to transmit some weight through the hand on railing.

Don’t lift or carry heavy weight on you.If you have to lift at any cost then lift from hand of opposite side.

Use western commodes with the adequate height.More the height more better it will be.

Avoid any activities that need sqqating .

Exercise your normal side leg sothat it is capable to compensate the weight bearing of affected limb.

Don’t sit on low height sofas or a chair.(for a normal person it should be distance from heel to popliteal fossa,a dimond shaped deppersion on the back side of knee.)

Don’t forget to exercise your knee even if the pain and stiffness subsides.

Try to maintain straight upright posture in front of mirror.
Visit your therapist for further advices and management