Do I have osteoarthritis?
Risk factor for osteoarthritis
How to diagnose osteoarthritis?
Red Flags
Relevant medical data
Osteoarthritis problems
How to control osteoarthritis?
Do exercises help against osteoarthritis?
What can I do against osteoarthritis?
Strength exercises osteoarthritis
Stamina exercises
Strength endurance exercises osteoarthritis
Balance exercises
Functional exercises
Hydrotherapy
Tai Chi
Stretching
Understanding osteoarthritis
Alternative treatments
Osteoarthritis physiotherapy Utrecht
Free osteoarthritis training schedule and brochure with tips and tricks
Do I have Arthritis?
Osteoarthritis means a quality decrease of the joint. For example the knee joint is made up of your femur and tibia bone. Cartilage is between the two ends of the femur and tibia bone. The function of cartilage is to smoothen and guide movement in the knee joint. Knee osteoarthritis means loss of cartilage. With a loss of cartilage you get more bone on bone contact. Bone on bone contact makes the body generate more bone in order to substitute the cartilage. This abnormal bone growth is contraproductieve: it leads to pain in the knee and limits the range of motion. and makes the quality of the knee joint worse. The abnormal bone growth misshapes the form of the bone, which leads to instability and pain.
Risicofactoren Artrose
Kenmerken:
Leeftijd: hoe ouder des te meer kans op artrose
Geslacht: onder vrouwen komt artrose vaker voor
Body Mass Index: hoog vetpercentage verhoogt de kans op artrose
Artrose in de familie: is een indicator dat u aanleg voor artrose zou hebben
Botbreuk: als u bijvoorbeeld een keer u knie hebt gebroken, verhoogt dit het risico op artrose in die knie in de toekomst
Diagnostisch test
Heup: Teken van Drehmann
Risk Factors
Osteoarthritis can be due to aging (primary osteoarthritis) or because of too much loading or an injury (secondary osteoarthritis). Arthritis gets worse over time (progressive disease), but the progress could be limited with physiotherapy
Down below a list of risk factors for osteoarthritis.
People older than 45 years old
Obesity
Hypermobility
Instability
Intensive and repetitive loading like playing basketball or construction work
Prior injury
Hereditary
How to Diagnose Arthritis
Evaluating favored natural position of the knee and hip
Evaluation problematic movements and activities: kneeling is painful
Physical examination: temperature, color, swelling, muscle tension
Pain in the knee which gets worse when start moving it after a significant amount of holding still
Stiff feeling of the joints (particularly in the morning longer than 1.5 hours)
Limited range of motion
Inner side of the knee is more often affected than outer side of the knee
Resistance (strength) tests
Stability tests
Drehman Test
Red Flags
unexplainable warmth and swollen (red) knee (bacterial infection);
unexplainable pain in hip and/or knee;
severe knee lock
bulge in groin
pain in rest and swelling (without trauma)
Red flags in case of prothesis
fever
infection
unexplainable pain with high intensity in hip
Relevant medical Data
radiological deformaties of joints
comorbidities
medication
prognosis
Problems
Function
proprioception
pain
mobility
stability
strength
endurance
alignement
(muscle) atrophy
(muscle) hypertension Hoe vaak u artrose oefeningen moet doen, hangt af van welke component van het bewegen u wilt oefenen.
Activities
transfers
walking
standing
sitting
move over
washing
getting dressed
going to the washroom
Participation
work
charity work
social life
recreation
sports
How to control Arthritis?
External factors
care tools
work or sports
facilities
family
friends
health care providers
colleagues
Personal factors
life style
character
experiences
self-reliance
age
gender
ethnicity
profession
social background
illness believes
Do exercises help against Arthritis?
There is evidence that exercises can limit the symptoms of osteoarthritis.
Exercising when you have knee osteoarthritis has positive effects on the following items:
Less pain
Increase in physical function
Quality of life is rated higher after an exercise program
Also, physiotherapy could postpone surgery. If surgery is no longer postponable, it is advised to get the knee muscles as strong as possible before going into surgery, because this helps you to recover faster after surgery (better in better out).
What can I do against Arthritis?
The following treatments can be considered depending on your needs and goals:
Strength exercises: right dosed exercises will reduce the progress of arthritis
Aerobic exercises
Functional exercises
Increase range of motion
Balance training (Tai Chi optional)
Improve problematic movements or activities like kneeling
Weight loss: will reduce the load on the knee
Education: a good understanding of arthritis and the course will help you.
Hydrotherapy
Massage
Stamina exercises
Increasing your stamina leads to less pain and less stiffness. Besides that, working on your stamina leads to weight loss. Less body weight means less load on the joints. Less load on the joints decrease the pain. In order to work on your stamina you have to be physical active for 2-3 minutes before the stamina system gets activated. Great stamina exercises against arthritis are walking or cycling for 30 minutes.
It is important to keep track of your technique. Due to pain people are tempted to change their movement behavior in order to avoid the pain. Compensating your movement to avoid pain is called antalgic movement. The short term advantage is that you can move with less pain. However, on the long term antalgic movement can cause more pain. Let Mick help you out with antalgic movement.
Strength Endurance
Strength endurance is a strength exercises with less emphasis on hypertrophy, but more emphasize on stamina.
The parameter of strength endurance are:
20-40 repetitions
3-5 series
90 seconds rest
You are supposed to be exhausted when you did around 30 repetitions. When you do not reach 20 repetitions, make the exercise less heavy. When 40 repetitions are too easy, create a heavier exercise.
Strength stamina exercises have the positive effect that it stimulates bone growth. Imagine that there is 20 to 40 times pressure on the joints. Every time that there is pressure on the joint, the hormonal system is activated. The hormonal system tell the brain that bone growth is required, because you use the joints often.
Three typical strength endurance exercises are:
Squats
Push ups
Walking on your toes
These are typical strength endurance exercises, because 20 repetitions are normally easily reachable.
Balance Exercises
Balance could be disturbed due to pain or limited range of motion, because of arthritis. Examples
De balans kan verstoord raken door pijn en bewegingsbeperking ten gevolge van artrose. Voorbeelden van balansoefeningen zijn met ogen dicht staan, op een zachte ondergrond lopen of dubbeltaken als buiten het steunvlak reiken.
Typical balance exercises are:
Walking over a line
Standing on one leg
Walking over a soft surface
Functional Exercises
Standing up from a chair, walking downstairs and kneeling are common activities which are difficult for people with arthritis. A physiotherapist could help you find 'strategies' to cope with these problems. Strategies are tips and exercises to make these activities easier and less painful.
'You only train on what you train' is a slogan which is very applicable to functional exercises. For example step ups is a very useful exercise to practice walking up the stairs, because you train the involved muscles and mobility of the joints. However, in the end it is about walking the stairs. We can not improve walking stairs by only doing step ups. We have to train the endgoal itself too.
Hydrotherapy
The feeling of floating in the water can feel like a relief. Less pressure on the joints make exercises possible which might not be possible 'on land'. Hydrotherapy is therefore also very handy to after an operation to start moving again. Besides the Romans already swore by the holy effect of warm water.
Tai Chi
Tai Chi is about making slow and controlled movements. Slow and controlled movements increase the cardiovascular system, strength, balance and decreases stress.
Strength Exercises
Arthritis often involves less range of motion in the joints. Stretching could decrease the limited range of motion.
Maintain the stretch at least for 30 seconds and repeat this as often as possible.
Examples of stretching exercises which could limit typical arthritis limited range of motions:
Leaning forward in a door opening
Iliopsoas stretch
Hanging backwards
Understanding Arthritis
Understanding about the effect of moving on arthrosis is essential for progress. For example if you believe that using your joints, will lead to more pain, is a common misperception. In these video's I will explain a little bit how to understand arthrosis. I can advice you about activities, participation and load. Further more how to deal with pain and immobility and how to maintain a healthy life style. If you need crutches or a walker, I can advise you how to use it.
Alternative Treatments
You want pain release on the short term. These treatments do not help for pain relieve in the long run;
It would make active exercise therapy easier. So it facilitates the treatments listed above.
Passive movements in joints
Thermotherapy (knee)
TENS (knee)
Knee brace/soles (knee)
Preoperative exercise therapy
Preoperative education
NB: do not use warmth therapy when there are signs of inflammation.