As physios, we commonly work with clients with arthritis and can be very helpful with decreasing pain, increasing function, and potentially even slowing its progression.
Your STRIDE physio would start with a thorough assessment. This is to find out your current abilities and identify/confirm the arthritis diagnosis. Where you are at greatly impacts the type of treatment and exercise that will be most effective for you at a specific point in time.
A big part of treatment will be to increase or maintain two important factors around the affected joints: range of motion and strength. Both of these factors have a huge impact on the day to day pain experienced as well as how one is able to function and participate in life – the most important thing! Let’s take a closer look at each of these factors and explore why they are important and what we might do through physio to help.
Range of Motion:
Why is it important…
It is common with arthritis to see a joint starting to stiffen up and lose range of motion. This directly affects the health of the joint and subsequently progression of arthritis.
The cartilage lining the joint surface does not have a direct blood supply. This means it must get the bulk of its nutrition from the fluid within the joint space. Nutrition is required in order to keep the cartilage intact and healthy.
Cartilage can be envisioned as a sponge. When the joint moves, it pushes the old fluid out of the cartilage, and on release, new fluid – which is full of nutrients – gets sucked up into the cartilage. If we begin to lose range in a joint, a portion of cartilage, which is not subjected to movement, will begin to get much less nutrition. This causes the cartilage health to decline and arthritis to progress more quickly.
How does physio help…
Often we can see big improvement in range of motion during even a single treatment session. A physio may use joint mobilization techniques in order to glide the joint into the stiff ranges of motion and improve its ability to move. These techniques are surprisingly comfortable and cause very little to no discomfort.
A few, simple home exercises would then be provided to help in maintaining and using this increased range of motion. By using this available range at home, it helps to increase joint health, maintain or increase range of motion, and can also provide some immediate decrease in pain.
Strength:
Why is it important…
Strength in the muscles surrounding a joint helps to create space within the joint, stabilize the joint, and take load off the joint. This is all very important and helps to minimize pain and ensures one is able to maintain or increase their day to day activities.
How does physio help…
Your physio will provide advice about both the type and amount of strengthening exercise that is appropriate for you. We will continue to encourage and modify the exercises as needed; but you, the client, have to do the work in order to make the change.
Strength exercises will likely be started in a slow way. This is to ensure the arthritic joint will tolerate the new form of exercise without causing an increase in pain. Over time, both the load and intensity of the exercise can be increased to continue to improve strength. Regardless of age or arthritis in the joint, strength is something that can be increased with appropriately prescribed exercise and hard work.
Other Frequently Asked Questions about arthritis…
Should I stop exercising or be careful of how much I do?
Exercise is good for arthritis. Full stop.
Of course, it is important that exercise is started in an appropriate and progressive fashion. This is particularly important with arthritis. You don’t want to shock the joint with a sudden increase in load or exercise. Suddenly doing more than you’re used to can often cause pain to increase and subsequently turn people off exercise.
Experiencing this pain after activity does not mean exercise is bad for the joint. It is just the joint telling you that you did too much and that you should progress into that activity level more slowly.
Once you’re able to successfully complete the activity level you’d like with minimal pain, keep moving/exercising in a consistent fashion. This helps keep the joint healthy, strong, and as pain free as possible.
Should I get x-rays?
Arthritis can typically be diagnosed in-clinic by a physio, physician, or nurse practitioner through our assessment and testing. Early on, x-rays typically would not change the course of treatment meaning that they most often aren’t necessary or even helpful.
Over time, this recommendation may change; for example, if it is not responding to treatment as expected or if surgery is being considered. Your physio would bring it to your attention if they felt you should return to your doctor to discuss pursuing the possibility of imaging.
Need more convincing to cool it on the x-rays? It has been proven in the research that the amount of arthritis detected on x-ray in no way correlates with a person’s level of pain or day to day function. This means, one individual may have mild arthritic changes with a great deal of pain and limitations in daily life, while the next person may have severe arthritis on x-ray with minimal pain and excellent day to day function.
When should I be considering surgery?
Joint replacement surgery can be considered for those with substantial arthritis that is limiting their ability to participate in and enjoy life. Deciding when this is right for you is a personal decision. Typically, taking the steps to pursue replacement is recommended if you have already tried conservative management (physio, pain meds, etc) and yet pain levels are still becoming unmanageable and/or your ability to participate in life is becoming impacted.
Surgical waitlists remain our reality. While awaiting surgery, the surgeon may recommend other treatment options to you such as offloading braces or joint injections. This can often help substantially in managing pain while awaiting surgery or may even allow you to choose to delay your procedure.
Have you consulted a physio for your arthritis? Start here with a thorough assessment with a STRIDE physio and let us help you hit your STRIDE!