Is it possible for those with osteoarthritis (OA) to avoid or delay hip and knee replacement surgery through physical therapy and exercise? Studies show that minimizing OA pain and getting people moving improve function and may delay the need for surgery. With the help of technology, physical therapists can encourage movement by decreasing or eliminating pain for these OA patients.
OA is the breakdown of cartilage that results in pain, swelling, decreased range of motion and stiffness. The most common chronic joint condition, OA impacts more than 27 million Americans. One in four Americans will develop hip OA by age 85, and one in two will develop knee OA in his or her lifetime.
Many people with OA feel the condition is inevitable, can’t handle the pain and become sedentary while waiting for a surgical intervention. Consider the pain cycle: Pain -> Decreased Movement-> Loss of Flexibility and Strength -> Deconditioning -> Poor Lower Extremity Mechanics. This pain cycle often leads to a sedentary lifestyle, which also results in an increased risk for diabetes, weight gain/obesity, coronary artery disease (CAD), hypertension and falls.
The vision of the American Physical Therapy Association (APTA) is to transform society by optimizing movement to improve the human experience. For those with OA, a physical therapist can help patients break the pain cycle and improve their quality of life by:
- Encouraging mobility
- Helping improve flexibility and strength
- Helping maintain cartilage health
- Helping normalize gait
Because cartilage is avascular and aneural, there is not a lot of blood flow in cartilage or excessive pain until it breaks down enough to expose the bony layer beneath it. Cartilage exists to absorb shock and withstand pressure, and loading it enough is important for cartilage health, just as load is important for all body tissue. While excessive loading is detrimental to someone with OA, moderate exercise with loads that are pain-free have proven beneficial.