Knee osteoarthritis is a degenerative joint disease. It is the result of wear and tear and progressive loss of articular cartilage. It is a common condition in the elderly population. Why it occurs in some people more than others is a perplexing problem. There is no doubt that the condition can be very frustrating to have this condition with a myriad of effects on everyday life – for example it would affect mobility, the ability to negotiate stairs or squat down to do common things at home.
Whilst the cause is unclear, there are three main modifiable risk factors
1.Weight
As knee osteoarthritis is mainly the result of wear and tear and progressive loss of articular cartilage, body weight is highly correlated to the severity of the condition. The more you weigh, the more joint reaction force occurs within the joint. Let’s give you an example:
Forces transmitted across the knee joint during normal walking range between 2- and 3-times body weight. Therefore, each additional kilogram in body weight is multiplied 2 or 3 times at the knee joint. (D’Lima et al., 2012)
2.Muscle Weakness/Imbalance
The quadriceps muscle group is one of the important muscle groups to support the knee and maintain knee function. Quadriceps muscle group weakness and atrophy in the knee osteoarthritis population were observed by the researchers. (Rice, McNair and Lewis, 2011)
Therefore, a rehabilitation program incorporating eccentric quadriceps strengthening exercises is recommended to improve knee pain and hence physical activities. (Arab et al., 2022)
3.Occupational risk
The physical demands due to occupational activities could be associated with increased odds of knee osteoarthritis occurring. Specifically, agricultural and construction sectors, which typically involve heavy lifting, frequent climbing, prolonged kneeling, squatting, and standing, carried increased odds of knee OA.
Physiotherapists can (a.) Introduce open kinetic chain, through-range mobility exercises and eccentric strengthening exercises to assist the body cope with the pressures of work. Secondly (b.) Physios can educate clients on preventable risk factors to assist clients to use their knee joints appropriately and to especially avoid overuse. (c.) If there are any biomechanical issues arising from the feet assessment and orthotic prescription would be invaluable too. (Reichenbach et al., 2020)
Trying to monitor these three risk factors and you may find your way to resolve your issues.
Reference list
Arab, F., Quddus, N., Khan, S., Alghadir, A. and Khan, M., 2022. Association of eccentric quadriceps torque with pain, physical function, and extension lag in women with grade ≤ II knee osteoarthritis: An observational study. Medicine, 101(31), p.e29923.
D’Lima, D., Fregly, B., Patil, S., Steklov, N. and Colwell, C., 2012. Knee joint forces: prediction, measurement, and significance. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, 226(2), pp.95-102.
Reichenbach, S., Felson, D., Hincapié, C., Heldner, S., Bütikofer, L., Lenz, A., da Costa, B., Bonel, H., Jones, R., Hawker, G. and Jüni, P., 2020. Effect of Biomechanical Footwear on Knee Pain in People With Knee Osteoarthritis. JAMA, 323(18), p.1802.
Rice, D., McNair, P. and Lewis, G., 2011. Mechanisms of quadriceps muscle weakness in knee joint osteoarthritis: the effects of prolonged vibration on torque and muscle activation in osteoarthritic and healthy control subjects. Arthritis Research & Therapy, 13(5), p.R151.
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