Tag Archives: Osteoarthritis

Arthritis, Custom Knee Brace, Custom Knee Bracing, Hip Pain, Knee Pain, Physiotherapy, Surgery, Total Hip replacement, Total Hip Replacement Surgery, Total Knee Replacement

Hip and Knee OA: Can Physiotherapy Prevent Surgery?

Getting that x-ray back with a diagnosis of osteoarthritis (OA) of the knee or hip can be alarming. Maybe you’ve also started to notice some persistent pain, and daily movements like stairs are starting to become harder. Rest assured, surgery is not the immediate next step. Physiotherapy treatment and conservative management is the first line treatment for hip and knee OA.

Understanding hip and knee OA

Simply put, OA involves natural wear and tear in the joints over time. The cartilage and joint surfaces change over time and show signs of degeneration. Thankfully, we now know that these structural changes are not the whole story. Even though an x-ray may show these signs, it does not automatically mean there is an issue. More importantly, you can have signs of OA without feeling pain or discomfort at all and there is something you can do about it. Ultimately, the strength of the muscles and tissues around your joint is what matters the most to how you move and function.

How does physiotherapy treat OA?

Single leg glute bridges are great strength builders, working the core, glutes, and lower body all at the same time.

More and more we are understanding that regular strength training is the key to building resilience around the joint. Here’s how physio can help:

  1. Strengthen: Even though the joint changes may be there, the load support comes from the surrounding musculature. This means strengthening the quads, hamstrings, calves, hips, and core. These muscles can replace the shock absorption for the joint, offloading stress from it
  2. Mobility: Motion is lotion, joints need this stimulation to stay healthy. Movement helps produce the joint fluid that lubricates the joint and gives it nutrients. A regular mobility program can improve lost range of motion and reduce morning stiffness.
  3. Education and activity modifications: OA is not a condition that goes away completely, it’s something that you will have to manage. Your Physiotherapist will help you figure out what activities in your life may have to be temporarily sidelined to avoid overuse, and when it is safe to go back to it again
  4. Gait aids and braces: We want you to be as independent and stay in touch with all your favourite activities as much as possible. Sometimes, this may involve doing things with a bit of help. Whether it’s going for a walk outside, or playing tennis, an aid like a walker, cane, or custom brace may help.

How does physiotherapy prevent or delay surgery?

Physiotherapy can either delay, or completely prevent the need for a total joint replacement. The earlier you start with rehabilitation and strengthening, the better it is. Major health organizations like the Osteoarthritis Research Society International (OARSI) recommended structured physical therapy and exercise plans as gold standard treatments for OA.

People who participate and complete these programs can delay their surgery for years, or even are able to forgo it completely. Worst case, if surgery is still necessary, research has shown that patients who engage in training beforehand have quicker recovery and better outcomes post-surgery.

What can I expect in a Physiotherapy session if I have hip or knee OA?

If you’re new to Physiotherapy, no worries! We’re here to help you and answer every question you may have. Here’s a general outline of what to expect at your first session.

  1. Comprehensive assessment: Your physio will ask you questions about your current symptoms, function, and goals. They will gather any relevant information about your medical history, previous injuries, and more. Afterwards, they will conduct a physical evaluation of your range of motion, strength, balance, and function.
  2. Creating a treatment plan: After the assessment, your physio will use this information to create a personalised plan for you. Based on your areas of weakness and goals for the future, a week by week plan will be presented to you.
  3. Treatment: Treatment will happen on the very first day. This part will be very individualised based on your unique factors. This part may consist of manual therapy, electrotherapy, cryo or heat therapy, and exercises. Here, your physio will also teach you your home exercise plan including cardiovascular training, strength and mobility work, and more!
  4. Outline for the future: Finally, there will be time for questions and your physio will educate you on what to expect in the future. They will tell you how often you will need to come in, and what the expectations for progression are.

Looking for help with a hip or knee OA?

Your hip or knee is something we can work on, it doesn’t have to be what stops your life. If you’re looking to improve your quality of life, get stronger, and delay a surgery, look for PhysioNow! We have expert clinicians at 10 locations across the West GTA to help. Look for us in Burlington, Oakville, Mississauga and Etobicoke. Book with PhysioNow today for your first assessment and treatment!

Hand Pain, Hand Pain Treatment

Thumb Arthritis: Physio 101

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Anatomy of the 1st CMC Joint

The 1st Carpo-meta-carpal (CMC) joint is more commonly referred to as the thumb joint. It is located at the base of the thumb between the carpal bones and the metacarpal bones. It is classified as a saddle joint, meaning it allows the thumb to move freely in many directions. As a result of this mobility, you can perform a wide variety of complicated tasks such as opening a jar, pinching an object, writing, and holding differently shape objects.

What is Thumb Arthritis?

Arthritis is a general condition that can affect any joint in the body. 1st CMC arthritis is specific to the thumb joint but as seen in the picture above, it may affect the other fingers in a similar presentation.

The bones that make up the CMC joint are covered in cartilage (tough but flexible tissue) which allows for smooth gliding in a healthy joint. With overuse and age, there eventual wear and tear on the cartilage which can result in the joint space narrowing and pain. Consequently, this increases friction within the space and can damage the joint tissues further. Osteoarthritis is the result of this overuse as the joint space narrows and more inflammation occurs as a result.

Symptoms of Thumb Arthritis

  • Pain and tenderness at the base of the thumb
  • Inflammation and redness around the base of thumb.
  • Deformity in the shape of joint (dependent on severity)
  • Pain with use
  • Enlarged appearance of the CMC joint
  • Reduction in strength of the joint
  • Increase in pain while grasping (such as opening a jar) or pinching (turning a key)

Muscles of the Thumb

There are the group of muscles who covers the CMC joint and helps in different movements of the thumb.

Flexors group: writing and Pinching grip

Extensor + abductor group: wider grip like opening a jar

Role of Physiotherapy in Relieving Thumb Arthritis Pain

Treatment may include supporting the joint through the use of aids like a soft brace or taping as seen above.

Physiotherapy plays a vital role in managing CMC arthritis by reducing pain and improving joint function and overall hand strength. Here are some key components of physiotherapy treatment for CMC arthritis:

  1. Pain Management:


    o Therapeutic Modalities: Physiotherapists use various modalities such as ice, heat, ultrasound, and electrical stimulation to reduce pain and inflammation.
    o Manual Therapy: Gentle joint mobilizations and soft tissue techniques can help alleviate pain and improve joint mobility.

  2. Exercises to Improve Function:

    o Range of Motion Exercises: Gentle stretching exercises help maintain and improve the range of motion in the thumb and hand.
    o Strengthening Exercises: Targeted exercises to strengthen the muscles around the thumb and wrist can enhance stability and function. Examples include thumb abduction and opposition exercises using resistance bands or putty.

  3. Splinting and Support:


    o Thumb Splints: Custom-made or prefabricated splints can provide support, reduce pain, and prevent further joint damage. Splints are often worn during activities that worsen symptoms.

  4. Activity Modification:


    o Ergonomic Advice: Physiotherapists provide guidance on modifying daily activities to reduce stress on the CMC joint. This may include using adaptive devices or altering grip techniques.
    o Joint Protection Strategies: Educating patients on techniques to protect the joint, such as avoiding repetitive gripping or pinching, can help manage symptoms and prevent further damage.

  5. Education and Self-Management:


    o Patient Education: Understanding the condition and its management is crucial. Physiotherapists educate patients about self-care, treatment options, and the expected outcomes.
    o Home Exercise Programs: Tailored home exercise programs empower patients to take an active role in their treatment, promoting long-term management and symptom relief.

Preventing Arthritis

While it may not be possible to completely prevent CMC arthritis, certain strategies can reduce the risk and delay its onset:

  • Ergonomic Adjustments: Use tools and devices designed to reduce stress on the thumb joint during activities.
  • Strengthening and Stretching: Regular exercises to maintain thumb and hand strength and flexibility.
  • Activity Modification: Avoid repetitive stress on the thumb joint by varying activities and using proper techniques.

Need more help?

CMC arthritis can significantly impact hand function, but physiotherapy offers a range of effective treatments to manage symptoms and improve your quality of life. If you are experiencing symptoms of CMC arthritis or any other type, look for PhysioNow! We have many expert Physiotherapists that can support your recovery. Book with PhysioNow today for your first assessment and treatment.

Exercise, Hip Pain, Knee Pain

Osteoarthritis: How Physiotherapy Can Stop Your Pain

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Osteoarthritis in the knee. Image by jcomp on Freepik

What is osteoarthritis (OA)?

Osteoarthritis (OA) is the most common form of arthritis. Alternatively, some people call it degenerative joint disease or “wear and tear” arthritis. It occurs most frequently in the hands, hips, and knees.

With OA, the cartilage within a joint begins to break down and the underlying bone begins to change. These changes usually develop slowly and get worse over time. Eventually, it can cause pain, stiffness, and swelling. In more severe cases, it also causes reduced function and disability; some people are no longer able to do daily tasks or work. Osteoarthritis (OA) is the most prevalent joint disease and a leading cause of disability in older adults.

Signs and symptoms of osteoarthritis:

  • Pain or aching
  • Stiffness
    Decreased range of motion (or flexibility)
  • Swelling

Risk factors:

  • Joint injury or overuse—Injury or overuse, such as repetitive knee bending or stress, can cause damage and increase the risk of OA in that joint
  • Age—The risk of developing OA increases with age.
  • Gender—Women are more likely to develop OA than men, especially after age 50
  • Obesity—Extra weight puts more stress on joints, particularly weight-bearing joints like the hips and knees. Consequently, this extra stress increases the risk of OA in that joint. Obesity may also have metabolic effects that increase the risk of OA
  • Genetics—People who have family members with OA are more likely to develop it. Additionally, people who have hand OA are more likely to develop knee OA
  • Race— Some Asian populations have lower risk for OA.

How is it diagnosed?

A doctor diagnoses OA through a review of symptoms, physical examination, X-rays, and lab tests. Furthermore, a rheumatologist, a doctor who specializes in arthritis and other related conditions, can help if there are any questions about the diagnosis.

How is it treated?

There is no cure for OA, so doctors usually treat OA symptoms with a combination of treatments which may include the following:

  • Increasing physical activity
  • Physical therapy with muscle strengthening exercises
  • Weight loss
  • Medications, including over-the-counter pain relievers and prescription drugs
  • Supportive devices such as crutches or canes
  • Surgery (if other treatment options have not been effective)

Osteoarthritis and Physiotherapy:

Physical therapy for osteoarthritis rehabilitation

Physical therapist helping a patient perform exercises for OA. Image by Freepik

Unfortunately, pharmacological treatments are mostly related to relieving symptoms, and there is no drug that is a 100% cure for OA. However, compelling evidence suggests that regular practice of resistance exercises as part of a physiotherapy program may prevent and control the development of chronic diseases, including OA. As a result, physiotherapy-supported exercise may result in improved quality of life of those affected by this disease.

Additionally, anti-inflammatory treatment before physical therapy may also enhance the effects of exercise. Thus, a combination of pharmacologic and physical therapy modalities is recommended for the optimal management of OA. Physical therapy aims to relieve pain, improve joint function, and improve the daily quality of life of those with OA. It is the go-to conservative treatment option for OA due to its effectiveness convenience, and low risk of harmful side effects.

If you are experiencing any such symptoms, our team of qualified physiotherapists at PhysioNow will assist and guide you through your individualized treatment and exercise plan. Book your first appointment with PhysioNow today to start improving your quality of life.