October was National Physical Therapy month

Published 7:10 pm Saturday, October 31, 2015

In my practice, I see patients who range in age from teenagers to those in their nineties, and one diagnosis that I commonly see is knee osteoarthritis — not to treat the arthritis, but the dysfunction that accompanies it. My observation is that the patients with osteoarthritis are getting younger. Osteoarthritis cannot be cured, but there are ways to manage the pain.

The knee joint is where the femur (thigh bone) and the tibia (shin bone) come together. The patella (kneecap) is found within the quadriceps muscle at the front of the joint. In the joint space, you will find the cartilage. Many people with osteoarthritis will find that their cartilage is worn, and when this happens they have more painful symptoms. The muscles involved are the quadriceps found on the front of the thigh, the hamstrings on the back of the thigh, and the gastrocnemius, which is the calf muscle.

Many times I will hear a patient say, “I can’t exercise, I have arthritis and my cartilage is worn out.” Physical activity, directed by a physical therapist, could be the answer to managing pain from this condition. When the biomechanics of the joint are studied, it is found that the “cushion” of the joint does not come primarily from the cartilage in the knee, but from the strength of the muscles that surround the joint. Many people with osteoarthritis have significant quadriceps weakness. Many people have an imbalance of the quadriceps muscles and the patella does not glide as smoothly as it should.

So what is the answer to this? There are many sides to the treatment of osteoarthritis, including managing the inflammation with medication and modalities. Research has shown that physical therapy is beneficial for treating the symptoms of osteoarthritis.

Recently, there was research performed suggesting that aquatic therapy was effective in decreasing the symptoms and increasing the mobility of those with osteoarthritis. The study followed 71 patients through six weeks of therapy. All of the patients verbalized a decrease in pain. They had increase in function demonstrated by standardized testing before and after the program. Even better, they maintained the gains six weeks after completing physical therapy. The key to this was that they continued their program after therapy was complete. This is the main reason I see patients repeatedly. They do not continue with the exercise program we developed.

This is encouraging news. We do offer this type of therapy in Washington. We actually have two heated pools at Vidant Wellness center. The smaller therapy pool is heated to 92 degrees. The larger pool is heated as well, but not as warm to allow for higher intensity exercise. What you need is your doctor’s approval (a prescription) and an appointment can be set. The therapist will perform an evaluation to see if the aquatic program is the right treatment for you, or if a land based treatment is more appropriate.

Maria Stalls, PT, CLT is manager of the physical therapy and of rehab services at Vidant Beaufort Hospital of Washington and can be reached at 252-975-4292.