Osteoarthritis (Knee)

Knee Osteoarthritis

What is it?

Osteoarthritis is the most common form of arthritis, and the knee is one of the most commonly affected joints.

Everyone’s joints go through a normal cycle of damage and repair during their lifetime, but sometimes the body’s process to repair our joints can cause changes in their shape or structure. When these changes happen in one or more of your joints, it’s known as osteoarthritis.

A joint is a part of the body where two or more bones meet – in your knee, it’s the thigh and shin bones. There is also a small bone at the front of the knee called the patella or kneecap.

The ends of our bones are covered in a smooth and slippery surface, known as cartilage. This allows the bones to move against each other without friction, and protects your joint from stress.

Your knee also has two other rings of a different type of cartilage known as menisci or meniscus, which help to share weight evenly across your knee joint, and there’s also cartilage underneath your kneecap.

Osteoarthritis causes the cartilage in your knee joint to thin and the surfaces of the joint to become rougher, which means that the knee doesn’t move as smoothly as it should, and it might feel painful and stiff.

Osteoarthritis can affect anyone at any age, but it’s more common in women over 50. [1]

 

What causes Osteoarthritis in knees?

The exact cause of osteoarthritis is unknown, however it’s likely that a combination of factors may contribute.

The likelihood of developing osteoarthritis in the knee can be increased by  

  • normal age related changes.  
  • a previous injury in the area.  
  • repetitive activities and physical jobs.   
  • inheriting certain genetics from your parents.  
  • being overweight. [2]

What can you do?

This exercise information has specific exercises to help maintain your joint range of movement and strengthen muscles around your knee. When attempting the exercises it is important to perform them with a good technique. There may be a slight increase in your pain and you may feel some muscle aching. If the exercises cause pain then you should allow time for this to settle before trying again. All exercises should be performed gently, slowly and ideally done three times a day. Choose 3-4 exercises to do each session.

Osteoarthritis Knee Exercises

Knee Flexion and Extension

Lying on your back with your knee straight. Slowly bend the affected knee as far as comfortable. Hold the position for 10 seconds and then slowly return to a straightened position. Repeat 10 times. [3]

Osteoarthritis Knee Exercises

Inner Range Quadriceps

Place a small rolled up towel under your knee. Tighten your thigh muscles and straighten your knee (keep the knee on the towel and lift your foot off the floor). Hold for 5-10 seconds and slowly relax. Repeat 10 times. [3]

Osteoarthritis Knee Exercises

Quadriceps Strengthening - Sit to Stand

Sit on a chair with your arms folded. Slowly stand up without using your arms. When upright, return slowly to the chair again without using your arms. Repeat 10 times. [3]

Osteoarthritis Knee Exercises

Quadriceps Strengthening - Mini Squat

Using a chair for balance, squat down bending both knees but keeping the back straight. The squat should be to no more than 45 degrees.  Repeat 10 times. [3]

Osteoarthritis Knee Exercises

Calf Strengthening - Heel Raises

Using a chair for balance, push up on to your tip toes and back down again. You can do this just on your affected leg if you are able to balance. Repeat 10 times. [3]

Osteoarthritis Knee Exercises

Step Up

Stand in front of a step. Step up 10 times with one leg leading and then repeat with the other leg leading. [3]

Osteoarthritis Knee Exercises

Clam

Lie on your side with your knees bent. Tighten your buttocks. Lift your top knee as far as you can, without letting your pelvis rotate forward or back. Keep your feet together and back straight during the exercise. Lower slowly back down. Repeat 10 times. [3]

Osteoarthritis Knee Exercises

Hamstring Stretch

Stand upright and place the foot of your affected leg on a step. Slowly lean forward at your hips until you feel a stretch at the back of your thigh. Keep your back straight. Hold for 20—30 seconds, repeat 5 times. [3]

Osteoarthritis Knee Exercises

Quadriceps Stretch

Stand upright, holding on to a firm support.  Loop a towel around the ankle of your affected leg. Keeping your back straight, use the towel to pull your heel towards your bottom to feel a stretch at the front of your thigh.  Hold for 20-30 seconds. Repeat 5 times. [3]

Osteoarthritis Knee Exercises

Calf Stretch

Stand in a walking position with the affected leg straight behind you and the other leg bent in front of you. Take support from a wall or chair.  Lean forwards until you feel the stretching in the calf of the straight leg. Hold for 30 seconds, repeat 5 times. [3]

This guide can help you to understand if you’re exercising at the right level. It’ll also let you see how much pain or discomfort is acceptable.

It can be helpful to rate your pain out of 10 (0 being no pain 10 being the worst pain you have ever had), for example:

  • 0 to 3 – minimal pain
  • 4 to 5 – acceptable pain
  • 6 to 10 – excessive pain

Pain during exercise
Aim to keep your pain within a rating of 0 to 5. If your pain gets above this level, you can change the exercises by:

  • reducing the number of times you do a movement
  • reducing the speed of a movement
  • increasing rest time between movements

Pain after exercise
Exercise should not make your existing pain worse overall. However, practicing new exercises can sometimes cause short term muscle pain as the body gets used to moving in new ways. This kind of pain should ease quickly and your pain should be no worse the morning after you’ve exercised. [4]

In the meantime if you find your symptoms worsening despite the exercises, or if you notice any new symptoms such as weakness or numbness or difficulty with mobility or weight bearing, then please seek a medical review. If your symptoms are particularly worrysome or troubling you can attend Urgent care or contact 111 out of hours.

References

1 - https://versusarthritis.org/about-arthritis/conditions/osteoarthritis-of-the-knee/ Versus arthritis OA knee

2 - https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions/osteoarthritis-of-the-knee/ NHS inform OA knee

3 - https://roh.nhs.uk/services-information/therapy/exercises-for-osteoarthritis-of-the-knee Royal Orthopaedic hospital - OA knee

4 - 4 - NHS Inform Scot - https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/exercises/exercises-for-tennis-elbow/