We all know someone that suffers from hip or knee osteoarthritis (OA), it’s that age-related wear and tear disease right, and surgery is the best option? It’s frightening how many times we hear this, because surgery is actually NOT the first line treatment for hip and knee OA. Instead, education on pain management, diet and a personalised exercise programme designed by a physiotherapist is recommended as the starting point for all people with hip and knee OA. So, where do you begin? Read on.

I have pain in my hip or knee, how do I start my road to recovery?

Education is a key component of hip or knee OA management. Why? Because the long-held belief about arthritis is that it’s a wear and tear disease, worsened by movement due to age-related changes. Many people are unaware that this is not the case, as research in the last decade has revealed the ‘damage’ found to their knee or hip on scans is not directly related to pain and function. For instance, plenty of people report high levels of pain and problems walking, yet their hip or knee scan has minimal signs of ‘damage’. On the contrary, people with severe ‘damage’ can report no symptoms at all!

Hence, hip or knee OA is complex and the pain associated with daily physical activities is normally due to:

• Lack of regular exercise (including resistance at a gym)
• Increased weight
• Poor diet
• High stress

For this reason, we highly recommend addressing the above factors first, before contemplating surgery, as there are many dangers fraught with surgery and the cost is significantly higher than the aforementioned lifestyle factors.
How will exercise help my pain? Won’t I wear out my joint and make it worse?

A logical and common question we get asked is how will exercise improve my pain? The simple answer is that pain limits your ability to be physically active (e.g. walking, gym, recreational sports etc), which is important for keeping muscles strong. This decline in physical activity progressively weakens the surrounding muscles, leading to higher joint loads and associated pain.

For this reason, it’s important that a management plan is put in place to build back your muscle strength and distribute that load evenly to muscles and joints. But, this doesn’t mean you should just jump into any exercise. Here are some simple starting exercises and tips for implementation:

Perform resistance-based exercises that are challenging (approximately 7-8/10 of your perceived maximum effort)
It’s completely normal to have pain flare up to 5/10 during and 24 hours after exercise
If you’re pain > 6/10, STOP doing the exercise and refrain from repeating until this subsides
Try completing knee extensions (for the front of the thigh) and leg press as starting exercises for 3 sets of 8-12 repetitions following the pain and difficulty guidelines above

What about hydrotherapy? Is this good for managing hip or knee pain?

Hydrotherapy, or aquatic exercise is a relaxing and effective management strategy for hip or knee OA. Check out the video below for a look at what you could be doing in the pool to reduce your pain.

How else can I improve my pain and ability to perform daily activities?

Weight management- this simply comes down to physics, the more you weigh, the more pressure you put through the joint= more pain. Therefore, if you’re overweight you need to think about ways to lose weight and we recommend you speak with a dietician or other healthcare provider about strategies to lose weight. Don’t know if you’re overweight? Click this link to calculate your body mass index (BMI): https://www.heartfoundation.org.au/your-heart/know-your-risks/healthy-weight/bmi-calculator