Treating Knee Arthritis: A Case for Exercise

Love to Eat? Introducing

Are you passionate about food, nutrition and recipes? Unleash your inner foodie and check out our brand-new site - share your favorite recipes at Nutrition-WOD today!

Page:  1 Next »
Print
By Mike Chin, CSCS, DPT

More than half of us will get arthritis, specifically OA (osteoarthritis), at some point in our lives, most likely in the latter half of life. But that doesn’t mean you can’t return to similar or modified activity with less pain, because you can!

What is OA (osteoarthritis)?

Symptoms of knee OA include swelling, warmth to the touch, and pain with weight-bearing activities and even at times of rest.
OA is a degenerative condition where the cartilage that covers the articulating bone begins to break down, and in the worst case results in bone-on-bone articulation. Specifically with the knee, we’re talking about the articulation between the thigh bone (femur), shin bone (tibia), and knee cap (patella). These three bones move together to allow you to squat, clean, run, jump, kick — you name it. Yes, of course, this includes picking things up and putting them down (with good deadlift form, obviously). With any lower extremity movement the knee joint will be stressed, and that is why over time we see degenerative changes.

Clinically, OA will be diagnosed by correlation of history, physical examination, and radiologic findings. Symptoms of knee OA include swelling, warmth to the touch, and pain with weight-bearing activities and even at times of rest. Knee OA may present with a loss of range of motion and is most commonly correlated with muscle weakness.

Two Kinds of Knee OA

The tibiofemoral joint is one of the two knee articulations where OA can occur. Radiographic findings will classify tibiofemoral knee OA into four grades. Without getting into too much detail, the scale basically begins with findings of possible extra small bodies of bone in the joint, progressing to extra large bodies of bone with significant joint space narrowing and deformity of the bone ends.

If symptoms of OA do come up, you’ve likely had a flare up — a sign that you’ve gone past your joint’s loading ability.
The patellafemoral joint is another spot for OA to occur. Patellafemoral OA, or “chondromalacia patella” in some references, is also classified into four grades, beginning with softening of the patella and progressing to fibrillations through the full cartilage and erosive changes down to the bone. It sounds scary, but do not worry; if you have some level of OA, and you are a CrossFitter, most likely you are at the beginning stages of this process.

Not everyone will have symptoms with low-grade OA, so if that is the case, keep mobilizing to strengthen the muscles around the joint, and stay away from overloading the joint. “Overloading” equates to using weights too heavy for you, poor biomechanics, too many reps, and not enough recovery time. But if symptoms of OA do come up, you’ve likely had a flare up — a sign that you’ve gone past your joint’s loading ability.

How Do You Address the Problem?

Although you may want to push through the pain, pain combined with swelling has been shown to shut down muscle function around the joint.
So how do you get back to hitting the WODs? First we need to get through the acute stage using the common acronym RICE: Rest, Ice, Compression, and Elevation. Getting through the acute stage does not necessarily mean getting it to feel better; rather, the swelling has gone down and you have close to full active range of motion without pain. The last thing you want to do is start loading the joint when there is still significant pain and swelling! Instinctively, you may want to push through the pain, but pain combined with swelling has been shown to shut down muscle function around the joint. In this case, if your muscle — the main shock absorber of the body — isn’t taking the load from the joint, then what is?  The joint surfaces and bone! We do not want this to occur with any injury, especially if you have OA.

Once the joint has cooled down, we can begin re-educating and strengthening the muscles around the joint.  Specifically for knees, we are talking about the quadriceps. This does not mean to go out there and immediately do a WOD with cleans and box jumps, or even air squats for that matter. Instead, the joint needs to be loaded in a progressive fashion.

Here is a general progression that we will use:

  1. Open chain strengthening at the injured joint and proximal muscles
  2. Closed chain strengthening with resistance less than body weight
  3. Closed chain isometric strengthening at full body weight
  4. Closed chain dynamic strengthening at proximal muscles groups
  5. Closed chain dynamic strengthening at injured joint

What do I mean by “progression”? Once the knee responds well to the load, then we move to the next phase of the progression; we do not do all the steps of the progression in one session.

You can work through many of these muscle strengthening progressions on your own using resistance bands.
“Open chain exercises” are when the resistance is a movable object (i.e., bicep curl, shoulder press). These exercises are beneficial from a rehabilitation perspective because we can get isolated recruitment for a specific muscle group, simple movement patterns, and minimal joint compression. A “closed chain exercise” is when the extremity being worked is fixed to an immovable object (pull up, handstand push up, squat). Closed chain exercises are good for multiple muscle groups, weight-bearing exercise, and — as we all know and love — functional movement patterns.

Printable Version
Page 1 2 Next »

We Are Scouting Top Writers

Are you passionate about fitness and have something to say? Reach a huge online community and get the discussion going - start writing for Tabata Times today!

Share this post
@TabataTimes on Twitter, become a fan on Facebook 

Contribute to this story by commenting below:

Advertise Here

Most Popular of All Time

paleobutter published the post Primal Cheese Board on Nutrition WOD
[yumprint-recipe id='115']
CrossFit A.P.E. shared an image on Facebook

Have a great and safe Labor Day Weekend. Enjoy your time with your endeavors, family or whatever you want to do. Many have kids (don't forget pets), spouses and commitments...so enjoy your time to even do nothing. Just like in our workouts, recovery is essential to our growth :) One thing is to please appreciateand acknowledge Deputy Jason Weber who just shot in his line of duty recently. He is not in the same privilege to enjoy this weekend as we all are. This 2014 Labor Day Weekend is for Klamath County Deputy Sheriff Jason Weber!

Eugene CrossFit posted an article
CrossFit Excellence shared an image on Facebook

Kick ass Saturday part 2...

CrossFit Excellence shared an image on Facebook

Kick ass Saturday team throwdown at PXT!

McMinnville CrossFit IMUA shared an image on Facebook

CrossFit Train shared an image on Facebook

Another great Saturday WOD!

CrossFit the Den shared an image on Facebook

A fun morning at the gym! Great work everyone!!!!!

CrossFit Sandpoint shared an image on Facebook

Hey everyone! Come see how good we look! The End of Summer Workout at City Beach was a great success. The weather cooperated, no one drowned and now we've all paid our dues for the long weekend.

Telegraph CrossFit posted on Facebook

Telegraph CrossFit Fantasy Football Draft Starts in 20minutes! Get your computers ready!

CrossFit Burlingame shared an image on Facebook

Open gym tomorrow from 10-12!!! Come on by and work on those weaknesses!!

McMinnville CrossFit IMUA shared an image on Facebook

Thanks for the superhero fun today, peeps! It was an AWESOME final summer WOD!

CrossFit the Den shared an image on Facebook

Last day in August at the gym, here were all the PR's for the month! Great work Den crew!!!!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Cypher shared an image on Facebook

Team DT-Cindy Smash-up!

CrossFit Burlingame shared an image on Facebook

Functional fitness at it's finest in today's wod!!!

McMinnville CrossFit IMUA shared an image on Facebook

Hawk eye vs. Black Widow...6 legged races!

CrossFit Burlingame posted on Facebook

Curious about Crossfit? Come by today at 11 for our free intro class and let us show you what it is all about!! :)

CrossFit Burlingame shared an image on Facebook

Are you getting everything you need to perform and recover at your best? Come by Crossfit Burlingame today and pick up your supplements to help get you there! Check out what we carry at www.purepharma.com

United Barbell shared a link on Facebook

Saturday WOD

CrossFit Oakland shared a link on Facebook

CFO will be running a weekend schedule on Monday Sept 1st for Labor Day: 8am, 9am and 10am group classes only.

CrossFit Train shared a link on Facebook

http://crossfittrain.com/blog/2014/8/29/going-rx-and-why-it-doesnt-matter

Beaverton CrossFit posted an article
Morgan Hill CrossFit shared a link on Facebook

Saturday http://wp.me/s3Bc8L-saturday

Berkeley CrossFit posted an article
Telegraph CrossFit shared a link on Facebook

Saturday 8/30/2014 WOD http://www.telegraphcrossfit.com/saturday-8302014/

Telegraph CrossFit posted an article
CrossFit Sweatshop posted an article
CrossFit Dark Element shared a link on Facebook

http://cfdarkelement.com/daily-wod/ Be confident in your abilities to overcome your weaknesses!

CrossFit Oakland posted on Facebook

Saturday's WOD: TIER 1 1 Minute at Each Station for 3 Rounds: Max Box Step Ups Max Push Press Max Calorie Row Max Wall Balls Max Kettlebell Sumo Deadlift High-Pull Rest 1 Minute Between Rounds TIER 2 & TIER 3 “Fight Gone Bad” 1 Minute at Each Station for 3 Rounds: Max Box Jumps @ 24”/20” Max Push Press @ 75#/55# Max Calorie Row Max Wall Balls @ 20#/14# Max Sumo Deadlift High-Pull @ 75#/55# Rest 1 Minute Between Rounds

San Carlos CrossFit shared an image on Facebook

Tomorrow regular class at 9:00am open gym at 10:00-11:00am. In teams of two, with only one partner working at a time*, complete: 100 Kettlebell Swings (53/35) 400 Meter Run 80 Push-ups 400 Meter Run 60 Box Overs (24/20)** 400 Meter Run 40 Over-Unders*** *Teammates will perform the 400 Meter Runs together and must stay within arms reach. **Any way you get over the box counts. Hurdle it, on then over, step up and over. *** Partner 1 planks while partner 2 jumps over, crawl under and stand for 1 complete rep.

CrossFit All Terrain posted an article
CrossFit Potrero Hill shared a link on Facebook

WOD- Saturday, Aug 30 Labor Day Schedule for Monday, Sept 1: 8:30am Elements 9:30 and 10:30 am regular class 9:30 Barbell Club Mobility: 1. Banded Heel Cord- Anterior Approach x20 2. Banded Heel Cord- Posterior Approach x20 3. Overhead Tissue Smash …

CrossFit West Santa Cruz shared a link on Facebook

Labor Day Hours http://wp.me/puz1A-4XJ

CrossFit West Santa Cruz posted an article
Good Times CrossFit shared a link on Facebook

CrossFit Potrero Hill posted an article
Corey's Gym posted an article
CrossFit Oakdale shared a link on Facebook

http://cfoakdale.com/2014/08/30/double-grace/

Telegraph CrossFit shared an image on Facebook

Banded Sprint Work #telegraphStrong #crossfit #sanfrancisco #fitchicks #telegraphcrossfit

CrossFit Burlingame shared an image on Facebook

After a tough week of training, there is nothing better than spending an hour getting mobilized and relaxed! Come to yoga tomorrow at 11!

CrossFit Burlingame shared an image on Facebook

Member appreciation party tonight at 8pm! See you there!!! :)

@TabataTimes on Twitter

Watch the latest episode of GPTV