April 2017

Hip and Knee Osteoarthritis Affects Younger People, Too
Ackerman, I., Kemp, J. Crossley, K., Culvenor, A., Hinman, R.
Journal of Orthopaedic and Sports Physical Therapy, February 2017, p 67-79.

This Clinical Commentary focused on evidence-based assessment and management approaches for “younger individuals” defined as those less than 40-45 years old.
Why is this important? Hip and knee osteoarthritis (OA) at younger ages has a significant impact on psychosocial well-being and work capacity. People who are affected by OA in their 40’s have decreased exercise tolerance to maintain a healthy weight and active lifestyle. It may further decrease work tolerance for jobs involving high labor which has the potential to decrease available work force for these jobs as well as limiting future job potential for those affected.
Why is this happening? Key risk factors for accelerated development of knee OA are obesity and a history of traumatic knee injury. Traumatic knee injury included anterior cruciate ligament (ACL) rupture and/or meniscal tears. Even more troubling was that having ACL reconstruction surgery “does not appear to prevent future onset of knee OA”. The bright spot in this research was that long distance running in youth did NOT seem to increase the risk of hip and knee OA later in life!
Should I ask my MD for imaging on my painful knee and hips? This commentary stated that imaging should be reserved for those with atypical signs and symptoms that “may indicate diagnoses other than OA”.
What can I do for my youth with knee and/or hip pain? The top recommendations were therapist-prescribed exercise programs to address impairments, specific activity modification, disease-related education, and weight control or weight loss (if applicable). There are specific exercises which have been proven to decrease stress to the hips and knees that can help young athletes. Also, strengthening exercises can help to “protect” the joint for athletes to decrease the risk for ACL rupture or meniscal tears.
What if I am a “younger person” showing signs of hip and/or knee OA? Physical therapy should focus on a specific patient-centered history, comprehensive evaluation including joint mobility, muscle strength, and performance-based measures, and outcome measures to assess symptoms and function over time.
The key “take away” from this article was the importance of early intervention to decrease progression of OA and allow people to maintain their desired level of activity through their lifetime. If you have any questions regarding OA, hip and/or knee pain, please feel free to contact us here at Physical Therapy for EveryBODY at amykonvalinpt@gmail.com or (360)367-0970.

When on a family vacation, my sacroiliac joint (near the tailbone) went out of place causing extreme pain down my right leg every time I stepped on my right foot. Which is a challenge when you are spending your days and nights walking around theme parks! During a meal break in the middle of our day, I spent several hours stretching and performing joint mobilization to alleviate the symptoms. That night, I carefully positioned myself while sleeping to ensure that the joint had a chance to relax and “get back into position”. And it worked! The next morning I woke up with minor soreness that wore off while we were walking around the amusement park. Score one for self-care techniques!

You may be thinking, “Well, that’s great, Amy, but I don’t have your knowledge to take care of myself when I am traveling!” So let me tell you about a patient who was traveling overseas on a 3 week tour of Europe. This patient had been pain free for over a year but had all of her symptoms come back one morning while traveling. She had to miss the scheduled tours that day and was concerned about her ability to even complete the trip! While she was in her hotel room, she remembered all the exercises and self-care techniques we had worked on during her treatment time. She started at the beginning and worked her way to the end of her exercise progression all in one day! The next day she woke up, felt fine, and had no further problems for the rest of her trip! This is the long term success that I strive for with each of my patients.

Physical Therapy is intended to facilitate healing through the use of hands on techniques, a personalized home exercise program, and large amounts of education specific to each patient’s needs. At least, this is the definition we use here at Physical Therapy for EveryBODY. We believe that each body is unique and each person can be helped through a process of learning how to restore optimal health to return them to their optimal lifestyle. That may be walking, yoga, marathons, being a super parent, or finally getting your splits! Each body is unique, each person has a distinct learning pattern, and everybody has their own goals. Call us and learn more about how we can help your body to reach the goals your mind sets! www.physicaltherapyforeverybody.com or E-mail at amykonvalinpt@gmail.com or feel free to call us at (360)367-0970.