Consultant orthopaedic surgeon Mr Sean Curry continues our series on therapeutic exercises with a guide to osteoarthritis of the knee and when exercise programmes are appropriate
Knee osteoarthritis is a common condition causing pain and disability, particularly in the elderly. The severity of the pain is not always matched by X-ray findings.
Drug treatments and surgery are not suitable for all. Physiotherapy is often recommended and can be very useful either in isolation or in conjunction with drug treatments or surgery.
Physiotherapy is often on a one-to-one basis and can require expensive equipment. NHS physiotherapy is also often rationed and only a limited number of treatments may be offered.
A home-exercise programme is an alternative and its aims are to improve the range of motion at the knee as well as maintain and improve the strength of the muscles around the knee. In one UK study of the benefits of a home-based exercise programme for knee pain, the pain reduction was greatest in patients who adhered most closely to the programme and the benefits were felt for up to two years.
Patients with frequent knee pain – on most days for at least a month.
Three exercises are described in the box, right, and in the accompanying video and patient information leaflet.
Straight leg raises involve gradually straightening up the leg from a seated position.
For static quads, patients lie down with their legs straight and feet pointing up. The knee is then gently pressed into the floor, contracting the muscles in the front of the leg before relaxing.
This exercise is progressed by combining it with raising the leg gently up from the floor.
Significant ischaemic heart disease or cardiac pacemaker.
Thirty minutes per day.
Mr Sean Curry is a consultant surgeon at the London Orthopaedic Clinic
The London Orthopaedic Clinic holds free monthly education sessions for GPs. For more information: www.londonorthopaedic.comExercise programme for knee OA Exercises for patients with osteoarthritis of the knee Exercises for patients with osteoarthritis of the knee: patient leaflet