1. KNEE OSTEOARTHRITIS AND
PHYSICAL THERAPY BASED
SOLUTIONS
DR. KUNJAL SHAH GADA
M.P.TH (SPORTS)

2. OBJECTIVES
• What is osteoarthritis of knee and how it affects
us.
• Explain physical therapy approach towards knee
problem
• Teach preventive strategies
• Details of physical therapy treatment options
available.

3. INTRODUCTION
• Osteoarthritis (OA) is the most common disease
affecting weight bearing joints. It gradually leads to a
disability restricting the individual from various daily
functional activities.
• It is currently a very big concern and slow growing
disability causing disease in our society which requires
awarness and preventive management.
• This condition does not follow the same course in
everybody and there are certain things that you can do
to help yourself and prevent problems in the future.

4. OA KNEES
• TIBIOFEMORAL JOINT
• PATELLO FEMORAL JOINT
• LINKAGES

5. THE KNEE JOINT ANATOMY

6. THE PATELLOFEMORAL JOINT

7. EFFECTS OF
OSTEOARTHRITIS ON
THE KNEE JOINT

8. EFFECTS OF OA KNEE
The cartilage
becomes thin
and worn
away
especially
where more
weight is
borne

9. EFFECTS OF OA KNEE
• The joint
space
becomes
narrower
allowing less
space
between the
bones for
movement.

10. • Increased stress/load
on the ligaments and
muscles and the
capsule may lead to
inflammation
(swelling). The capsule
may become
thickened.

11. EFFECTS OF OA KNEE
• New bone forms
at the edge of the
joint which can be
quite rough
(osteophytes).

12. EFFECTS OF OA KNEE
• Cartilage may fragment to give loose pieces
causing symptoms of locking or giving way of the
knee.

13. EFFECTS OF OA KNEE
• The inflammation and
swelling may cause pain.
• Decreased mobility due to
pain/ aching and fear of
making the knee worse may
lead to muscles wasting and
weakening, therefore
causing more stress and
decreased protection to the
knee joint.
• The knee becomes stiff as it
is moved less through its
available range of
movement.

14. Grades of OA KNEE

15. OTHER CONDITIONS ASSOCIATED
WITH OA KNEES
• PATELLOFEMORAL PAIN SYNDROME
• SCIATICA
• FLAT FOOT/ PRONATED FOOT
• TRAUMATIC ARTHRITIS
• MENISCAL/ ACL/PCL LIGAMENT TEAR.
• OBESITY
• FAULTY POSTURE.

16. PHYSIOTHERAPY
ASSESMENT IN
OSTEOARTHRITIS OF
KNEE

17. PHYSIOTHERAPY ASSESMENT
o Chief Complains (Functional Problems)
o Tightness / Weakness
o Hip Musculature Tone / Strength
o Foot posture
o Gait Problems
o Proprioception
o Daily functional activity restriction.
BIO
MECHAN
ICS

18. CHIEF COMPLAINS
Area of Pain
Pain Scale
What Activities Cause/ relieve Pain
Problem since how many Days / Months / Years
Daily Routine (Job / Housework)
Clicking / Locking of Joint
Swelling / Temperature

19. BIOMECHANICS-(TIGHTNESS/
WEAKNESS)
• When muscles around knee & thigh are tight they
are not able to contract to their full capacity, as a
result over a period of time the become weak as
well…hence the term tight / weak muscles
• Such problems in turn results in deformities and
other complications like knock knees, bow legs,
abnormal gait

20. BIOMECHANICS (HIP
MUSCULATURE / TONE)

21. (BIOMECHANICS)FOO
T POSTURE

22. BIOMECHANICS (ABNORMAL GAIT)

23. PROPRIOCEPTION

24. DAILY FUNCTIONAL ACTIVITIES
• Squatting
• Climbing up.
• Descending stairs
• Getting in and out
of the car
• Walking or
standing for log
time
• Sitting cross
legged.
• Early morning
stiffness.

25. POSSIBLE TREATMENTS
• Physiotherapy rehabilitation
• Aids
• Medication
• Surgery

26. Physical Therapy Treatment Options
• Preventive Strategies
• Joint Mobilizations
• Taping
• Knee Braces & Stick
• Foot Posture Corrections & Footwear Change
• Gait Rehabilitation
• Accupuncture / Soft Tissue Release
• Ergonomic Analysis & Correction
• Basic Rehabilitation (4 Weeks)
• Advanced Rehabilitation (8 Weeks)

27. PREVENTIVE STRATEGIES
• Any kind of physical activity (Climbing Stairs / Walking /
Jogging / Cycling / Yoga / Gym / Swimming / Sport)
• Use good footwear with arch support
• Avoid roaming around bear foot in house
• Every time you want to pick something from ground, try
and squat in a right manner
• Whenever a tiring day in office / house…. stretch your
body before going to bed
• Use a stool / small table to alternate weight shift if u have
to stand for long hours
• Consult a physical therapist whenever minor / major
problems

28. JOINT MOBILIZATIONS
• Improve Joint Mobility
• Improve Blood Flow In The Joint

29. TAPING
• Helps in Improving
Alignment
• Used in Pain Relief
• Reduces Swelling
• Prevents Excessive
Movement

30. Knee Braces & Stick

31. Foot Posture Correction

32. GAIT REHABILITATION

33. Accupuncture / Soft Tissue Release

34. Ergonomic Analysis

35. BASIC REHABILITATION
PROGRAMME
FOR 1 MONTH /FIVE TIMES A WEEK/
TWICE A DAY

36. FIRST WEEK
• NON WEIGHT BEARING EXERCISES
• STRETCHING
• JOINT MOBILIZATIONS
• FOOT POSTURE CORRECTION
• WEIGHT CONTROL MEASURES
• ORTHOTIC AID/ TAPING
• ACCUPUNCTURE/ SOFT TISSUE RELEASE

37. 2ND WEEK
• STRENGTHENING EXERCISES
• STRETCHING
• ACCUPUNCTURE/ SOFT TISSUE RELEASE
• CARDIO (SWIMMING/ CYCLING)
• FOOTWEAR ASSESMENT AND MODIFICATION

38. 3RD & 4TH WEEK
• STRENGTHENING AND WEIGHT BEARING
EXERCISES
• FUNCTIONAL REHABILIATATION
• ACCUPUNCTURE/ SOFT TISSUE RELEASE.
• CARDIO EXERCISES
• POSTURE ASSESMENT AND CORRECTION

39. ADVANCED REHABILITATION
(2 MONTHS/ 3 DAYS A WEEK)
• STRENGTHENING WITH WEIGHTS
• BALANCE TRAINING
• GAIT REHABILITATION
• CARDIO (SWIMMING/ CYCLING)
• REGULAR STRETCHING
• FULL BODY MASSAGE (ONCE A WEEK)
• ACCUPUNCTURE/ SOFT TISSUE RELEASE

40. Any Questions ?