KNEE OSTEOARTHRITIS

Diagnosis

It is now accepted that the best way to diagnosis osteoarthritis in your knee (and many other joints for that matter) is your health practitioner interviewing you thoroughly about your problem and closely examining your knee – especially how it looks, feels, moves and most importantly, determining what you can and can’t do easily.

In most cases X-rays and/or scans are not necessary for diagnosis, and are not helpful for determining the severity of your problem or what treatment is best for you.

Management

The most important person involved in managing your knee arthritis is you!

A Physiotherapist’s role is to educate and advise you on the nature of your problem and how best to manage it so you can minimize its effect on your daily life. So, in a way, your physiotherapist acts like your personal “body” coach!

In the case of knee osteoarthritis, there are three main areas of management that are the key to a good outcome:

1.      Keeping your joint healthy – Learning how to protect your knee from exacerbations, what best to do if such a flare up occurs and maintaining your knee joint in as good a condition as possible. Your physiotherapist can advise you on all of these important strategies.

2.      Exercise – this includes strengthening and stretching exercises and increasing your general fitness – your physiotherapist will design a program especially for you and your lifestyle. Research has shown that exercise is as effective as drug treatment for management of knee osteoarthritis and, of course, has less side-effects and great side benefits!

3.      Weight loss and load management – knees are very sensitive to weight gain, so even a small loss of weight can reap great benefits for your knee. Your physiotherapist can give you advice on modifying your activity, exercise and/or sport routines so you are not overloading the knee.

Good management of knee osteoarthritis means less pain and disability and hopefully puts off or negates the need for surgery in the future.

Warning: Sitting may kill you!

In recent years, Australians have become increasingly accustomed to sitting down—at work, on the couch, in the car—and it’s taking a major toll on the health of individuals and our economy.

This sedentary lifestyle is part of the widespread problem of obesity and other related health diseases that lead to more than 7,200 deaths each year. This is why Albert Park Physiotherapy supports the Australian Physiotherapy Association’s ‘Australia’s Biggest Killers’ campaign; aiming to encourage Australians to get off the couch, get moving, and embrace healthy and active lifestyles.  

Obesity in Australia—what’s the impact?
In the past twenty years, obesity has become the leading cause of premature death and illness in Australia, with 14 million Australians now considered overweight or obese.

In their latest study, the Monash Obesity and Diabetes Institute found that if weight gain continues at current levels, close to eighty per cent of adults and thirty-three per cent of children will be overweight or obese by 2025.

Being overweight or obese puts you at high risk of:

•   Heart disease
•   Stroke
•   Type 2 diabetes
•   High blood pressure (hypertension)
•   Kidney disease
•   Osteoarthritis
•   Endometrial, breast, and colon cancers
•   Mental health and eating disorders

How can you tell if you are at risk of being overweight or obese?
By using two well recognised methods of determining if you are overweight or obese, such as the Body Mass Index (BMI) and Waist Circumference.

BMI
BMI= weight(kg)/height (m)2

•   25 to 29.9 (Overweight)
•   30 to 39.9 (Obese)
•   40+ (Severely obese)

Waist Circumference
You are more likely to develop obesity-related health problems if you are: 

•    Male with > 95cm waist circumference
•    Female with > 80cm waist circumference

Combatting the issue—it all starts with getting active
Research shows that more than 6.4 million Australians are currently doing less than an hour and a half of physical activity per week. Sitting is associated with weight gain and obesity, unhealthy blood-glucose and blood-lipid profiles, and premature death from heart disease. To combat these outcomes we need to be moving more—not just exercising for thirty minutes, but regularly moving throughout the day; even something as simple as standing up while you’re at work.

Inactivity is not the only cause of weight gain. There may be other determinants at play such as social, environmental, behavioural, genetic, physiological, or psychological factors. Thus, we need a range of resources, education, and support services that can help us to make long-term changes to our quality of life.

How a Physio can help
At Albert Park Physiotherapy, our physiotherapists can: design exercise programs for individuals who are obese or overweight; identify and prescribe programs most suited to your medical condition; develop a program of exercise to increase your physical activity safely and effectively; and help identify necessary and achievable changes in your lifestyle.

An initial referral to a physio can be a good way to get started with short-term goals that will assist you to maintain a healthy lifestyle.

Resources:
100 ways to move
ABC Health and Wellbeing
Australian Institute of Health and Welfare
Baker IDI Heart & Diabetes Institute
Better Health Channel
Heart Foundation
Monash Obesity and Diabetes Institute
Obesity Australia

Australia's Biggest Killer. Australian Physiotherapy Association (APA). (2016, June). Retrieved from http://www.physiotherapy.asn.au/APAWCM/Advocacy/Campaigns/APAWCM/
Advocacy/Campaigns/Australia_s_Biggest_Killer.aspx 

‘Is screen time affecting more than kids’ minds?’

This year, a research team at Curtin University in Perth are leading a world first study into the impact of touchscreen devices on children’s physical development. The study, currently in the planning phase, will take place over a five-year period and involve looking for evidence that supports the theory that the use of screen time in very young children:

·       Increases risk of obesity;

·       Results in poorer motor skills from prolonged sitting; and

·       May lead to poor neck posture and consequent neck pain later in life.

Researchers are hoping to use the results of the study to develop guidelines that will help health practitioners to make recommendations. 

So far, the research team have completed a small motion analysis study of three ten-year-olds, comparing effects of playing on a tablet, watching television, and playing with physical toys. The results of the study found that the children were more sedentary when using the tablet and watching TV than playing with toys, where they were found to have more varied muscle activity. Those who played with the tablet also had more neck flexion than the other two.

The new study will build on this research, along with a previous study by the same research group on children’s TV watching habits between ages five to seventeen. Researchers anticipate an even greater impact from touch screen devices due to their portability; their use is not limited to the household as with a TV.

Whilst the Australian Department of Health suggests that children under two years should not have any ‘screen time’, a national survey of 150 parents found that two-thirds of children aged between zero to five, are already using tablets, and more than a third use them for more than thirty minutes each day.

It’s not all bad news - technology does have some positive effects, as researchers have found games such as Pokemon Go and Kinect useful in engaging children in physical activity if used the right way.

General Message: If your child learns good habits early regarding screen time,  it should set them up well for a healthy childhood and well into onto adulthood as well. 

Reference: Australian Physiotherapy Association. (2016). ‘Is screen time affecting more than kids’ minds?’ InMotion October 2016. 24-25.