Knee Arthritis: Understand The Early Warning Signs

In Lower Extremity Pains by Royce Bowman, PT, Director

Do you find yourself wincing and experiencing a dull ache in your knee, especially after sitting for long periods of time? Do you feel stiffness when you first stand up? Maybe, you feel like something is rubbing against the side of your knee when you walk.

These are all common symptoms of early stage knee osteoarthritis.

In this blogpost, we will cover the basics on what knee osteoarthritis is, how it can impact your life and how to get relief from physical therapy.

What Does Knee Arthritis Feel Like? 

Common symptoms

  • Pain walking up and down stairs – On their initial visit, many knee pain patients express difficulty when navigating up and down stairs. Working through the full range of motion can create increased pressure. Even so, you can experience pain with something as simple as walking or weight-bearing activities.
  • Snap crackle pop – Patients express a lot of crackling, popping in the joint. The swelling in the joint space contributes to the popping or crackling feeling as your knee moves. With pain, the popping and cracking becomes more of a concern. Also, you have an exchange of gases, just like popping your knuckles. At times, that can be painful.
  • Swelling – will feel like an increase in pressure, when you’re bending the knee. This feels like putting a balloon inside of a nutcracker. The pressure moves to the back of the knee. Then, you often feel a pressing and a swelling pain, right around the kneecap. Due to swelling, a patient can feel tightness and have difficulty fitting pants over the knee.
  • Joint stiffness- painful movement, swelling makes it more difficult to move into flexion.

How Does Knee Swelling and Stiffness Affect Your Range of Motion (ROM)?

When you’ve been sedentary, you’ll feel stiffness and your motion is going to be lacking. The pressure limits your ability to straighten and bend your leg fully. In turn, this causes problems with walking and standing. With your ROM compromised, your legs don’t bend properly when you sit. Patients tend to plop down and risk additional injury.

As you can see, this creates a wicked combination of complications. And that is going to make it more painful. And then lead to, you know, debilitating changes and decreasing function and quality of life, especially if left untreated.

How Knee Arthritis Symptoms Affect Your Life and Work

For those living and working with an active job on a daily basis, you may be limited in your ability to complete your work obligations. You may work slower and require seated rest breaks.

Eventually, your knee pain can lead to full on activity modification and a change in your job description. Not to mention, the pain can increase and affect you after your working hours.

Osteoarthritis can affect those with sedentary jobs. When you’re spending a lot of time in a seated position, and have to stand, you’ll feel the stiffness and shooting pain in your knee. This leads to fatigue and you’ll be limited in your ability to do ordinary things.

  • Driving becomes painful with just the need to move your knee little by little.
  • Cleaning, mowing the grass, or participating in your kids/grandkids lives becomes limited.
  • Getting in and out of the tub or a shower grows precarious due to your limited range of motion.

These examples show how you’ll have a decreased quality of life. You’re not able to do what you need to do to care for your family, friends, and loved ones. Coupled with the pain and debilitating changes, arthritic knees weigh on you emotionally.

“…My typical appointment took about two hours and started with prepping the muscles using electricity, muscle building and coordination exercises, stretches, weight machines, and the elliptical and recumbent bicycle, massage and icing. My doctor said, “Your recovery is remarkable. You had severely injured your knee. I expected to see inflammation. Your muscles are strong and muscles usually atrophy very quickly.” I did not have to have surgery. Also if your prescription says two days a week, ask your doctor to increase it to three days a week. I’m convinced that it made a difference…” – Susan Thacker https://goo.gl/maps/68QX2iDWaTG2AXX16

Causes of Knee Arthritis

Age – with our aging population, osteoarthritis is rampant in the physical therapy field. Osteoarthritis is our most prominent arthritis diagnosis, especially in the knee.

The swelling and inflammation leads to the breakdown of structures within the joint capsule, especially the cartilage. As the shock absorber of the knee, the meniscus, gets leaned on quite a bit. As that wears down, you’re going to have more pressure, compression and swelling. This is where the bone on bone comes from. This points to the pathology of osteoarthritis.

Again, once arthritis progresses to a certain point, patients feel more pain which affects daily activities.

Weight – research  shows the literal impact weight places on your knee function. On a basic scale, any increase in weight multiplies the force and demand on your muscles, bones, cartilage, tendons and ligaments.

knee pain illustrationOn the other hand, decreasing your weight by 10 pounds can significantly lessen knee pain. Also, we often see improved function and quality of life reporting by osteoarthritis patients who lose weight.

Often, when you get on the path of recovering through exercise, arthritis doesn’t become as limiting of a pain. We find patients who exercise make significant changes in weight and body composition.

Knee injury – Todd Gurley, an NFL player and a young man in his 20’s has missed games due to arthritis. People, who think of osteoarthritis as a degenerative disease, wonder “how can you possibly get arthritis at that age?”

Traumatic injuries, ACL meniscal injuries, or any surgical intervention can lead to automatic inflammation and osteoarthritis.

Repetitive stress disorder – think about jobs which require squatting, standing for long periods of time, or walking up and down stairs. Jogging and running are repetitive activities. These repetitive activities put stress on muscles, joints, and ligaments which can lead to osteoarthritis.

Familial osteoarthritis – researchers haven’t determined why, but osteoarthritis often runs in families. Some research points at similar diets and lifestyles. Also, some people tend to be more prone to inflammation. Of course, inflammation fuels osteoarthritis.

Diagnosing Knee Pain

In general, patients going through knee pain often seek out a physician or orthopedic specialist. Often prescribed, x-rays usually show mild to moderate degeneration in the knee. Again, this is something that’s been shown to be part of the aging process.

In physical therapy, we ask questions. While arthritis could be present on any x-ray or MRI, we want to know how this arthritis is limiting the patient. Where might they be weaker or limited in motion? How does this turn into an individualized program ensuring the patient gets what they need out of their time in physical therapy?

What About Knee Surgery?

When you’ve got a younger person who’s battling arthritis, we evaluate their ability to exercise. Can they jog one or two days a week? How much do they want to avoid surgery? If they’re not able to do the things they want, we level with them. We ask if they are getting enough out of their exercise program. Or, do you think you need to look into surgery?

On the other hand, if someone

  • can’t meet their basic range of motion goals
  • pain is overwhelming
  • they’re not able to complete the basics of their daily life or
  • can barely get through their home exercises without experiencing pain

that’s when we need to sit down and have a conversation.

We’ll tell a patient they need to step back and seek help from an orthopedist and explore other options. That’s not an easy conversation to have, but that’s part of the work a physical therapist does.

Be proactive and vigilant about your physical health. Don’t let knee osteoarthritis sideline you!

Do you have questions about your first visit or insurance? You can schedule an appointment by calling or completing our HIPAA compliant appointment.