Sep 23, 2013 By Jim Black for The 4 min read

Justin Deskovich shares a story about his grandmother, who eight years ago was told she had knee osteoarthritis (OA). As he describes it, she was diagnosed with “two 1-inch potholes” in her knee cartilage.

Today, he says, her knees still function well and she remains active, partly because she underwent physical therapy and followed the exercise advice of Deskovich, a physical therapist with Orthopedic & Sports Physical Therapy Associates, in Farmington.

The story illustrates the importance of each person’s role in managing and preventing knee OA. Although a number of surgical and non-surgical treatments can ease knee OA pain, none works as effectively if patients aren’t willing to exercise, optimize their weight and adhere to the recommendations of their physician or physical therapist, Deskovich and other experts say.

“It all comes down to patient accountability,” Deskovich says. “Home exercise compliance is such a key. You need to do these treatments to prevent surgery, and the patient is going to be accountable for his or her actions. My personal experience is that if I have a highly motivated person who’s not fearful of movement and they do what I say, 75 percent are avoiding a knee replacement.”

Keep moving

The human body has 207 bones but more than 650 skeletal muscles, all of which support the function of the knee and other joints. People who remain inactive lose muscle mass and tone, while those who stay physically active can maintain their muscles and promote better joint function. Plus, keeping knees mobile stimulates production of natural lubricating fluids that protect the knee joint and its articular cartilage.

“Sedentary lifestyles are very correlated with arthritis. The more you sit, the more damage you’re doing to your joints,” says Jose Ramirez-Del Toro, a physical medicine specialist with The Orthopedic Group. “You should start with a physical therapy consultation, so they can teach you how to do these strengthening exercises. If you have strong muscles, they’ll act like shock absorbers and prevent potential wear and tear in the knee.”

Physical therapists educate patients about exercises, perform manual therapy to improve joint mobility, and diagnose and correct movement disorders and other variables that cause joint pain, Deskovich explains. For example, a patient who compensates for a hip or ankle problem may add stress to the knee. “We need to make sure that we correct imbalances that are leading to the problems that cause knee pain,” he says. “You have to change the environment where you give patients mobility where they need it and stability or strength where they need it.”

Among the most crucial muscles for stabilizing and maintaining function in the knee are the quadriceps and hamstrings, Deskovich says (see chart for exercises that target these muscles).

Although exercise is a must, it’s equally important to do the right types of physical activity. In general, Deskovich says, low-impact aerobic exercise like biking, swimming, elliptical machines and light treadmill walking are better for knee OA patients, while basketball, running, jogging and singles tennis tend to cause more knee strain.

“An exercise prescription from a physical therapist would be the safest route,” he says. “I would rather get patients sooner than later. If you’ve had knee arthritis symptoms for more than a couple weeks to a month, they’re probably not going to go away on their own at that point. If we can catch it earlier, the better chance we have to treat it.”

Shed pounds

A lack of physical activity contributes to obesity, a leading risk factor for knee OA. Added pounds place added stress on the knees with each step. Plus, emerging research suggests that obesity also might contribute to arthritis on a metabolic level, as fat cells produce toxic, inflammatory substances that may damage cartilage.

Staying active and following a healthful diet can minimize the risk of OA in the knee and other joints. Ramirez-Del Toro recommends an anti-inflammatory diet rich in fruits, vegetables and whole grains and low in red meat, fried, fatty or processed foods, and foods and beverages with added sugar.

“Going on an anti-inflammatory diet will certainly cut pounds off,” he says. “Just changing how you eat can decrease inflammation dramatically. We eat a lot of foods that are fried and tasty, but those are the foods that can be harmful to a lot of our joints.

“The most important things you can do are the lifestyle modifications and physical activity because those are the things that have long-term benefits for the joints,” he adds. “All of these things tend to help joints and slow down the disease process of arthritis and sometimes mitigate it altogether.”