Knee Osteoarthritis (KOA)

Osteoarthritis (OA) stands as one of the prevailing chronic and degenerative maladies affecting cartilage, particularly prevalent among the elderly populace, with a notable predilection towards women. It is a common condition of the musculoskeletal system that can occur in any joint such as the upper limbs or spine, but it is mainly observed in large joints of the lower extremities, such as the hip and knee. These weight-bearing joints bear the brunt of loading activities, which require smooth, successful completion and absorption of loads or vibrations. Moreover, the progression of OA involves the gradual deterioration and depletion of articular cartilage concurrent with osteophyte development, synovial membrane inflammation, and hypochondriac bone destruction. Clinical manifestations include pain, stiffness, swelling, joint deformities, and functional impairment, with advanced stages potentially leading to muscular atrophy, further compromising the quality of life for afflicted individuals. OA is also among the diseases with the highest rate of comorbidity, which include: cardiovascular diseases, diabetes, obesity, chronic obstructive pulmonary disease (COPD), chronic pain and even depression (de Rooij et al., 2014).

Research by Tsokanos et al. (2021) has indicated that therapeutic treatments such as manual therapy (MT) and exercise contributes positively toward the treatment of patients suffering from KOA by reducing pain and increasing functionality. In addition, Nejati et al. (2015) had previously shown that performing exercise while also receiving MT for the knee showed significant positive effects that lasted up to a year.

Manual therapy encompasses a variety of hands-on techniques performed by trained healthcare practitioners to diagnose, treat, and manage musculoskeletal and neuromuscular conditions. Some common manual therapy techniques include:

• Joint Mobilization: This technique involves the passive movement of a joint within its natural range of motion. It aims to improve joint mobility, reduce pain, and restore function. Joint mobilization is often applied to the spine or extremity joints.
• Soft Tissue Massage: Massage therapy involves the manipulation of soft tissues, including muscles, tendons, and ligaments. Various techniques such as effleurage, petrissage, and deep tissue massage are employed to enhance blood circulation, reduce muscle tension, and promote relaxation.
• Myofascial Release: This technique focuses on the fascia, a connective tissue that surrounds muscles, bones, and organs. Practitioners use sustained pressure to release tension and tightness in the fascial system, promoting improved mobility and reducing pain.
• Trigger Point Therapy: Trigger points are localized areas of muscle tightness and tenderness. Therapists apply pressure to these points to release tension and alleviate pain. This technique is often incorporated into massage or manual therapy sessions.
• Strain-Counterstrain: Also known as positional release, this technique involves placing the body or a specific joint in a position of minimal strain, allowing muscles to relax and pain to diminish. It is particularly useful for treating muscle spasms and acute pain.
• Stretching Techniques: Manual therapists use various stretching methods to improve flexibility, enhance range of motion, and alleviate muscle tightness. This may include static stretching, dynamic stretching, and proprioceptive neuromuscular facilitation (PNF) stretching.
• Neural Tissue Mobilization: This technique focuses on mobilizing and releasing tension in the neural structures, such as nerves and nerve roots. It aims to address conditions involving nerve compression or irritation, such as sciatica.

As part of a comprehensive approach to managing musculoskeletal disorders and promoting overall well-being, myotherapists here at HBM may employ these techniques, among others, to treat KOA.

Listed below are some details of a client dealing with KOA who is seeking treatment here at HBM, which may also serve as a case study:

Age: 70+

Gender: F

Symptoms: Pain and swelling in both knees (particularly in right), with apprehension and restriction fully bending and straightening knees out.

Medical history: Recent scans showing severe OA of R knee, no previous surgery to lower limbs.

Lifestyle: Retired but still active. Walks at least 10k steps/day, and goes for aquarobics class daily.

The client has to date received 2x treatments here at HBM in the span of a month and noted an improvement in pain and functionality. After the second treatment she mentions how the treatment has given her hope for managing her knee pain again.

If you or someone you know are dealing with KOA, book in an appointment to see us now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain.

Simply click this booking link for the myotherapy initial consultation with our experienced myotherapist Jerry Song.