Physio Knee FAQs

The Knee is a very complex joint, with many potential structures that can be injured or become inflamed, including the supportive ligaments, its powerful muscles or tendons, the meniscal cartilages (the ones footballers typically injury) and the protective joint bursas (sacs of fluid that act as cushions between tendons and bones). One commonly seen condition is Osteoarthritis of the Knee. This is a condition that causes roughening and thinning of the articular cartilage that lines the bones and acts as a protective layer over the bone ends. This can be accompanied; • By bony spurs (osteophytes) at the edges of the joint. • Thickening of the synovium (the layer of tissue that produces the fluid that it needs to lubricate the joint) and this produces excessive fluid causing the joint to swell. • Thickening of supportive soft tissues of the Knee • Ultimately in the advanced stages, the Knee joint may start to show signs of deformity due to a change of angulation of the bones in relation to each other.

Symptoms of Osteoarthritic (OA) Knee can include; • Pain (often over the inner Knee) • Stiffness of the Knee (especially first thing or after periods of rest) • A grating or grinding sensation (crepitus) when the Knee is moving • Swelling (can be hard or soft) • Thigh Muscle (Quadriceps muscle) weakness or wasting • Knee giving way or “letting you down” feeling • Pain on Kneeling • Difficulty with functional activities eg ascending or often worse, descending stairs

• Age; OA usually starts from the late 40’s onwards, due a combination of weakening muscles, gradual wearing of the articular cartilage and the body being less able to heal itself with age. • Gender; OA is more common and severe in Women then Men • Joint injury; Any major injury or operation to the Knee will predispose the Knee to earlier onset of OA changes than would be usually expected. Normal activity and exercise don’t cause OA, but very hard, repetitive or physically demanding jobs can increase the risk. • Joint abnormalities; if you were born with joint abnormalities or developed joint problems in childhood, it can lead to early onset and more severe OA than would be expected. • Genetic factors; There is no clear genetic link to OA, but strong Family history can be seen in some cases of OA Knee. • Following other types of Joint disease; Sufferers of Rheumatoid Arthritis and Gout can cause articular cartilage damage which can lead to OA changes.

There is no “cure” for OA Knee but there are many self management things that you can do to help control the symptoms of pain and joint stiffness. • Keeping Fit and Active is very helpful, making sure there is a balance between activity and rest. • Strengthening exercises for the Thigh muscles and extremely important and will help support the Knee Joint. • Prevention of Joint stiffness • Control swelling with Ice (an ice pack / bag of frozen peas wrapped in a damp T-towel for 10 mins) • Local warmth can be soothing for an achy Knee • Weight management; This will help reduce stress on the inflamed joint. Every pound lost equates to x 8 less pounds of pressure on the knee when coming down stairs.! • Tablets; see your GP or Pharmacist for advice on Analgesia or Non Steroidal drugs. • Creams / gels; There are many anti-inflammatory gels that can be applied to the Joint that are absorbed through the skin and can be helpful in some cases for providing pain relief to the Knee.

Try the exercises available on our website under Whole School Wellbeing > Pastoral & Wellbeing resources > select area of the body on the SAS website. (This area is password protected for clients only. Please contact SAS to verify you are an SAS client to access the password. repeat regularly during the day, little and often ( X5- 10 Repetitions , x3-5 / day)

• You can be referred by the SAS Nursing Team to our Network of Physiotherapists. • We only use Qualified Physiotherapists who are HCPC (Health and Care Professions Council) registered and are members of the CSP (Chartered Society of Physiotherapy).