Millions of people around the world are desperate for a solution for their knee osteoarthritis pain, but the pain relief game has changed. With the rise of opioid abuse, people are beginning to recognize the detriments of relying on NSAIDs and/or prescription medication that not only have a high risk of forming dependencies, but really only mask their symptoms. This leaves a gap to be filled; how can their symptoms be cured instead of covered up?
Knee Osteoarthritis Pain Relief Starts Here
If we’re removing pharmacological interventions from the equation, healthcare professionals are now tasked with providing evidence-based solutions to these patients. Fortunately, years of research have proven over and over that elastic resistance-based exercise can deliver a reduction in knee osteoarthritis pain and an increase in strength and mobility. More specifically, one systematic review of 45 studies on knee osteoarthritis strengthening found at least a 30% increase in strength was necessary for improvements in pain and disability (Bartholdy et al. 2017). Let’s dive into all of the factors that can help you meet or exceed this 30% increase in strength and help relieve your patients of their daily discomfort (and the research studies that prove these methods aren’t too good to be true).
What to Train for Knee Osteoarthritis Pain Relief
“The knee, duh” is an expected response; and yes, classic knee-focused exercises like the leg press done with a TheraBand Elastic Resistance Band can significantly improve pain and function in older adults with knee osteoarthritis (Chang et al. 2012). However, researchers have also found that hip muscle strength is a factor in excessive knee adductor force (Chang et al. 2005).
It might seem counterintuitive to focus on the hip when building a knee osteoarthritis rehabilitation protocol, but Dr. Vladimir Janda’s work with phasic and tonic muscle systems as well as his muscle imbalance syndromes prove that regional interdependence plays a massive role in chronic pain. This was further proven through two studies:
- All pain, function, and strength measures significantly improved in the hip training exercise group vs. a control group. Strengthening hip muscles using TheraBand Elastic Resistance Bands and Cuff Weights can successfully reduce symptoms of medial knee osteoarthritis (Download the protocol here) (Bennell 2010).
- An exercise program resulted significantly increased hip abduction strength, functional performance as well as a reduction in knee pain to reach the level equal to the non-arthritis group. The authors concluded that TheraBand exercise bands could be used effectively to reduce pain and increase strength and function in knee osteoarthritis patients (Sled et al. 2010).
Based on the results of these studies, hip strengthening exercises are a must-have addition to your knee arthritis rehabilitation protocol.
How You Should Use Elastic Resistance Training
When building these exercise programs, clinicians commonly favor isometric training over dynamic training because of the common range of motion and function deficits that come with osteoarthritis. To confirm this concept, researchers put both to the test in a 16-week trial.
Turns out, both groups decreased knee pain by 28% to 58% while performing functional tasks, and other measures of pain and functioning were significantly seen in both groups. The researchers concluded, “dynamic or isometric resistance training improves functional ability and reduces knee joint pain in patients with knee osteoarthritis” (Topp et al. 2002). While your training recommendations will vary based on patient and symptom severity, know that you’re not limited to isometric alone… your patients might be more ‘dynamic’ than you think!
Evidence-Based Additions to Knee Osteoarthritis Exercise Training
When building a knee osteoarthritis rehabilitation program, consider these three additions for a boost of pain relief:
In 2015, researchers investigated the addition of manual therapy to exercise for the reduction of pain and increase of physical function in people with knee osteoarthritis. The results proved that “providing manual therapy in addition to exercise therapy improved treatment effectiveness compared to providing exercise therapy sessions alone” (Abbott et al. 2015). Another study indicated that a home exercise program for patients with osteoarthritis of the knee yield important benefits, and adding a small number of additional clinical visits for the application of manual therapy and supervised exercise adds greater symptomatic relief (Deyle et al. 2005).
Whether you’re using a hands-on approach or instrument assisted soft tissue mobilization (IASTM) tools like HawkGrips, manual therapy is a worthwhile adjunct to the prescription of rehabilitative exercise.
Stability training has been proven to be an effective addition to resistance training in patients with knee osteoarthritis. One study in particular found that patients who used TheraBand Elastic Bands for open-chain lower extremity exercises and patients who performed balance training and agility exercises using TheraBand Stability Trainers both found significant improvements in quality of life (Rogers et al. 2012). Whether used separately or in combination, both modalities are research recommended ways to help alleviate pain and improve function.
Knee pain can strike at any hour of the day, so your patients need portable pain relief they can use anytime, anywhere. That’s where topical analgesics play a massive role. One study found that “the use of topically applied 3.5% menthol ointment may provide temporary pain relief and help improve tolerance and compliance with activity in patients with knee osteoarthritis” (Brosky et al. 2012).
When choosing a topical analgesic to offer, Biofreeze is not only incredibly well researched, but well recognized and trusted among clinicians and patients alike. Providing your patients with Biofreeze Professional both in clinic and at home is an easy, cost-effective pain management solution that you can pose as a valuable extension of your care.
But Wait… What About Surgery?
Because there is no known cure for arthritis, knee osteoarthritis treatment is based on symptom management through medication, surgery and physical therapy. Some arthritis sufferers believe that exercise may cause more harm than good, and typically opt for arthroscopic surgery to ‘clean-out’ the knee. In addition to the cost of surgery, there are obvious risks. Despite the high number of arthroscopic surgeries for knee arthritis (also known as “debridement”), little evidence supported its efficacy.
In fact, researchers set out to determine if physical and medical therapy was as effective as arthroscopic surgery in the treatment of knee osteoarthritis. The researchers found that physical therapy, including TheraBand exercise, was indeed as effective, resulting in similar outcomes for pain and function (view the protocol here) (Kirkley et al. 2008).
However, if patients are not completely comfortable with substituting surgery, using exercise in a prehabilitation protocol has also been proven to give promising results. One study’s findings stated that older adults with severe knee osteoarthritis who engage in a resistance band and step exercise program before their total knee arthroscopy improved their knee flexion and extension strength and the ability to perform some functional tasks (Swank et al. 2011). No matter which side you or your patients are on, exercise and knee osteoarthritis go hand-in-hand (leg-in-leg?).
Bottom Line: Elastic Resistance Training is Best for Knee Osteoarthritis Pain Relief
Staying active is important for everyone, but especially so for those suffering from knee osteoarthritis. Not only will structured exercise programs prescribed by a healthcare profession benefit them physically, but it will also help alleviate their daily pain so that they may lead more comfortable, productive lives. As a bonus to your expert care, providing your patients with tools like the TheraBand CLX Elastic Resistance Band gives them unmatched in convenience, portability and ease-of-use in all in-clinic and home programs.
Also, check out our friends from the Arthritis Foundation! The Arthritis Foundation pain toolkit also contains excellent, free resources to help you with “Breaking the Arthritis Pain Chain.”