Unfortunately, on the whole, physiotherapists don’t do a very good job at letting the public know what it is we actually do. Other health professionals, such as chiropractors, are well known for their ‘spinal cracking’ but physiotherapists on the other hand are generally thought of as glorified ‘masseuses’ or the people that ‘run onto the sporting field’.
As a result of this, people are generally unaware of the hundreds of conditions that physiotherapists commonly treat, including osteoarthritis and joint pain. Joint pain affects over 40% of the Australian population in some way. Whether it be the major peripheral joints like knee, hip or shoulder or smaller joints such as those in the fingers or feet, joint pain can have a deleterious effect on day to day function.
So what can a physiotherapist do for joint pain.
Before I explain what it is a physiotherapist can do for joint pain, let me discuss what commonly causes joint pain.
In the vast majority of cases, joint pain is caused by a gradual overloading of the joint. This occurs over a long period of time, and usually starts with a loading of muscle tissue. This muscle tissue will become weak and tight until it cannot sustain any more force being applied to it. This usually happens in situations of poor posture for prolonged periods. (see this article on why a massage wont work for back pain). This loading is then transferred onto the joints and over a long period of time, the internal structures of the joint (such as cartilage) will gradually wear aware causing excessive loading or ‘bone-on-bone’.
Globally, with our ageing population, this is becoming a significant problem. As a result, health agencies around the world are investing heavily into research around what the best practice is for managing joint pain.
Physiotherapy for joint pain is a hot topic at the moment and thankfully there is a lot of positives outcomes from this research. In simple terms, physiotherapy for joint pain works in two ways:
- Restore normal ranges of motion to the joint
- Strengthens surrounding muscles so they can deal with loading
Restore normal ranges of motion to the joint
As a result of the process mentioned above, the joints become stiff and lose small amounts of movement. This ‘stiffening’ process is actually a protective mechanism that is employed by your body to support our body weight when our muscles have fatigued, however it unfortunately leads to the commonly associated stiffness and soreness that joint issues are known for. Through specialized physiotherapy techniques, we are able to gently mobilise (move) the stiff joints so that they have a normal amount of ‘free-play’ within them. This reduces both the stiffness and pain and makes the joint feel much ‘freer’.
Strengthens surrounding muscles so they can deal with loading
Through an individualized exercise program which strengthens the correct muscles in a synchronized order, long term joint pain can be significantly reduced and with compliance, resolved completely.
By strengthening the muscles around the joint, as the joint is loaded, these muscles do more of the work as opposed to the sore and inflamed joint being loaded.
Let’s take the knee for example as it is one of the most common areas that a physiotherapist can help joint pain.
If the knee joint is osteoarthritic and stiff, then more than likely, the local muscles have atrophied (reduced in size) and lost their activation potential (hard for you to tense them). Therefore, it is important the physiotherapists delivers both activation (knee squeezes) and leg strengthening (leg press) in the appropriate order and timing to resolve both of the aforementioned impairments.
There is a lot that physiotherapists can do for joint pain and arthritis. It does not and should no longer be labelled ‘a part of ageing’. So the next time you get told that, or hear people say that, then make sure you tell them that there is plenty you can do to reduce the effects of joint pain, it just requires a little bit of hard work and dedication!