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Osteoarthritic Physio Clinic at The Sogunro Practice in St Albans


 “My hip is getting increasingly painful and stiff  and the painkillers and exercises I’ve been given aren’t helping”

Your joints are exposed to regular minor damage as a normal part of life and generally your body repairs it without you experiencing any symptoms. Osteoarthritis develops when there is damage to the protective cartilage on the ends of your bones that the body can’t fully repair. This results in joint pain and stiffness that usually develops gradually over time, most frequently in the hands, knees, hips, feet and spine. Osteoarthritis is a long-term condition, so it’s helpful to understand what causes it, what can make it worse, and things you can do to relieve your symptoms and help stabilise the condition.

What causes Osteoarthritis?

Often it’s a mix of factors that can increase your risk of developing osteoarthritis:

Age: osteoarthritis is usually starts from late 40’s onwards
Gender: it is more common in and often more severe in women
Obesity: being overweight puts excess strain on weight-bearing joints, such as knees and hips, increasing the risk of developing osteoarthritis and accelerating its progress
Joint injury: injury to a joint can result in the development of osteoarthritis in that joint later in life – injury can result from a traumatic injury to the joint (eg from an accident), or gradual injury as a result of long-term repeated heavy activities (eg from some types of sport or from a physically demanding occupation)
Joint abnormalities: abnormalities present from birth or as a result of illness can lead to the development of osteoarthritis earlier in life – unusually shaped bones, such as shallow hip sockets will allow the joint to move beyond its optimum range and can contribute to damage to the joint surfaces leading to osteoarthritis

What is Osteoarthritis?

Understanding what happens to your joint when osteoarthritis develops can help you to appreciate how the right exercises, stretches and musculoskeletal treatments can help.

The surfaces of your bones where they meet to form a joint are protected with smooth cartilage. Osteoarthritis causes changes to this protective cartilage so that it becomes pitted, rough and brittle. The different components of the joint then become over-active trying to protect, repair and stabilise the joint:
Bone beneath the damaged cartilage thickens and bony spurs form, preventing normal or smooth movement of the joint
Fluid is produced inside the joint for protection, causing the joint to become swollen and stiff
Ligaments thicken and tighten to try to stabilise the joint, creating further stiffness and pain as the joint becomes tight and compressed

The result is a swollen, stiff and compressed joint that is painful to move. At the extreme, in severe osteoarthritis, if the cartilage becomes too thin it leaves the ends of the bones exposed so that they rub together and start to wear away causing extreme pain, and at worst forcing the joint out of the normal position.

What can I do to help myself?

Osteoarthritis can’t be cured, but the condition can settle down over a number of years, and there is plenty you can do to relieve your symptoms and to help stabilise the condition.

Staying active is one of the most effective ways to reduce pain and keep your joints supple and muscles strong. The idea of exercising stiff and painful joints can be a daunting prospect, and many people are afraid to exercise because they believe that it will cause even more damage to their joints. But the reality is that inactivity leads to weaker muscles and stiffer and more painful joints, making movement even more difficult.

However the right strengthening and stretching exercises and musculoskeletal treatments can help relieve pain and keep you mobile:
Strengthening exercises: it’s normal to feel reluctant to move when you are in pain, but this will cause your joints to become stiffer and more painful, and after a very short time your muscles will weaken and get smaller. If your muscles get weaker your joints become more unstable, leading to more pain and inflammation, and eventually you become unable to do things that you could manage before. Strengthening exercises make your muscles stronger to help support the affected joints and keep you mobile.
Stretching exercises: Stretching exercises are designed to improve or maintain your joint mobility to reduce painful compression caused by osteoarthritis. In a short time, lack of movement causes the supporting structures around your joint (muscles, tendons and ligaments) to thicken and contract, further compressing your joint and creating more discomfort, pain and reduced mobility. The correct stretching exercises improve and maintain flexibility of your ligaments and tendons to get the best movement from your joints, help to keep your joints mobile and help ease aches and pains.
Musculoskeletal (MSK) treatments: MSK treatments such as manual soft tissue massage, electrotherapies and clinical acupuncture are used to help prevent muscles losing their elasticity, to relax tight muscles, to activate inhibited muscles and to increase circulation around the joint to reduce inflammation and pain.

Even if your osteoarthritis does progress to a more severe stage and the joint needs to be replaced there is a lot you can do to prepare your muscles, tendons and ligaments to get the best outcome possible.

Applied Pilates – how can we help?

Choosing the right strengthening and stretching exercises can help relieve pain and keep you mobile. The muscles that control joint movement provide significant joint stability if they are maintained in a healthy condition, and a combination of improved muscle tone and maintained joint mobility helps you to manage your osteoarthritis by protecting the affected joints from accelerated long-term damage.

However your osteoarthritis exercise programme must be tailored to fit your specific needs, taking into account the location and progression of your osteoarthritis, levels of fitness and your personal long-term objectives. It is essential that your instructor understands the nature of your condition and that only clinically appropriate exercises are used, therefore it’s important to make sure you attend a form of clinical pilates, such as Applied Pilates both to avoid damage and to achieve results. Any generic pilates routine, or classical pilates, or fitness pilates is therefore inappropriate as a tool for stabilising osteoarthritis, or for prehab or rehab should an operation be required. At the Sogunro Practice we use only condition-specific Applied Pilates exercises that have been clinically tried and tested, and we have years of experience dealing with a wide range of orthopaedic surgeries.

This type of clinical pilates is predominantly found in the 1:1 physiotherapy environment, and so is generally inaccessible outside of a clinical or rehabilitation context. However our unique format, where each client follows their own personalised routine within a small group environment means that Applied Pilates is a cost effective way to achieve your strength and mobility goals.

Osteolates and Physiotherapy – how can we help?

When a joint becomes dysfunctional through wear and tear, or due to traumatic damage, the nervous system selectively inhibits some muscles around the joint to avoid pain. The remaining functioning muscles begin to dominate and “guard” the joint, creating more misalignment, increasing instability, pain and dysfunction. We use Osteolates and Physiotherapy soft tissue treatment techniques to redress the imbalance and specifically to increase circulation in the area to reduce pain, to relax tight and guarding muscles, and to activate inhibited muscles. Osteolates and Physiotherapy treatment additionally helps prevent muscles becoming fibrotic (losing their elasticity) and formation of adhesions that can cause long-term chronic issues.

Other advice we provide for you

Osteoarthritis is a long-term condition, we can assist you to set realistic goals, help you understand the cause of pain and/or dysfunction at each stage, and give you the confidence to keep you moving through acute and chronic phases of osteoarthritis progression.

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