Knee, Osteoarthritis. Can exercise worsen situation?

Chris32

I have osteoarthritis in my right knee and am curious about how others decide the level of exercise. 

It seems to me, a non-medical person,  that in my case the very exercises designed to strengthen my knee muscles are actually causing the joint to deteriorate even further. Unfortunately, I am not aware at the time that an activity is triggering a later flare-up.

For 12 months, I have been following an exercise regime from physiotherapists in the NHS, and from a private company on behalf of the NHS.  Sadly, the situation with my knee has become progressively worse despite, and it seems almost because of, the exercises.

  I've walked regularly all my life, so as well as the exercise programme, I have continued to walk and use the Apple Health app and the NHS "Active 10"  app ( both excellent tools, by the way) to monitor progress, or in this case lack of progress.  Over the year, my walks have had to been reduced in distance as pain has increased. The active-10 also measures the level of brisk walking. That has now been reduced to zero. Last week I was caught outside in heavy rain and quickened my pace, unintentionally achieved 10 minutes brisk walking on the app. That has left me awake at night with pain and stuck indoors hobbling around with a stick for 3 days so far. 

The physiotherapist  has now referring me to a more senior colleague with an appointment set for 4 weeks time, and has suggested that in the meantime I stop the load-bearing exercises such as wall squats.

 
 

Naomi33

Hello @Chris32 and welcome to the online community.

Sorry to hear your concerns about exercise and pains.

The following links maybe of use….

https://www.versusarthritis.org/news/2020/january/moving-more-with-the-escape-pain-programme/

https://www.nuffieldhealth.com/about-us/our-impact/healthy-life/joint-pain-programme

The above guide you through different exercises and then you decide what suits you best.

Best wishes @Naomi33

Chris32

Thanks for your quick response with information. I actually attended an escape programme for my hip about a year ago, and my hip has improved to a level where it is no longer a problem, so they do really work. The group sessions were a great help, along with the one-on-one guidance as well.

However, my knee started giving me issues quite soon afterwards. I know that a similar session with supervision and guidance doing the exercises would help with my knee, but I am not sure I would be eligible for a second course, and knowing that others need to join the escape programme, I don't want to take a place unnecessarily. I still have the notes about managing the pain and can apply them to the knee issue. I guess I was trying to get a feel from other sufferers when I should back-off when exercising. I know it's not a case of simply stopping when it hurts.

Chris32

Update: Stuck indoors, 4 days into flare-up. Today, after a few steps with a stick I found that it was simply too painful to bend the knee backwards to a 90deg angle. In the past I have had some relief using an ancient Infrared massage machine.( see image). Today after eventually getting seated, I began gently swing the leg backwards, each time edging further into the "pain zone" while applying the infrared gun to the joint. Eventually, it went all the way back and the pain disappeared. YIPPEE! At the moment the pain does return after I walk a few steps, but my hope is that, doing this very carefully I might beat this b*** flare-up.

I've not mentioned/shown the brand as I am not sure I am allowed to post it here

upthecreak

Hi @Chris32 , I am suffering the same way and wondering the same thing. I have severe OA in both knees as well as pseudogout, and despite the advice to walk as it's excellent for OA, I am finding that it puts me in a huge flare up - the current one has been 5 days with no sign of abating, just because I dared to amble around a couple of shops with my son at the weekend. The pain is indescribable. In fact, I've just posted about how I think it's time to start using my wheelchair for anything that involves me walking as the price is too high otherwise.

I know, of course, that we should 'use it or lose it' so I will try and find a way to exercise at home, but for now, at least, walking is out of the question.

Chris32

Hi upthecreak (I love that name!), I am currently avoiding exercise involving walking, as I get a great deal of pain bending the knee afterwards; similar to the pain level of a dislocated shoulder. As I mentioned once in a seated position, if I flex the knee slowly while heating it with the old heat lamp mentioned above, I can increase the range of movement and the pain is sort of rubbed away. That's until I try walking again. Going through the pain barrier when walking does not help. Yesterday I was prescribed Cocodamol 15mg/500grms and Declafenac 3%gel. I feel the effects of the cocodamol on the rest of my body and can see how it could be addictive, but the pain in my knee on that first flex after walking is only reduced to about 75%. Better than nothing I guess.

upthecreak

@Chris32 thanks! I do use a lot of heat as I find that soothes, if not relieves the pain. I did hear someone else recommending a heat lamp so I will have to look into them. I am a bit limited with meds as I don't tolerate a lot of them well. I am on Cocodamol and have been for years for spinal issues, as well as amitriptyline for nerve pain. I use ibuprofen gel, too but I can't take anti-inflammatories at all - I ended up in hospital for a suspected heart attack which turned out to be gastritis caused by Naproxen. Nothing is touching the pain of this flare, however, so I guess I will just have to ride it out. I hope you have some improvement soon.

Chris32

Focusing on the knee, I made a small discovery today. In none medical terms I found a small soft bulge in a cleft on the outside of the knee when the joint is very carefully folded back. It doesn't exist in the other "good" knee. Aha! I think there must be swelling in there and it's being squeezed out… Inflammation, something to work on.

Thanks to Jane on the Versus Arthritis help desk for her guidance on dealing with inflammation.

Currently I am making myself an ice-pack by soaking an out-of-date bag of dried chick peas.

stickywicket

A swelling on the back of the knee sounds like a Baker's Cyst. Annoying things. https://www.nhs.uk/conditions/bakers-cyst/

It's easy to overdo things with OA, with or without exercises. But exercises are essential so we just have to monitor what happens and adjust accordingly.

Squats? Ouch😁

Chris32

(Swelling at the front, in the cleft beside the Knee cap)

Chris32

8 days into this new pain in the knee. It’s stiff too painful to bend the knee to sit down after standing . I have however found a work-around, although it looks and seems odd!
After walking a few paces then I bend the knee back to the edge of the pain at a 30deg angle. At that point I flick the leg to the left ( or right) slightly, but quite quickly . Then I can pull the leg all the way back and sit down without pain. It remains relatively pain-free through the full range until the next time I stand on it. This may be unique to me and I have no idea what’s happening in there but at leat I can sit down after walking. This may just help someone else

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