Exercises for gonarthrosis of the knee joint of 1st and 2nd severity are the most accessible and effective method of restoring the full range of motion in the joint, which also has an anesthetic effect. More than half of the patients note that with regular exercise, joint pain is significantly reduced, and this makes it possible to reduce the dose of painkillers.
Even if the diagnosis of gonarthrosis of the knee joint has not been made (this is especially typical for stage 1 of the disease, which proceeds almost unnoticed), exercises can be used for prevention after injuries.
Complications
Without qualified treatment started on time, gonarthrosis destroys the knee joint, which leads to disability. Possible complications of an advanced disease cannot be discounted. The load on the spine increases by 75%!
Diagnoses that result from untreated gonarthrosis:
- spinal column deformity, canal stenosis;
- radiculitis;
- herniated intervertebral discs;
- degenerative changes (osteochondrosis);
- vertebral mobility;
- premature wear of adjacent joints;
- accumulation of fluid in the joint capsule (effusion).
This course of events complicates treatment. Doctors resort to a series of surgical operations, because other therapy is no longer effective.
Another complex
It is recommended to begin this complex with stretching, especially the tendons along the back of the knee - this helps improve the elasticity of the muscles and ligaments.
Then you will need a wide and long piece of fabric, such as an old sheet. Fold it so that you get a long strip, the width of which is about 20 cm, then lie on the floor. Hold the ends of the sheet with both hands, place your right foot in the loop formed, and straighten your leg. Pull the sheet towards you, while moving your leg further to the side. Feeling tension (but not pain), hold for 20 seconds. Then relax and repeat the exercise again. Do the same for the other leg.
For the second exercise you need a chair. Hands are placed on his back. The right leg should be bent at the knee, and the left leg should be lunged back. Make sure your left leg is straight. Try to hold the stretch for 20 seconds. Do this exercise 5 times for each leg.
Next, lie on the floor, bend your legs at the knee joints. Raise your upper body, your elbows should touch the floor and rest against it. Raise your straightened right leg up without extending your toes. Hold your leg in the air at the level of your left knee for a few seconds, then slowly lower it. Repeat 10 times for each leg.
When lying on the floor, your legs are bent at the knees; between them you need to hold a pillow or ball, which is pressed firmly. Hold the position of extreme tension for 5 seconds, then relax. Repeat 10 times.
Standing straight, place one hand on the wall or back of a chair. Rise onto your tiptoes so that your heels are as high as possible above the floor surface, and hold for three seconds. Lower yourself smoothly, then repeat ten times in a row.
In the same position, shift your body weight to your left leg, and take your right leg to the side in a straightened state. Having reached the extreme position, hold for three seconds and lower your leg. Repeat 10 times for each limb.
By doing everything correctly and regularly, you will soon notice that the pain has subsided and your mobility has increased. There are quite a lot of methods, and it is important that the doctor selects the complex for you, taking into account the stage of the disease and the characteristics of its course.
We suggest watching a video with some exercises.
Treatment
Gonarthrosis is treated conservatively and surgically. Conservative techniques are used by orthopedic traumatologists when therapy is started on time and the prognosis is positive. In the acute period, rest is indicated.
Complex treatment consists of:
- prescribing medications in the form of injections: steroid hormones, chondroprotectors;
- physiotherapy: electrophoresis, magnetic therapy, laser therapy, UHF;
- acupuncture (acupuncture);
- balneotherapy (mud);
- physical therapy during the recovery period;
- rehabilitation in a sanatorium.
The third stage of the disease involves surgical intervention. Surgeons perform endoprosthetics. This is the only way to restore motor activity. After the operation, long-term rehabilitation will be required: from 3 to 6 months.
Medicines
At stage 3 of the disease, medications must be prescribed to cope with unpleasant symptoms.
Treatment during exacerbation of gonarthrosis
The presence of exacerbation of gonarthrosis is indicated by pain at rest, swelling and redness of the joint.
- In the third degree of the disease (as in others), non-steroidal anti-inflammatory drugs (NSAIDs) are usually prescribed to eliminate the exacerbation. Many drugs in this group are well known to patients: these are indomethacin, meloxicam (Movalis), diclofenac, ibuprofen and others.
- If the pain is very severe, hormonal drugs - glucocorticosteroids, which are administered intravenously or inside the joint (prednisolone, metipred), can give a quick and powerful effect.
- In rare cases, when acute pain is unbearable, powerful narcotic painkillers, such as tramadol, may be needed.
The need for strong analgesics (tramadol) more often occurs with stage 3 disease and with exacerbations of gonarthrosis, although the intensity of pain does not always directly depend on the degree of destruction of the structures of the knee joint.
Treatment during remission
After the exacerbation has been relieved, treatment with all of the above medications should be stopped: NSAIDs and glucocorticoids have many negative effects on the gastrointestinal tract and can worsen the condition of already suffering cartilage; and tramadol is addictive.
Symptomatic remedies
(if the table is not completely visible, scroll to the right)
| Means | Description, effect |
| Paracetamol | This inexpensive and well-known drug significantly relieves pain and improves joint mobility without exacerbation, even with pronounced changes in the joints, such as occur with grade 3 gonarthrosis. You can take it even for years, if you do not exceed the permitted dosage. |
| All coxibs (celecoxib, rofecoxib and others) are drugs from the group of selective cyclooxygenase-2 inhibitors | They have a pronounced analgesic and anti-inflammatory effect, stronger than that of paracetamol, but they also have more side effects. With grade 3 gonarthrosis, it is often not possible to achieve significant relief with paracetamol: for such patients, the use of coxibs is absolutely justified. |
| Ointments and gels based on NSAIDs (diclofenac, ibuprofen) | They penetrate well into the joint cavity, eliminating pain, but unlike the same drugs in tablets, they do not have negative effects on the functioning of internal organs. External remedies for grade 3 gonarthrosis can be combined with oral medications to achieve maximum pain relief. |
Drugs that restore cartilage
Paracetamol and coxibs improve the quality of life of patients, but do not protect joint tissue from further destruction and do not stop the progression of the disease.
They cope with these tasks:
- Chondroprotectors are preparations based on chondroitin sulfate (structum) and glucosamine (DONA, chondroxide). Both are taken orally in tablets, capsules, and powders, but they begin to act no earlier than 2–8 weeks after the start of administration.
- Hyaluronic acid and its preparations, which are injected into the cavity of the knee joint. One treatment reduces pain and improves joint mobility for a period of 3 months to one year, without disturbing the gastrointestinal tract.
Chondroprotectors are indicated for patients with any degree of osteoarthritis. For patients with stage 3 disease who do not get complete relief from tablet medications, hyaluronic acid injections can be a real salvation from pain and poor mobility in the knees.
Chondroprotectors are an important component in the treatment of the disease
Prevention of gonarthrosis
Taking the following measures will help reduce stress on the joint:
- use a cane;
- wear an orthopedic brace (orthosis);
- choose comfortable shoes;
- follow a diet to maintain optimal weight;
- strengthen your leg muscles with exercises;
- minimize the risk of injury;
- treat inflammatory processes in a timely manner;
- take a reasonable approach to physical activity;
- Follow your daily routine and improve your sleep.
Prevention for gonarthrosis plays an important role in the tactics of containing the progression of the disease.
Methods and techniques
Four massage systems are used, known by the names: Oriental, Russian, Swedish and Finnish. Each has its own characteristics in the treatment of joints with arthrosis. Let's take a look at what each of them is.
In the eastern system, massage is aimed at releasing the muscles associated with diseased joints from venous blood and improving the motor functions of the joints.
The Russian massage system is based on rubbing and stroking sore joints with arthrosis. The founder of the system advises combining all massage techniques with exercises and hydrotherapy.
The Swedish system involves stroking and rubbing sore spots in combination with joint movements.
The Finnish system is close to the Swedish one, but with some differences: everything is done the same way using thumb tufts.
The massage is carried out in combination with several basic techniques, these are: stroking, rubbing, kneading, vibration.
Stroking with the palms is done to relax the muscle tissue around the affected areas. This improves blood flow, relieves tension, and stimulates lymph flow.
Rubbing joints for arthrosis is the main technique for massaging arthritic joints, in terms of providing a profound effect on ligaments and muscles. During the rubbing process, blood flow and lymph drainage in the knee joints accelerate.
Kneading is an integral massage procedure in the form of consistent, gentle pressure on skin areas. By kneading each area, the massage therapist acts on the deeper layers of the skin and on the trophism of muscle tissue.
Vibration is a specific shaking of muscles and skin. Thanks to the changing amplitude of movements, the massage therapist transmits the vibrations of his hands to diseased tissues located at a deeper level.
The general session, preparatory massage, consists of three parts: introductory, main and final. At the introductory and final stages, movements differ in the degree of pressure and slowness. The massage therapist carries out the most intensive manipulations during the main stage, when the muscle tissue is already fully prepared for exercises for the knees.
Anatomy of the knee joint
The knee joint consists of two surfaces, which are formed by the tibia and femur. The front of the knee joint is protected by the patella, which moves between the condyles of the femur. The fibula does not participate in the formation of the knee joint and essentially does not bear any functional load, due to which it is often used for the reconstruction of other bone elements in the body.
All articular surfaces: the tibia, femur and the inner surface of the patella are lined with hyaline cartilage, which is very smooth in texture, has a high degree of strength and elasticity, the thickness of this dense and elastic structure reaches 5-6 mm. Cartilage absorbs shock during physical activity, prevents friction and softens impacts.
Diagnostics
Diagnosis of gonarthrosis of the knee joint is carried out by an orthopedist-traumatologist or a rheumatologist. It begins with collecting anamnesis and examining the patient by a specialist. This is necessary to identify typical signs of degenerative changes (pain, limited mobility, etc.) and their causes.
In the future, the patient, at the discretion of the doctor, may be referred to undergo the following studies:
- Ultrasound.
Used to study the contours of the joint, the quantity and quality of synovium; identifying pathological changes in the menisci, inflammatory processes. The study provides a complete picture of the condition of ligaments, muscles, tissues, and allows us to identify changes in the size of the joint space.
- Magnetic resonance and computed tomography.
These methods are aimed at detecting the smallest changes and pathological manifestations, as well as differentiating gonarthrosis of the knee joint from post-traumatic arthrosis, arthritis, and tumor processes.
- X-ray examination
. Allows you to assess the width of the joint space, identify subchondral sclerosis, osteophytes, changes in the shape and structure of the joint cavity. An x-ray shows the presence of bone changes, tumors, cysts, and various injuries.
In some cases, puncture and/or arthroscopy are prescribed as an additional diagnosis of gonarthrosis of the knee joint.
- Puncture
– under local anesthesia, the joint is pierced with a long special needle, and joint fluid is taken from it for further analysis;
- Arthroscopy
– collection of biomaterial for histological examination. This manipulation is performed by inserting an arthroscope into the joint through a small puncture. The device is equipped with a camera and lighting; it transmits the image to the monitor and allows you to see the joint from the inside. The specialist assesses the condition of the joint and determines its changes. This method is the most effective for identifying gonarthrosis of the knee joint. The procedure is performed using local anesthesia.