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Knee pain? Surgery vs conservative management

Recent media attention has given a lot of credence to exercise to minimise the need for surgery with exercise.

This is not new information in the physiotherapy world and we have known the benefits of the right exercises for a long time and also the problems created with the wrong exercises. The important emphasis in this article is twice a week supervised exercise. Many people will put the effort in after the surgery, but if they started earlier with the same intensity the story could be very different.

When approaching knee pain at Neurospace, our team of physiotherapists, exercise physiologists and massage therapists have a 4-pronged approach:

1. Alignment: from the feet up through the knee, hips and spine we will help restore the biomechanical alignment. This will often be about flexibility of certain structures that are tight and contributing to poor wear pattern of the knee.

2. Strength: for the ankle, knees, hip, core as needed, focusing on the imbalances and then a more global approach. In particular, strength with eccentric and closed chain emphasis is important for knee control.

3. Motor control: to stabilise the alignment through stance phase of gait and then into more advanced activities including stairs.

4. Laser therapy: for pain relief, accelerated healing, reduction of scarring and to help restore the knee cartilage.

Your current weight may be a factor.  This may need attention with general reconditioning and fitness work, and diet advice. Losing a few kilograms can make a big difference on reducing the pressure going through your knees.

How much weight is going through your knees during different activities?

Walking across level ground: 1.5x your bodyweight

Up and down stairs: 2-3x bodyweight

Squatting to tie your shoelace or pick something up: 4-5x your bodyweight

Bracing may also be an option to help support and offload the knee while trying to rebuild the strength and control.  This needs to be carefully considered and fitted to get the best outcome.

Deborah Carrera

Physiotherapist

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