What do we know about osteoarthritis?

Osteoarthritis (OA), sometimes referred to wear and tear of the joint, is a chronic condition and the most common joint disease. It is normally classified by pain, stiffness, swelling and reduced function of the joint. The most common two joints to develop osteoarthritis are the knee and hip (Timmins et al., 2016). According to a study in 2013, 8 million people in the UK have osteoarthritis (Arthritis Research UK, 2013), although this statistic has likely increased since then as obesity is on the rise (which is one of the biggest risk factors).

Who is more at risk?

Listed below are some of the main risk-factors for developing osteoarthritis:

·        Over 40 years old

·        Female

·        Genetics (if your parents had it)

·        Obesity (overweight)

·        A previous joint injury

·        A physically demanding job

·        Other joint diseases

Can running cause  knee osteoarthritis?

A literature review looked into the role of running in the development of knee osteoarthritis (Timmins et al., 2016). Whilst the review was inconclusive, one study it cited reported that runners had a 50% reduced likelihood of undergoing surgery due to osteoarthritis compared to a sedentary population. Another study concluded that recreational runners had a lower incidence of hip and knee osteoarthritis (3.5% of runners) than individuals who were sedentary (10% of sedentary individuals). It also highlighted that most of the studies that reported a higher incidence of knee or hip osteoarthritis in runners were those studies that investigated elite and professional level athletes, and not recreational runners.

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Recreational runners have less of a risk of developing knee or hip osteoarthritis compared to non-runners, sedentary individuals and competitive athletes (Alentorn-Geli et al., 2017).

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How is osteoarthritis diagnosed?

Diagnosis of osteoarthritis is generally through a physical examination of the joint, reported symptoms and radiographic imaging (X-ray or MRI).

How can you cure it?

There is no cure for osteoarthritis. However there are things you can do to reduce pain, improve function and potentially slow the progression of the condition (depending on why you've developed it in the first place). Conservative treatment methods to try and delay the need for joint replacement surgery include:

·        Regular exercise (both strengthening and aerobic exercise)

·        Reducing stress on the affected joint

·        Losing weight (if overweight/obese)

·        Painkillers

·        Physiotherapy

·        Injections

How can Run3D help?

A Run3D gait and biomechanical evaluation enables our clinicians to accurately measure exactly how a patient is walking and/or running and to gather information on why he is likely to be walking/running in this way. By combining the results of the gait analysis and musculoskeletal testing, we have a clear picture of how the patient moves as well as the factors likely to be influencing these movement patterns. This information is used as the foundations of our data-driven approach, enabling us to target the areas that require improvement through rehabilitation techniques such as strength and mobility work, footwear recommendations and gait re-education.

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There are certain gait patterns as well as strength and range of motion deficits that are more prevalent in people with hip and knee osteoarthritis, as summarised in the injury crib-sheets shown below. All these factors are objectively measured in a Run3D assessment, enabling our clinician to identify exactly which of them a patient presents with so that the patient can be given a data-driven, individualised treatment plan.

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There is no cure for knee osteoarthritis. However, Run3D can help to deliver individualised treatment protocols, which can potentially decrease the rate of disease progression, improve function and reduce pain.

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Knee Osteoarthritis Case Study

Recently one of our clinic al partners used the walking analysis of Run3D to assess a patient with knee osteoarthritis. We are going to use this case to demonstrate how the patient's gait and musculoskeletal test results married-up with the risk-factors cited in our Knee Osteoarthritis crib-sheet and used to create a conservative treatment plan.

The scientific literature suggests that eleven of the kinematic parameters and nine of the strength and flexibility parameters measured by Run3D are associated with or commonly seen in patients with knee osteoarthritis.

After undergoing a walking gait analysis and musculoskeletal testing at a Run3D clinic, it was found that the patient presented with five of the eleven kinematic risk-factors, with a further three of them either borderline or lower on the affected side. In addition, five of the nine strength and flexibility risk-factors (three clearly indicated and two either borderline lower on the affected side) were apparent, and three were not measured.

The results of the Run3D assessment coupled with the information presented in the Knee Osteoarthritis crib-sheet allowed the clinician to quickly and easily identify the biomechanical parameters associated with the patient’s condition and deliver an individualized treatment plan. For example, reduced range of motion in the quadriceps, hamstrings and ankle dorsiflexion are all associated with knee osteoarthritis. However, the results of the Run3D assessment revealed that this patient had good hamstring range of movement, enabling the clinician to eliminate hamstring flexibility from his treatment plan and focus instead on the areas that matter.

While we cannot cure knee osteoarthritis, conservative rehabilitation methods can be used to potentially decrease the rate of progression, improve function and reduce pain. Following his Run3D assessment, the patient was given an individualized rehabilitation programme and will be followed-up to monitor his progress.

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References:

Timmins, K, Leech, F., Batt, M., Edwards, K., 2016, Running and Knee Osteoarthritis, A Systematic Review and Meta-Analysis, The American Journal of Sports Medicine, Vol, 45. No. 6, pp. 1447-1457.

Arthritis Research UK, 2013, www.arthritisresearchuk.org

Alentorn-Geli et al. 2017, The association of recreational and competitive running with hip and knee osteoarthritis: a systematic review and meta-analysis, Journal of Orthopaedics in Sports and Physical Therapy, Vol. 47, No. 6, pp. 373-390.

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