Did you know that knee osteoarthritis affects nearly 14 million adults in the United States1 per year? Or that meniscus tears are present in 60-90%1 of those with knee osteoarthritis? With symptoms ranging from knee pain, swelling, stiffness and limited range of motion, medication, injections, surgery and physical therapy are all commonly prescribed to manage knee pain. Medication and injections, however, may simply serve to mask your pain. Surgery can be costly and taxing on your body. Physical therapy, on the other hand, emphasizes a more holistic approach to the body with emphasis on education, pain management and strength and conditioning.
At first glance, it can be frustrating when you are referred to physical therapy for management of knee pain related to structural issues like osteoarthritis or a knee joint tear. Is the physical therapist going to magically reverse your arthritis or heal your meniscus? Shouldn’t you address the structural problem head-on instead of just “strengthening around it?”
Not necessarily.
Surgery or osteoarthritis physical therapy?
If we dig deeper, a better question to consider might be, “Do I need to change the structure of my knee in order to resume the activities I enjoy?” There are several studies to suggest that abnormal findings on X-rays and MRIs can be common, even in persons without knee pain. In fact, a 2020 study2 of a population with a median age of 44 and no knee pain found that an astounding 97% of knees had abnormalities on MRI. In addition, when comparing physical therapy management to surgical intervention, there are many cases with similar outcomes.
Now, this is not to say that everyone with knee pain should get physical therapy instead of surgery. Sometimes, surgery is exactly what’s needed to improve your overall quality of life. However, including a physical therapist on your health care team – before and after surgery – is beneficial, even without changing the structural abnormalities that are often presumed to be the problem.
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- Bhushan R. Deshpande, BS, Jeffrey N. Katz, MD, MSc, Daniel H. Solomon, MD, MPH, Edward H. Yelin, PhD, David J. Hunter, MBBS, PhD, Stephen P. Messier, PhD, Lisa G. Suter, MD, and Elena Losina, PhD. The number of persons with symptomatic knee osteoarthritis in the United States: Impact of race/ethnicity, age, sex, and obesity (2017)
- Horga, L.M., Hirschmann, A.C., Henckel, J. et al. Prevalence of abnormal findings in 230 knees of asymptomatic adults using 3.0 T MRI. Skeletal Radiol (2020)
By: Patrick Smith, P.T., DPT. Patrick is board-certified clinical specialist in sports physical and orthopedic physical therapy, a fellow of the American Academy of Orthopedic Manual Physical Therapists and a treating physical therapist with NovaCare Rehabilitation in Philadelphia, PA.
RUSH Physical Therapy and NovaCare are part of the Select Medical Outpatient Division family of brands.
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