Call 07 3102 3337

Call 07 3102 3337

reception@praxisphysio.com.au

Call 07 3102 3337
Book Online
Rotator Cuff Repair: A Physiotherapy Guide on Recovery and Rehabilitation

Rotator Cuff Repair: A Physiotherapy Guide on Recovery and Rehabilitation

by | Jun 12, 2025 | Pain, Shoulder, Surgery

What to Expect from Rotator Cuff Repair: A Physiotherapy Perspective on Recovery and Rehabilitation

Rotator cuff repair surgery is a common and highly effective intervention for individuals suffering from persistent shoulder pain, weakness, or dysfunction due to a torn rotator cuff. Many patients turn to Google with phrases like “rotator cuff surgery recovery timeline,” “shoulder rehab exercises,” or “physiotherapy after shoulder surgery” when looking for answers about what comes next (that may have brought you here!).

While surgical techniques have advanced significantly, the rehabilitation process that follows is equally important in determining a successful outcome. In this Praxis What You Preach blog, we outline what patients can expect from physiotherapy after rotator cuff repair, based on current evidence, clinical best practice and our years of experience dealing with post operative patients.

Phase 1: Protection and Pain Management (Weeks 0–6)

The early stage of rehabilitation focuses on protecting the surgical repair, minimising pain, and reducing inflammation. Patients are typically placed in a shoulder immobiliser or sling for 4–6 weeks to allow early tendon-to-bone healing (Sgroi & Cilenti, 2018; Nikolaidou et al., 2017).

  • Passive Range of Motion (PROM) may begin within this phase under the supervision of a physiotherapist to prevent stiffness while avoiding strain on the healing tendon (Conti et al., 2009).
  • Key goals include:
    • Pain control (using ice, medication, or electrotherapy)
    • Preventing stiffness through gentle PROM in safe planes
    • Maintaining mobility of the elbow, wrist, and hand

“Excessive immobilisation can contribute to shoulder stiffness and muscle atrophy, yet too much movement too soon may compromise tendon healing” (Littlewood et al., 2015).

Phase 2: Controlled Mobilisation (Weeks 7–11)

Once the tendon is more securely integrated with bone, the sling is discontinued and patients begin active-assisted and then active range of motion (AAROM → AROM).

  • Exercises now include:
    • Assisted shoulder flexion and external rotation
    • Scapular control and retraction exercises
    • Isometric strengthening for deltoid and scapular stabilisers

This phase is critical to restoring functional movement without overloading the healing tendon. A slow and structured progression is essential. According to Bandara et al. (2021), protocols that are milestone-based (rather than time-based alone) yield better individualised outcomes.

“Criteria to progress should include pain-free PROM and AROM without compensation or shoulder shrug” (Sgroi & Cilenti, 2018).

Phase 3: Strengthening and Neuromuscular Control (Weeks 12+)

At approximately 12 weeks, patients typically progress to resisted exercises that begin to strengthen the repaired rotator cuff and surrounding musculature. At this stage:

  • Isotonic rotator cuff and scapular muscle training begins
  • Progressive resistance exercises (e.g. banded ER/IR, rows)
  • Incorporation of proprioception and dynamic control (e.g. rhythmic stabilisation, closed-chain activities)

The focus shifts from range of motion to building load tolerance and functional strength. Exercise selection considers tendon healing biology, which shows more mature tendon-to-bone healing around the 12–16 week mark (Nikolaidou et al., 2017; Conti et al., 2009).

“Initiation of functional loading early in the rehabilitation programme does not adversely affect clinical outcome, provided it is gradual and well-monitored” (Littlewood et al., 2015).

Phase 4: Return to Activity and Sport-Specific Rehabilitation (Month 4+)

From four months onwards, many patients begin returning to higher-level tasks depending on their goals:

  • Overhead activities for daily life or sport
  • Plyometric and ballistic loading for athletes
  • Work conditioning or manual labour readiness

At Praxis Physiotherapy, we tailor this phase to your individual goals—whether that’s lifting your toddler, swinging a golf club, or returning to competitive sport.

Some protocols extend formal physiotherapy through months 6–12 for more complex tears or high-functioning individuals.

Communication and Individualisation are Key

Every patient recovers at a different rate depending on:

  • Size and chronicity of the tear
  • Surgical technique
  • Pre-existing stiffness or atrophy
  • Adherence to rehabilitation and exercise

Close collaboration between surgeon, physiotherapist, and patient is essential for long-term success (Sgroi & Cilenti, 2018; Nikolaidou et al., 2017).

“There is strong evidence that early initiation of rehabilitation does not adversely affect clinical outcomes, but should always be individualised” (Littlewood et al., 2015; Bandara et al., 2021).

Final Thoughts 

Rotator cuff repair is only the beginning of the journey. At Praxis Physiotherapy, we provide evidence-based, goal-oriented care from day one post-op through to full return to work, life, and sport.

If you’re preparing for rotator cuff surgery or are currently in recovery, book an appointment at one of our Brisbane locations to begin a structured and personalised rehabilitation program. Begin your recovery the right way.

Until next time, Praxis What You Preach

📍 Clinics in Teneriffe, Buranda, and Carseldine

💪 Trusted by athletes. Backed by evidence. Here for everyone.

Your Guide to Total Knee Replacement Surgery

Your Guide to Total Knee Replacement Surgery

by | Jun 1, 2025 | Knee, Pain, Surgery

 Total knee replacement (TKR) is a life-changing procedure for individuals suffering from chronic knee pain, typically caused by osteoarthritis. At Praxis Physiotherapy, we understand that total knee replacement (TKR) surgery is a major decision. As such, we are committed to helping patients navigate their surgical journey and maximize outcomes through tailored prehabilitation and rehabilitation programs.

This guide is designed to walk you through what to expect before and after surgery, how physiotherapy plays a crucial role, and the advanced, evidence-based services we offer to support your journey.

Why Physiotherapy Matters

Physiotherapy isn’t just something you do after surgery—it’s a vital part of your preparation. Prehabilitation (prehab) that begins around six weeks before surgery can improve muscle strength, mobility, and balance, leading to quicker, more successful recoveries post-surgery (Domínguez-Navarro et al., 2020).

Similarly, post-operative physiotherapy supports improved pain relief, better joint function, and faster return to daily activities (Artz et al., 2015), (Fatoye et al., 2021).

Pre-Surgery: Building a Strong Foundation

It’s easy to think, “Why do physio now when the knee is being replaced anyway?” But strengthening and conditioning your body beforehand significantly boosts your post-surgery recovery, helping you get back on your feet faster and with greater confidence. We can address any questions or concerns you may have leading up to the surgery.

Timeline: Ideally begins 6-8 weeks prior to surgery.

Goals:

  • Strengthen muscles around the knee
  • Improve joint mobility
  • Enhance balance and proprioception
  • Educate on post-operative exercises

Key Interventions at Praxis:

  • Reformer Pilates: Our modified prehab programs integrate Pilates to build core stability and lower limb strength. It’s a safe, adaptable way to enhance neuromuscular control before surgery (Levine et al., 2009).
  • Balance Training: Proven to improve post-surgical function when combined with strength training [(Domínguez-Navarro et al., 2020)].
  • Education: We prepare you with strategies to navigate the early post-op period, including mobility aids and pain management.

  • Expert Manual Therapy: Enhances joint mobility, reduces pre-surgical stiffness, and prepares surrounding tissues for optimal post-surgery performance.

Early Post-Op Phase (0-6 weeks)

Immediately following surgery, your primary goals will be managing pain, reducing swelling, and restoring basic mobility.

Many assume recovery only begins once the surgical pain fades—but getting moving early is critical. Guided physiotherapy helps you regain mobility safely, reduce complications, and build confidence from the very start.

Expect:

  • Supervised sessions with focus on safe movement and circulation
  • Gentle range-of-motion and isometric exercises
  • Gait retraining using assistive devices

Evidence-based benefit: Early mobilisation and physiotherapy within days of surgery improve short-term outcomes (Isaac et al., 2005).

Mid to Late Post-Op Phase (6 weeks – 6 months)

At this stage, the intensity of therapy increases to target long-term function. Don’t settle for “good enough” recovery. This phase is where you rebuild your strength, stability, and full mobility—setting the stage for lasting function and confidence in your new joint.

Our Therapeutic Arsenal Includes:

  • Blood Flow Restriction (BFR) Training: Using pneumatic cuffs, we simulate high-load training effects using light resistance. Safe and effective for improving strength post-TKR (Piva et al., 2019).
  • Functional Strength & Balance Training: Tailored to your activity goals.
  • Reformer Pilates: Reactivated in this phase to support low-impact, whole-body conditioning.
  • Access to On-Site Gym Facilities: Ensures continuity and transition from rehab to independent exercise.

Patients receiving a combination of manual therapy and exercise had better functional outcomes than those receiving exercise alone (Karaborklu Argut et al., 2021), a practice we fully embrace at Praxis.

Clinical Expertise You Can Trust

Praxis Physiotherapy works in close collaboration with orthopaedic knee surgeon Dr. Kelly Macgroarty, ensuring a seamless continuum of care. However, we welcome referrals from any orthopaedic surgeon.

You’re not alone in this process. Our experienced team is with you every step of the way—offering expert care, tailored planning, and hands-on support backed by evidence and close collaboration with your surgical team

Our clinicians are highly skilled in post-TKR rehabilitation and stay up-to-date with the latest evidence-based interventions.

What Does the Research Say?

Recent studies underscore the critical value of physiotherapy before and after knee replacement surgery. Prehabilitation, including strength and balance training, has been shown to improve early recovery outcomes [(Domínguez-Navarro et al., 2020)]. Combining manual therapy with exercise yields superior functional gains compared to exercise alone [(Karaborklu Argut et al., 2021), (Abbott et al., 2013)]. Blood Flow Restriction (BFR) training and Pilates have emerged as safe, effective adjuncts to conventional rehabilitation protocols [(Levine et al., 2009), (Piva et al., 2019)]. While short-term improvements in pain and mobility are well-documented, the long-term benefits of physiotherapy interventions vary across studies, highlighting the importance of personalized care and follow-up [(Artz et al., 2015), (Fatoye et al., 2021)].

What Makes Praxis Different?

  • Prehab programs starting 6+ weeks before surgery
  • Use of advanced modalities: BFR cuffs, Reformer Pilates
  • Access to gyms within our clinics
  • Close collaboration with top orthopaedic surgeons
  • One-on-one care tailored to your surgical timeline and goals

Ready to Begin Your Journey?

Total knee replacement doesn’t have to mean months of struggle and guesswork. With the right physiotherapy strategy—starting before your surgery—you can dramatically improve your mobility, reduce pain, and return faster to the activities you love. Reach out to Praxis Physiotherapy today to schedule your pre-operative assessment or post-surgical consultation. Let us guide your recovery with confidence, care, and clinical expertise.

Until next time, Praxis What You Preach…

📍 Clinics in Teneriffe, Buranda, and Carseldine

💪 Trusted by athletes. Backed by evidence. Here for everyone.

References

  • Artz, N. et al. (2015). Effectiveness of physiotherapy exercise following total knee replacement: systematic review and meta-analysis. BMC Musculoskeletal Disorders.
  • Domínguez-Navarro, F. et al. (2020). Preoperative strengthening and balance training. Knee Surgery, Sports Traumatology, Arthroscopy.
  • Fatoye, F. et al. (2021). Clinical and cost-effectiveness of physiotherapy interventions. Archives of Orthopaedic and Trauma Surgery.
  • Karaborklu Argut, S. et al. (2021). Exercise and manual therapy vs exercise alone. PM&R.
  • Levine, B. et al. (2009). Pilates for rehabilitation after total joint arthroplasty. Clinical Orthopaedics and Related Research.
  • Piva, S. et al. (2019). Later-stage exercise vs usual care. JAMA Network Open.
    Book Online

    Visit Us

    CARSELDINE CLUB COOPS
    751 Beams Road
    Carseldine QLD 4034

    TENERIFFE
    91 Commercial Road
    Teneriffe QLD 4005

    WOOLLOONGABBA
    Shop LE201, Level 2
    Centro Buranda Shopping Centre
    Cnr Ipswich Rd & Cornwall Street
    Woolloongabba QLD 4120

    Services

    Physiotherapy

    Sports Physiotherapy

    Reformer Pilates

    Clinical Pilates

    Remedial Massage

    Strength & Conditioning

    Telehealth

    Dietetics

    Contact Us

    P: 07 3102 3337
    F: 07 3056 3295

    reception@praxisphysio.com.au

    Copyright 2025 Praxis Physiotherapy. All Rights Reserved.

    Pain in the Neck: Why Your Neck Hurts and What To Do About It

    Pain in the Neck: Why Your Neck Hurts and What To Do About It

    by | May 1, 2025 | Massage, Neck, Pain

    Neck pain is one of the most common reasons people seek physiotherapy – and for good reason. Whether it creeps in during long days at the desk, flares after a tough workout, or simply starts for no apparent reason, it can become an ongoing source of discomfort and limitation.

    At Praxis Physiotherapy, we see patients every week with neck pain ranging from occasional stiffness to chronic, persistent aches. The good news? Physiotherapy – particularly manual therapy and targeted exercise – can make a real difference.

    So, What Causes Neck Pain?

    Most neck pain we treat is classed as “non-specific neck pain” (Verhagen 2021; Almalki et al. 2024). That means it doesn’t come from a single clear source like a fracture or disc bulge, but rather a combination of mechanical, postural, and sometimes psychosocial factors.

    Risk factors include:

    • Prolonged static or awkward postures (like slouching over a desk)
    • High computer use (>75% of the workday)
    • Stress, anxiety, poor sleep or low mood
    • Lack of physical activity or poor muscle endurance (Cagnie et al. 2007; Louw et al. 2017)

    Side view of senior man holding neck with visible discomfort, highlighting neck pain relief.

    Importantly, neck pain often fluctuates – it might settle for weeks or months before flaring again. Up to 70% of people will experience neck pain in their lifetime, and around half of those will go on to experience recurring or chronic symptoms (Osborne et al. 2024).

    What Actually Helps?

    Let’s get straight to it. Here’s what the research says works – and what doesn’t.

    Targeted Strengthening Exercises

    A recent meta-analysis by Louw et al. (2017) showed strengthening exercises are consistently more effective than doing nothing. These exercises improve both pain and quality of life for office workers with non-specific neck pain.

    Chen et al. (2018) reinforced this, finding the biggest improvements came from neck/shoulder-specific strength work done consistently. The same review highlighted that those who stuck to their program got the best results — a helpful reminder that consistency trumps intensity.

    Interestingly, Osborne et al. (2024) found neck-specific resistance training not only helped pain but also changed how the nervous system processed pain – reducing hypersensitivity measured by QST (quantitative sensory testing). That’s not just “feeling better” – it’s a measurable shift in how your body interprets threat and discomfort.

    Manual Therapy (With Exercise)

    Close-up of a therapist giving a relaxing shoulder massage, enhancing wellness and stress relief.

    Cervical and thoracic mobilisations – particularly when paired with exercise – help reduce pain and restore movement (Verhagen 2021; Damgaard et al. 2013). At Praxis, we’ll often use hands-on techniques in the early phase to loosen stiff joints or reduce muscle guard

    ing, before layering in exercise to drive long-term change.

    Manual therapy alone can offer short-term relief, but it’s the combination with exercise that produces meaningful, sustained improvement.

    Close-up of woman using blue massage balls for neck relief against a wall.A Multimodal Approach

    Combining manual therapy, strengthening, posture coaching, and education works better than relying on just one of these (Damgaard et al. 2013). This reflects our whole-person approach at Praxis – treating not just the neck, but the patterns, habits, and loads that contribute to the issue.

    What About Stretching?

    Stretching can feel good – and sometimes helps with short-term symptom relief – but strengthening is where the real long-term benefit lies (Louw et al. 2017). That said, we’ll often include mobility work alongside strengthening in the early phases of your rehab, especially if movement is limited or provoking.

    And What Doesn’t Help?

    Unfortunately, there’s still a lot of outdated advice and overreliance on passive treatments. Prolonged rest, neck braces, or relying solely on massage or dry needling – without addressing strength, posture, or movement – rarely produce lasting results.

    Electrotherapy or ultrasound alone have limited evidence (Damgaard et al. 2013), and while they may provide short-term comfort, they don’t improve long-term function or resilience.

    What You Can Expect at Praxis

    Your physio will:

    1. Take a thorough history and assessment to rule out anything serious.
    2. Identify movement deficits, strength imbalances, or aggravating work setups.
    3. Use manual therapy to settle symptoms and restore range of motion.
    4. Build a personalised exercise plan focused on restoring strength and endurance.
    5. Offer ergonomic and postural coaching to help you load your neck better, not less.

    Whether you’re a desk-bound professional, a busy parent, or an elite athlete – your neck pain deserves proper, evidence-based care.

    Struggling with neck pain that just won’t go away? Let one of our experienced physios at Praxis guide you back to feeling and moving better – book today

    Until next Praxis What You Preach..

    📍 Clinics in Teneriffe, Buranda, and Carseldine
    💪 Trusted by athletes. Backed by evidence. Here for everyone.

    Why The “Wait And See” Approach May Leave You With A Poorer Outcome.

    Why The “Wait And See” Approach May Leave You With A Poorer Outcome.

    by | May 29, 2023 | Pain, Recovery

    We are all guilty of it. Putting off seeing someone about that niggle. “it will be right” we tell ourselves as we trudge on through life, sport and recreation. The “wait and see” approach, when applied to acute musculoskeletal injuries, refers to a common tendency for individuals to delay seeking appropriate medical intervention and instead hope that the injury will resolve on its own over time. While some minor injuries may indeed improve with rest and self-care, this approach can potentially lead to poorer outcomes in several ways. Let’s take a look at how putting off seeking treatment have a negative affect on your rehabilitation.

    Delayed Diagnosis:

    “Dr Google” is great but often it doesn’t always provide the end user (you) a balanced view. By waiting to seek medical attention, you risk delaying the accurate diagnosis of your injury. Prompt diagnosis is crucial as it allows for appropriate treatment planning and prevents potential complications. Certain injuries, such as fractures or ligament tears, may require specific interventions like imaging, immobilization, casting, or surgery. Without timely assessment, the injury might worsen or heal improperly. Even something less “serious” like a muscle tear has been shown to do better with early interventions, when compared to delayed rehabilitation.

    Increased Pain and Discomfort:

    Many acute musculoskeletal injuries, such as sprains, strains, or muscle tears, can be quite painful. Delaying treatment means prolonging your pain and discomfort. Seeking appropriate care early on can provide pain relief measures, such as solid advice and education regarding what positions or activities may ease or aggravate your pain. Further, physiotherapists can offer manual therapy techniques to manage your symptoms effectively. When appropriate, they can refer to other healthcare professionals regarding medications for pain relief.

    Impaired Healing:

    Many a moon ago (and unfortunately in some corners of the rehabilitation world) the number one method for recovery was rest. In fact, one study that explored the effects of prolonged bed rest on back pain is the “Oslo Back Pain Study” published in 1998. This study followed 278 patients with acute low back pain and randomly assigned them to two groups: one that received two days of bed rest and one that received seven days of bed rest. The study found that there was no significant difference in pain intensity, functional disability, or sick leave between the two groups. This has been further backed up with a cochrane review in 2005 outlining the same results.

    Proper management and intervention in the early stages of an acute injury can facilitate optimal healing. Physiotherapy, for example, can play a crucial role in promoting healing by utilising specific exercises, manual therapy, and modalities to reduce pain, restore joint mobility, improve muscle strength, and prevent complications like muscle stiffness or spasm. Delaying physiotherapy may lead to prolonged healing time, reduced range of motion, muscle weakness, and diminished functional outcomes even reducing the chance of developing chronic pain.

    Delaying Care Implications:

    A landmark study by Linton et al (1993) from the Orebro Medical Center in Sweden found that early active physical therapy significantly reduces the risk of chronic pain in patients experiencing their first episode of acute musculoskeletal pain. In the study, patients were either seen by a physical therapist within three days of injury or had to wait weeks to months for treatment. All patients were medically assessed to rule out serious conditions, and the early intervention group received tailored advice on maintaining daily activities and exercises, with optional ongoing treatment for up to 12 weeks.

    At 12-month follow-up, early intervention led to markedly better outcomes: only 2% of this group developed chronic pain versus 15% in the delayed group. Those receiving early therapy also had fewer days off work—32% missed no days at all, and only 17% were off for more than 30 days, compared to 31% in the delayed treatment group. These results highlight the clear benefits of early, active physiotherapy in preventing chronic disability.

    Functional Limitations and Disability:

    Without timely intervention, an acute musculoskeletal injury can lead to functional limitations, decreased mobility, and potential disability. The longer you wait to address the injury, the more time it may take to regain full function and return to your regular activities. Physiotherapy can help expedite the recovery process by providing targeted exercises and interventions aimed at restoring strength, flexibility, and functional abilities.

    Psychological Impact:

    Acute injuries can have a significant psychological impact in some people, causing frustration, anxiety, and a sense of helplessness. Delaying treatment may exacerbate these emotional challenges, as prolonged pain and functional limitations can lead to increased stress and reduced quality of life. Seeking prompt medical attention and engaging in a comprehensive rehabilitation program, including physiotherapy, can help address both the physical and psychological aspects of the injury. As they say, fail to plan is a plan to fail.

    In summary, taking a “wait and see” approach to acute musculoskeletal injuries often leads to poorer outcomes. Early medical advice—especially when combined with physiotherapy—can accelerate healing, reduce pain and disability, and support a faster return to full activity. At the very least, it ensures you’re on the right path from the start. So, if you do find yourself injured (hopefully not anytime soon!), don’t hesitate to reach out to one of our expert and friendly Praxis Physios. We’re here to help you recover with confidence.

    Until next time… Praxis What You Preach

    📍 Clinics in Teneriffe, Buranda, and Carseldine

    💪 Trusted by athletes. Backed by evidence. Here for everyone.

    References:

    1. Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147:478–491. [PubMed]
    2. Linton SJ, Helsing A, Anderson DA. Controlled study of effects of an early intervention on acute musculoskeletal pain problems. Pain. 1993;54:353–359. [PubMed]
    3. Pinnington MA, Miller J, Stanley I. An evaluation of prompt access to physiotherapy in the management of low back pain in primary care. Fam Pract. 2004;21:372–380. [PubMed]
    4. Bigos S, Boyer O, et al. Acute low back pain in adults. AHCPR Publication 95-0642. 1994.
    5. Fritz JM, Delitto A, Erhard RE. Spine. Vol. 28. 2003. Comparison of classification-based physical therapy with therapy based on clinical practiced guidelines for patients with acute low back pain: A randomized clinical trial; pp. 1363–1371. [PubMed]
    6. Delitto A, Erhard RE, Bowling RW. A treatment based classification approach to low back syndrome: Identifying and staging patients for conservative treatment. Phys Ther. 1995;75:470–485. [PubMed]
    7. Spengler D, Bigos SJ, Martin NZ, Zeh J, Fisher L, Nachenson A. Back injuries in industry: A retrospective study. Overview and cost analysis. Spine. 1986;2:241–245. [PubMed]
    8. Leavitt SS, Johnson TL, Beyer JD. The process of recovery, Part 1. Med. Surg. 1971;40:7–14.[PubMed]
    9. Hagen, K. B., Jamtvedt, G., Hilde, G., & Winnem, M. F. (2005). The updated cochrane review of bed rest for low back pain and sciatica. Spine, 30(5), 542–546. https://doi.org/10.1097/01.brs.0000154625.02586.95
    Knee Osteoarthritis: Is ‘Bone on Bone’ a painful life sentence?

    Knee Osteoarthritis: Is ‘Bone on Bone’ a painful life sentence?

    by | May 16, 2023 | Knee, Osteoarthritis, Pain, Surgery

    • Knee Osteoarthritis is a common ailment responsible for pain, loss of function and reduced quality of life
    • Rates of knee OA are set to increase
    • Whilst there is no cure, exercise therapy under the guidance of a physiotherapist is considered a front line treatment to help reduce the severity of symptoms
    • There are options before a knee replacement

    Do your knees go crackle and pop? Pain with walking, stairs or getting out of a chair? Stiffness and pain first thing in the morning or after a long car ride? These are signs that you may be living with the early or even advanced symptoms of knee osteoarthritis (OA). Don’t fear though – there is plenty that can be done immediately.

    What is “OA”?

    Osteoarthritis (OA) is an increasingly prevalent source of musculoskeletal pain and dysfunction. OA is a disease of the joint – including cartilage, bone, capsule and other associated tissues. This disease process can cause chronic pain, reduced physical function and diminished quality of life. The ageing population and increased global prevalence of obesity are anticipated to dramatically increase the impacts of knee OA and its associated impairments [1]. Although osteoarthritis can affect any joint, OA is knee is one of the most common complaints.

    Presentation

    It most commonly presents in people over the age of 50, and is often described as being painful, stiff and occasionally swollen. In terms of a tissue level, knee OA describes the gradual deterioration of the supportive cartilage within the knee joint. As the cartilage wears away with time, the protective joint space between the bones decreases. With a reduced cartilage lining to protect and support the spacing of the knee joint, the Femur and Tibia (knee bones) are increasingly less likely to dissipate forces through the joint . With time, it should be expected that bone spurs (osteophytes) may form in and around the joint as the bones react to repetitive contact with each other.

    Management

    The management of knee OA largely consists of exercises addressing strength, range of motion, quality of movement, emphasizing joint control, pain reduction and weight management.

    Strength Training

    Strength training should be the cornerstone of addressing knee OA, particularly the early signs. Strengthening the muscles around the knee joint, such as the quadriceps, hamstrings, and glutes provide better support to the knee, reducing stress on the joint and helping to alleviate pain and discomfort. Movement associated with exercise has an added benefit – It increases joint lubrication. Loading of the joint stimulates the production and distribution of synovial fluid within the joint. This fluid acts as a lubricant, reducing friction and providing cushioning to the joint surfaces. Improved lubrication can help alleviate pain during movement.

    Range of motion

    Knee osteoarthritis often leads to stiffness and limited range of motion in the joint. Physiotherapy can include specific exercises, manual therapy and stretches to improve joint flexibility, helping to restore a more normal range of motion and enhancing mobility. The greater the restoration of range, the better the knee feels.

    Pain reduction

    Both strength training and physiotherapy can help reduce pain associated with knee OA. As mentioned, stronger muscles provide better support to the joint, relieving pressure and reducing pain during movement. Physiotherapy may provide education of aggravating and easing factors (eg. hot / cold packs, hydrotherapy) as well as liaise with your GP for adequate analgesic medications.

    Lifestyle modifications

    Adopting a healthy lifestyle can play a pivotal role in managing knee osteoarthritis. Maintaining a healthy weight reduces the stress on the knee joints. Regular low-impact exercises such as swimming, cycling and reformer pilates help improve strength, flexibility, and overall joint health. A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can promote weight loss and provide essential nutrients for joint health. Quitting smoking and minimizing alcohol consumption are also beneficial.

    Improved weight management

    Regular exercise can assist in weight management, which is crucial for individuals with knee osteoarthritis. Excess weight puts additional strain on the knee joint, contributing to pain and progression of the condition. By maintaining a healthy weight, exercise helps to reduce the load on the joint and alleviate pain.

    Surgical Interventions

    When conservative measures fail to provide relief, surgical interventions may be necessary. Procedures such as arthroscopy, osteotomy, and joint replacement surgery can help repair damaged tissues, realign the joint, or replace the damaged joint with a prosthetic. These surgeries can significantly improve mobility and reduce pain, allowing individuals to resume their daily activities. Physiotherapy can aid in preparing you for the surgery, as well as rebuild your “new” knee after a knee replacement has been completed.

    In conclusion, while knee osteoarthritis can be challenging, it is not a condition that should hinder individuals from leading fulfilling lives. By implementing lifestyle modifications, exploring various treatment options, and working closely with your physiotherapist, individuals can effectively manage their symptoms, alleviate pain, and enjoy an active lifestyle with a sense of well-being. If conservative options fail, there are surgical interventions that can be investigated. If you are wanting to look after your knees, or already suffering from knee pain, chat to our knowledgeable Praxis Physios to discuss your treatment options at any stage of OA’s progression.

    Until next time,

    Praxis what you Preach

    Fact or Fiction Friday – Lower back Pain and MRI’s

    Fact or Fiction Friday – Lower back Pain and MRI’s

    by | Nov 8, 2022 | Lower Back, Pain

    I need to get an MRI to help with the management of my lower back pain

    Answer – FICTION

    In a recent narrative review, Wang and colleagues (2018) concluded that MRI imaging in the early stages of lower back pain can have detrimental effects including more pain, less improvement, higher risk of surgery and worse overall health status. In fact, one study reported that patients that received an MRI within the first month had an 8x greater risk for surgery and 5x more medical costs!

    If you do NOT present with severe neurological deficits, signs of a serious or specific underlying condition or have persistent pain >6 weeks which is unresponsive to conservative treatment then there likely isn’t a need for further investigation!

    To get help with your long standing back pain or even that acute flare up, give us a call on (07) 3102 3337 or book online  so we can sort you out.

    #praxiswhatyoupreach #praxisphysio #factorfictionfriday #physioeducation #preventprepareperform #pain #backpain #lowerbackpain #MRI #patienteducation

    Wang Y, et al. Informed appropriate imaging for low back pain management: A narrative review. Journal of Orthopaedic Translation. 2018.