Knee > Arthritis > Treatments

R.I.C.E., Bracing, and Physical Therapy


Light exercise is one of the most effective ways to relieve arthritis pain by stimulating circulation and strengthening the muscles, ligaments, and tendons around your knee. Strong muscles take pressure off the bones so there is less grinding in the knee joint during activities. In conjunction with a healthy diet, exercise also can help you lose weight, which takes stress off your arthritic knee.


In the first few weeks of rehabilitation, your physical therapist usually helps you stretch the muscles in your hamstrings, quadriceps, and calves while flexing and extending your knee to restore a full, pain-free range of motion.


When pain has decreased, physicians generally recommend at least 30 minutes of low-impact exercise a day for patients with arthritis. You should try to cut back on activities that place added stress on your knees, like running and strenuous weight lifting. Cross-training exercise programs are commonly prescribed when you have arthritis. Depending on your preferences, your workouts may vary each day between cycling, cross-country skiing machines, elliptical training machines, swimming, and other low-impact cardiovascular exercises. Walking is usually better for arthritic knees than running, and many patients prefer swimming, which takes your body weight off your knees and makes movement easier.


Strength training usually focuses on moving light weights through a complete, controlled range of motion. You should generally avoid trying to lift as much as possible with your quadriceps and hamstrings. Your physical therapist typically teaches you to move slowly through the entire movement, like bending and straightening your knee, with enough resistance to work your muscles without stressing the bones in your knee. Once your physical therapist has taught you a proper exercise program, it is important to find time each day to perform the prescribed exercises.


   Knee strengthening exercises: Cartilage injuries

Prevention [top]

After rehabilitation, preventing osteoarthritis is a process of slowing the progression and spread of the disease. Because patients remain at risk for continued pain in their knees after treatment, it is important they are proactive in managing their conditions. Maintaining aerobic cardiovascular fitness has been an effective method for preventing the progression of osteoarthritis. Light, daily exercise is much better for an arthritic knee than occasional, heavy exercise. When you have arthritis in your knees, it is especially important to avoid suffering any serious knee injuries, like torn ligaments or fractured bones, because arthritis can complicate knee injury treatment. You should avoid high-impact or repetitive stress sports, like football and distance running, that commonly cause severe knee injuries. Depending on the severity of your arthritis, your physician may also recommend limiting your participation in sports that involve sprinting, twisting, or jumping. Because osteoarthritis has multiple causes and may be related to genetic factors, no simple prevention tactic will help everyone avoid increased arthritic pain. To prevent the spread of arthritis, physicians generally recommend that you take the following precautions:

   Avoid anything that makes pain last for over an hour or two.

   Perform controlled range of motion activities that do not overload the joint.

   Avoid heavy impact on the knees during everyday and athletic activities.

   Gently strengthen the muscles in your thigh and lower leg to help protect the bones and cartilage in your knee.

Non-contact activities are a great way to keeping joints and bones healthy and maintain fitness over time. Exercise also helps promote weight loss, which can take stress off your knees.

Treatment Introduction [top]

Arthritis treatments begin with the least invasive techniques. A combination of activity modification, bracing and support, and light exercise can initially ease arthritis pain. Immediately after you are diagnosed with osteoarthritis, your physician may prescribe R.I.C.E. (Rest, Ice, Compression, and Elevation):

   Rest - continuing some form of light exercise is important for circulation and bone strength, but you should usually decrease the intensity of your involvement in physical activities if arthritis is causing pain. You do not want to risk suffering joint injuries in contact sports due to excessive twisting, jumping, or pivoting.

   Ice - apply ice packs to the painful knee for about 20 minutes every three or four hours. You will probably need to do this for two or three weeks or until the pain subsides, and you may need to regularly ice an arthritic knee after exercise or activities. One effective way to apply ice is to use a bag of frozen vegetables, particularly frozen peas, which molds easily to the shape of the knee. It won't leak and it can be re-used. (Warning: do not eat the contents after thawing and re-freezing.)

   Compression - Though braces are never a substitute for strong leg muscles, physicians may prescribe knee sleeves or braces for some patients to wear for extra support during activities that strain their knees.

   Elevation - raising your knee to a level higher than your heart helps reduce swelling. Try to prop your knee or ankle up on a couple of pillows when lying down or sleeping. Your physician may refer you to a physical therapist, who can teach you proper exercise techniques that help maintain joint strength and flexibility you strong without risking further damage to the knees. Many heat treatments are also available, including heat lamps, hot showers, heating pads, heat ointments, and whirlpool or bath treatments. Many people with arthritis alleviate pain with heat treatment before activities and ice afterwards. Heat treatment is not as common as ice and is usually left to your physical therapist's discretion.

R.I.C.E., Bracing, and Physical Therapy
   Treatment Introduction
Intra-articular Corticosteroid Injection
Unicompartmental Knee Replacement
Total Knee Replacement

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