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Osteoarthritis(OA) | Causes and Diagnosis with Aquatic Therapy

Posted on Aug 24 2020
Posted by: Dr. Firdaus Shaikh (PT)

Osteoarthritis (OA) is the most common type of arthritis with an overall prevalence of 22% to 39% in India. The Global Burden of Disease Study revealed that OA of the knee is now ranked as the 11th leading cause of years lived with disability making it one of the most common causes of knee pain.The prevalence increases as you age and is more likely in females than in males.

What is Osteoarthritis?
A healthy joint consists of two bones each lined with a layer of cartilage, which is essentially a tissue that helps in absorbing shock and enables the two bones to move over each other without any friction. One of the main causes of OA is the gradual loss of this cartilage due to repeated wear and tear over the years. This means the uneven ends of two bones will rub against each other causing increased friction and thus pain in the joint. It’s like driving a car on a bumpy road that has no suspension for shock absorption.
With reduced shock-absorption, relatively high impact activities, that increasing the pressures on the knee such as walking, running, or climbing stairs generally worsen these symptoms.

The Symptoms are:
• Joint Pain
• Swelling
• Joint stiffness that increases in early mornings and with inactivity
• Reduced range of movement and function
• Occasional cracking noise with movement

Exercise Therapy plays an integral part in the treatment journey, as it helps to strengthen and stabilize the joint, preventing further damage. Many clinical studies have claimed that exercise therapy is essential in delaying the progression of osteoarthritis and even proven to delay the need for surgery. As the muscles around your knee get stronger they would in turn help in providing better stabilization, shock absorption, and overall protection to the joint. However, the pain resulting from the impact forces that the knee withstands during land exercises makes rehabilitation a painful experience and ends up demotivating the patient.
This is where Aquatic Therapy can come to the rescue and aid in rehabilitation.

What is Aquatic Therapy?
Aquatic therapy, earlier known as Hydrotherapy, Water therapy, or Aqua therapy is a form of physiotherapy wherein the exercise therapy is performed in the aquatic environment with an aim to utilize the therapeutic benefits of water. A recent research conducted by Copenhagen University Hospital in Denmark analyzed 13 clinical trials that evaluated the efficacy of aquatic therapy exercises on a total of 1,190 patients with Hip and Knee OA. They concluded that Aquatic exercises were effective in reducing pain, improving the quality of life and minimizing disability in patients with Hip and Knee OA.

Here are 7 reasons why you should include Aquatic Therapy in your rehab

1. Reduced pressure on the joint- Exercising in water is ideal for weight-bearing joints like Knee and Hip as the buoyancy reduces the effects of gravity acting on these joints, thereby reducing the overall weight on your joint. According to American physical therapy association a submersion up-to neck-deep water can reduce about 90% stress on the joints.

2. Reduction in Pain-The joint offloading as explained above helps in reducing the pressure from the joint and thereby causing a reduction in pain. Along with reduced joint stresses, exercising in a heated pool has an added benefit in Pain relief as the warmth of the water helps in reducing the muscle tension around your knee.

3. Reduction in swelling- Hydrostatic pressure is an overall pressure exerted by the water on your joint while it’s under submersion. This pressure provides the necessary compression to the joint to help in reducing the swelling.

4. Low-Impact strengthening- The viscosity of water acts as a natural resistance to movement. The higher viscosity makes your muscles work comparatively harder than it would on land for the same exercise.Thereby allowing greater strength gains but with a reduced impact on the joint.In addition to the water’s natural resistance, we also use aquatic resistive equipment to further enhance the strength gains.

5. Faster recovery- Scientific research has indicated that Aquatic therapy can significantly reduce the patient’s overall rehabilitation time. Aquatic therapy enables you to perform more functional based exercises like squats, lunges, etc. much early in the rehabilitation as it is better tolerated in water versus on land.

6. Enables weight loss through aerobic exercises- Weight loss is an important component in the management of arthritis. However, Aerobic exercises that are essential for weight loss like brisk walking, running, etc. can increase the pain in the arthritic joint. Aquatic therapy on the other hand enables you to perform these exercises as the buoyancy of water reduces the weight and the pressure from the joints as explained above. At AquaCentric we have a specialized underwater treadmill with secured handrails and live screen monitoring for immediate feedback. The pools are also equipped with an underwater cycle and elliptical trainer which is an excellent add on to the low-impact aerobic exercise program.

7. Can be done by anyone- Swimming is not a prerequisite for participation in the Aquatic therapy program. The therapy pool is about chest-deep and does not require one to swim or go underwater. A therapist will be assisting you throughout the session making it inclusive to patients across all ages and disability.Incase of severe disability, wherein a patient is unable to enter the pool himself, a mechanized lift is used to lower the client into the pool.

Apart from the clinical benefits mentioned above, another advantage seen with Aquatic therapy is a higher compliance to treatment as exercises are relatively pain-free and easier to perform in water. Hence, Aquatic therapy can be a smart switch in order to provide a more holistic experience to achieve your rehabilitation goals.
As the pain reduces and the function improves, a gradual transition into land based therapy can be made allowing easier carryover of function back on land

For more information about aquatic therapy and our arthritic care programs please contact us here.