FEATURE: EXERCISE IN KNEE OA RITIS INAPPROPRIATE ADVICE She needed to exercise to help her pain This then means simple movements like IS COMMON and the rest of her health and well-being. getting out of a chair and walking begin to hurt, even though there is very little Advice to rest and avoid pain Helen asked a common and important stress on the joint, and certainly no is commonly provided to people question – what about the pain, and damage occurring. But Helen had become with knee and other joint pains. This associated damage? I explained to completely disabled by fear, stopped advice is often wrong, and harmful. Helen that pain and damage reported exercising, and her condition had become Inactivity and rest makes pain and on an MRI or X-Ray are poorly related. much worse. We had to get her moving. osteoarthritis worse, not better in the Pain is actually the brain’s response to longer term. Our joints need movement a perceived threat, which motivates us HELEN IS NOT ALONE and exercise to stimulate repair and to be protective. One of the biggest keep them strong. There is undisputable problems we see in people with long Osteoarthritis affects 2.2 million evidence that staying active and regular standing pain like Helen, is that factors Australians. The condition costs our participation in exercise is safe and will unrelated to damage, begin to drive health system $2.1 billion per year, mostly help improve pain, and a person’s overall and increase this perceived threat. due to surgical interventions, like joint quality of life. This is true for knee replacement surgery. This surgery helps osteoarthritis, low back pain and almost Modern neuroscience’s understanding in the right person, but in most (2/3) any other painful conditions I regularly of pain tells us pain is influenced by fear,cases, completion of an exercise program see as a physiotherapist. anxiety, stress, changes in mood, and supervised by a physiotherapist will delay poor sleep. All of these factors were the need for joint replacement surgeries EDUCATING PEOPLE WITH contributing to Helen’s pain. As a result, by at least two years. Some people will PAIN IS ESSENTIAL she had become over protective. never need surgery if they stay active. Educating Helen about the importance If someone is told their joint is damaged A big problem we have in Australia is of exercise and dispelling common and ‘wearing out’ like Helen was, they many people are told to rest when they myths is a big challenge I often face. begin worrying about exercising it. have pain, rather than stay active. A large VOLUME 36 • ISSUE 2 2018 31 dnulbocaj/segamiytteg