2. Medication: 1/12 course of Naproxen. Oddly, had not tried NSAID’s previously. Immediately helped his night pain. Sleep is important for many reasons, but it’s particularly important during intensive rehab, and can help break a pain cycle. 7/
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3. Cycling: He bought an exercise bike. 🚴♂️ for 20-30 minutes. Every. Single. Day. Good evidence that lubricant secreting cells in synovial joints respond well to cyclical movement. But also a great exercise for restoring belief in the legs, and modulating his knee pain. 8/
4. Restore extension: poor extension = poor result. We used *manual therapy* to help. 😬. Twice/week. 😬🤯. For 6 weeks..FFD’s can be hard to change, so he was pushed pretty hard. Patient needs to stretch. A lot. Multiple times daily for at least 5 minutes per time. 9/
5. The physio sessions weren’t just ‘hands-on’. Also a combination of coaching and motivation. It’s important for patients to see incremental ‘wins’ to help sustain them through a long rehab. In the initial stages progress can be slow, so in person sessions are invaluable. 10/
6. Strengthening: *Controversially* we used open chain resistance.🤯.an exercise demonised like few others. But they can be invaluable in patients with atrophied quads who struggle with WB load. Used sensibly they’re fine, and offer a step to heavier WB load. 11/
- 6/52 sleep was undisturbed.
- 3/12 climbing stairs pain free.
- 12/12 full function restored, and working without restriction.
- 2 years he cycled Mt Ventoux!
- 8 years after he was 🚴♂️ regularly, in the gym x 2/week, and comes for a ‘loosen up’ as symptoms dictate. 12/
Too many OA patients are told they've failed rehab, when in fact rehab has failed them. They often don't improve because they weren't given permission or guidance to push themselves. Not all patients will, but all should be given the chance. 13/
Comments
- 6/52 sleep was undisturbed.
- 3/12 climbing stairs pain free.
- 12/12 full function restored, and working without restriction.
- 2 years he cycled Mt Ventoux!
- 8 years after he was 🚴♂️ regularly, in the gym x 2/week, and comes for a ‘loosen up’ as symptoms dictate. 12/