In our practice osteoarthritis most commonly is seen in the knees and low back. Our plan for spinal treatment was outlined previously. Patients with OA of the knee are generally affected bilaterally but with one knee worse than the other. The medial compartment is most often affected. There are always signs of inflammation, which includes tenderness and swelling. Depending on how acute the problem is we will use either heat or ice, but ultrasound also seems to very helpful. Additionally there is generally some dgree of immobility and quadriceps weakness. They have difficulty elevating or lowering their body weight when going up and down stairs. These patients respond very well to cycling for mobility and closed chain exercises emphasizing the quadriceps. Closed chain exercise such as the leg press can be done with light weight and poses minimal stress upon the knee joint. Just getting the knee to move actively into flexion and extension seems to improve mobility and improvements in strength are seen almost immediately. Four weeks of therapy should significantly improve mobility, strength and function.

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