Osteoarthritis is the most common form of degenerative arthritis; it occurs commonly in the joints which weight bear causing them to become painful resulting in limitations in movement and function. The joints which can be affected are the knees, hips and feet specifically the big toe along with joints which are used a lot in daily life such as the hands, back and neck. ‘Around a third of people aged 45 years and over in the UK, a total of 8.75 million people, have sought treatment for osteoarthritis’ (Arthritis research, UK). In the synovial joints such as the hip, knee, toes, fingers and wrists the structure of these joints allows movement of two adjoining bones. By Rachel Ross, Soul Pilates Teacher At each end of these bones is a covering of articular hyaline cartilage which has a smooth slippery surface, this allows the bones to move against each other almost without friction.
The joint is surrounded by a synovial membrane (the synovium), which secretes synovial fluid into the joint cavity nourishing the cartilage and lubricating the joint. There is also a fibrous capsule supported by ligaments which holds the joint in place and stops the bones moving too far. The tendons anchor the muscles to the bone, the joint is also supplied with nerves and blood vessels. When a joint develops osteoarthritis, the articular hyaline cartilage starts to thin and become rough this means that the joint doesn’t move as smoothly as it should. The body then tries to repair this causing the tissues surrounding the joint to become more active than normal. Sometimes this repair process doesn’t work as well as well as it should and can change the structure of the joint. This may lead to bony growths called osteophytes developing and therefore limiting the mobility of the joint. The synovium may thicken and produce more fluid than normal, the surrounding fibrous capsule and tissues may stretch leading to the joint becoming less stable. This along with surrounding muscle weakness can lead to pain and inflammation and difficulty in moving the joint, which may eventually lead to the joint requiring a joint replacement for the knee or hip. There are many factors which can lead to Osteoarthritis; age, obesity, genetic factors, occupation, injury, joint abnormalities or as a result of other joint diseases such as rheumatoid arthritis. Depending on the severity of the disease and the joints affected mobility can be severally restricted leading to difficulties in everyday activities, such as personal care, walking, climbing stairs, fastening buttons or opening food jars, as well as poor sleep from chronic pain. In severe cases it can have a huge effect on a person’s independence and well-being and quality of life. So how can Pilates help manage the symptoms and associated pain of Osteoarthritis? Within the studio here at Soul Pilates we look specifically at the muscular, fascia and ligaments surrounding the joint and how this can affect the body up and down the kinetic chain in terms of range of motion and stability. For example, in osteoarthritis of the knee, we focus on strengthening around the knee the quadriceps, adductors, hamstrings, and abductors, but we would also look at the biomechanics of the feet, hips pelvis and back, whilst also looking at your gait (how you walk) and your standing and sitting posture. We have a variety of Pilates equipment; Cadillac also known as a Trapeze table, Reformer, Combo Chair and Ladder Barrel as well as small props, all of which we can use to strengthen the musculature and mobilise the joints in a gentle and supported way. The equipment allows us to adapt to the client specific needs to build up strength and gradually load the tissues working up from closed chain exercises to open chain and weight bearing at the client’s pace, with a focus on functional exercises to support your daily activities. This approach also works for those individuals who are maybe pre or post joint replacement surgery as a result of Osteoarthritis. We are continually looking at movement patterns and how to achieve alignment of the body to reduce the amount of stress on the joints and encourage efficient movement. In addition to this, here at Soul Pilates we take a holistic approach and focus not just the physical condition but also the response on a client’s nervous system, specifically in the management of pain and how we can use a more holistic approach designed to harness the power of the mind to lower stress, lessen pain and improve overall health by focusing on the connection between the mind and body.
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