Do you have hip or knee osteoarthritis? You’ll be glad you did the GLA:D program

April 11, 2022

What is osteoarthritis?

Osteoarthritis (OA) is a joint condition characterised by inflammation and changes to the joint capsule, bone, cartilage, and muscles. If you have OA you are definitely not alone, as 1 in 11 Australians (2.1 million) on average are also diagnosed with the condition, with the hips and knees being the most commonly affected joints. Don’t let this worry you though, because the good news is that there is a proven strategy that can help you to manage your symptoms of hip/knee OA, and improve your level of function that could be just as beneficial as surgery! But first, let’s debunk some myths about OA.

Facts and myths about knee/hip OA

• Myth 1: The degree of OA predicts levels of pain and disability.
  • FACT: Although scans seem to provide definitive findings, it is well known that imaging findings correlate poorly to pain and disability. In fact, it is common and normal to find structural changes on imaging, but for people to be completely symptom free!
• Myth 2: Pain means damage is occurring in the joint.
  • FACT: Pain is not an accurate and reliable indicator of damage. This is because pain is a sensory and emotional experience that can be influenced by various physical, psychological, and situational factors. Therefore, feeling pain does not always equate to damage.
• Myth 3: Exercise is risky, dangerous and harmful.
  • FACT: Exercise and movement are some of the best things you can do to maintain and improve joint health. Synovial fluid keeps our cartilage well-nourished and healthy. The best way to circulate synovial fluid throughout our joints, is to move them and load them through exercise and physical activity. Thus, exercise is safe and extremely beneficial.
• Myth 4: Rest is helpful.
  • FACT: Rest and avoidance can actually make pain worse. We now know that it is important to safely load our joints through movement and exercise, through methods such as basic strength training. This form of exercise improves the resilience of our joints, making them gradually able to tolerate more stress and load during our day-to-day lives. As a result, this reduces our risk of further injury, it may slow down OA progression, and will help us to move and participate in our daily lives more freely and with less worry!

What do the guidelines say?

The Royal Australian College of General Practitioner (RACGP) guidelines recommend exercise, along with education and weight management, as first-line therapies in the management of OA. Education refers to gaining a good understanding of how you can self-manage your OA. Weight management (if appropriate) is included as a first-line therapy, given that higher body weight places greater load on our hips and knees, which can worsen symptoms of OA. Losing as much as 5% of your body weight can significantly reduce symptom severity.

Second-line therapies include pharmacological pain relief, aids and manual therapy. Meanwhile, surgery is recommended as a third-line treatment, and should only be considered if the first two lines of therapy are not effective in relieving symptoms and improving function. Importantly, these two lines of treatment should still be combined with exercise therapy, education and weight management.

GLA:D program

 

GLA:D (Good Life with osteoArthritis: Denmark) is an education and exercise program, created by researchers in Denmark for people with hip or knee OA symptoms. The success of this program has led to it being implemented internationally.

The GLA:D program involves two 1-hour exercise classes per week across six weeks. The exercises in this program are simple but effective in improving joint control, movement quality, strength, trust in your hip/knee and function during daily living and sport. The program also includes two education sessions, run by a GLA:D trained physiotherapist, where you will learn about understanding OA, treatment options, exercise and self-management.

Why we think you’ll be ‘glad’ you did it

Regardless of age, OA severity, functional status or pain levels, exercise therapy is strongly recommended for all people with hip/knee OA. Compared to other treatments, such as manual therapy, medications and injections, exercise therapy is cost-effective and is the most effective non-surgical treatment for hip/knee OA. In fact, research from the GLA:D program in Australia shows an average pain reduction of 36%, significant improvement in joint confidence, less reliance on pain relief medication and a reduction in perceived need for surgery! This program offers a structured, easy-to-follow and guided management plan.

Despite these promising results, the GLA:D program may not be suitable for all people with hip/knee OA. Thus, it is recommended that you consult with your physiotherapist to see whether this program would be appropriate for you.

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