Written by Jerar Lahoud, Accredited Exercise Physiologist, Move 2 Thrive Clinic, Minchinbury.
Introduction
Knee Osteoarthritis (Osteoarthritis) is one of the most common musculoskeletal conditions, affecting around 1 in 4 people over the age of 40.
It’s not just “wear and tear” of the joint – Osteoarthritis is a complex process involving cartilage, bone, inflammation, and even changes in the way the nervous system responds. For clinicians and the general public alike, understanding Osteoarthritis beyond the joint is the key to better management and quality of life.
Is Osteoarthritis Really Just “Wear and Tear”?
If Knee Osteoarthritis was as simple as “wear and tear”, why do astronauts present with cartilage deterioration, and why do recreational runners have the lowest occurrence of Osteoarthritis?
If Osteoarthritis was a matter of “wear and tear”, the outcomes of the groups should be the opposite – However, this is not what we see. Why is that?
Knee Osteoarthritis involves the whole body; systemic changes that can lead to pain, stiffness, difficulty with daily activities, and reduced quality of life.
Importantly, Osteoarthritis often coexists with other conditions such as cardiovascular disease, type 2 diabetes, and mental health challenges – highlighting the systemic nature of the condition.
Knee Osteoarthritis and Imaging
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Although imaging is often used in the context of knee Osteoarthritis, a mix of clinical presentation, medical history and physical signs are important to consider rather than X-ray imaging findings alone.
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Interestingly:
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Around 50% of people with knee Osteoarthritis changes on X-ray report no pain at all.
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People have knee pain without any imaging abnormality present.
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What does this mean?
The fact that imaging findings are inconsistent with symptoms, means that imaging results do not determine or predict outcomes, and they don’t need to change in order for pain and function to improve.
Knee Osteoarthritis as a Whole-Body Process
Knee Osteoarthritis is not simply an issue at the joint level. There are real systemic changes that influence pain symptoms.
These factors include:
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Pro-inflammatory states influenced by gut health
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Sickness/infections
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Psychological well-being
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Genetics
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Comorbid conditions
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Stress
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Adipose tissue
These systemic changes may explain why Osteoarthritis is common in joints such as the wrist despite minimal loading to the area.
This may explain why astronauts experience cartilage deterioration in space, despite almost no loading to the knee, while recreational runners present with the lowest occurrences of Osteoarthritis.
This dispels another common myth that Osteoarthritis is caused by the force of body weight and activity.
Bioplasticity and Osteoarthritis
Bioplasticity describes the body’s ability to adapt and respond to various challenges or stressors – this can lead to both advantageous and disadvantageous changes.
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Advantageous changes include improvements in strength, range of motion, pain and physical function.
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Disadvantageous changes include increase in pain or unnecessary protective responses.
Joint structures, including cartilage bone, muscles, tendons and ligaments exhibit bioplastic properties. They can all adapt and change in a given environment.
In the correct environment, bodily structures can improve for the better – healthier, stronger and more resilient.
👉 Think back to the example of the astronaut and the runner. The cartilage structures in the runners need positive adaptations to handle the requirements of running – the astronaut does not require these adaptations.
So What Can You Do for Knee Osteoarthritis?
Analogous to baking a cake, recovery from knee Osteoarthritis requires the right mix of ingredients.
These ingredients include:
1. Improving Knowledge
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Help you sort helpful from unhelpful advice
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Reduce stress responses
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Help improve your inflammation and activity
2. Increasing Activity
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Make you feel stronger and more confident
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Reduce inflammation and weight loss
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Improve gut microbiome
3. Decreasing Inflammation
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Improves movement and bodily structure health
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Improves thinking and enhances memory
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Enhances the body’s ability to adapt and change
Our Exercise Physiology services in Minchinbury and Western Sydney can help you find the right “mix of ingredients” for your knee health.
10 Tips to Reduce Inflammation
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Gradually increase physical activity
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Incorporate anti-inflammatory foods
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Seek knowledge
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Challenge negative perceptions
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Laugh regularly
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Improve social support
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Healthy sleeping habits
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Spend time in nature
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Reduce smoking and alcohol consumption
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Have a stress response plan
Looking for guidance? Book a session with a mobile exercise physiologist in Western Sydney to help put these tips into practice.
The Role of Exercise in Knee Osteoarthritis
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Exercise is recommended as first-line management by all current international guidelines for knee Osteoarthritis.
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Since Osteoarthritis is influenced by a range of systemic changes, exercise helps improve pain and physical function through a wide range systemic influences.
These include:
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Physical benefits (strength, range of motion, improved function)
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Psychological benefits (sleep, stress, wellbeing)
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Anti-inflammatory changes
Where Do You Start?
Finding an appropriate level of physical activity for you is essential.
An appropriate amount of activity will provide the right environment for change. The key is to provide a level of challenge to the body that is enough to trigger positive adaptation, but not too much to trigger heightened levels of pain and protective responses.
This may look like heightened levels of stress, pain and reduced levels of physical function.
Over time, your body will adapt to that level of physical activity, and to keep improving, you’ll need to continue increasing the level of activity or stimulus for change.
The Sweet Zone for Change
It is important to consider that a wide variety of factors may influence how large the sweet zone for change is on any given day.
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If we do too much too soon, we may experience heightened levels of pain, discomfort, stiffness or reduced range of motion to name a few.
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Although this may feel scary and often can be worrying, it is rarely a reflection of damage and injury.
Heightened levels of symptoms with Osteoarthritis are often the body’s way of protecting you from doing too much too soon. After a few days, symptoms are likely to reduce and this experience may give you a good reflection of where your body and protective system is at.
Working with a healthcare professional can assist to reduce concern, improve confidence and provide guidance on the journey to recovery.
If symptoms are present, yet tolerable, it is often safe to continue, particularly if serious pathology is ruled out. It is important to consult with a medical professional to rule these things out.
Final Thoughts
Knee Osteoarthritis is not just about joints – it’s about the whole body. By understanding knowledge, movement, and inflammation, you can create better outcomes for your long-term health.
Ready to take the next step? Book an appointment with a Move 2 Thrive exercise physiologist in Minchinbury or arrange a mobile consultation across Western Sydney and Greater Sydney.
About the Author
Jerar Lahoud, Accredited Exercise Physiologist
Jerar Lahoud is an Accredited Exercise Physiologist at Move 2 Thrive Clinic, Minchinbury. With extensive experience supporting clients across Western Sydney and Greater Sydney, Jerar specialises in exercise-based management of chronic conditions, musculoskeletal rehabilitation, and performance improvement. He is passionate about empowering people with knowledge, movement, and strategies for long-term health.
