How to Manage Knee Osteoarthritis After a Flare

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Knee osteoarthritis (OA) flares can disrupt the quality of your life. After an episode, most neglect to address the side effects. Once the flare subsides, however, focusing on regaining strength and function is crucial, as weakness and lack of motion put you at risk of another attack. A recovery plan can help you return to daily activities while minimizing the risk of future flare-ups. Here’s a step-by-step guide to rebuilding knee function after a flare.

Older woman sitting on couch at home while experiencing knee pain caused by an osteoarthritis flare up

Step 1: Reactivate the Key Muscles

Once severe knee pain subsides, reactivate the muscles used for weight-bearing function. These muscles help you to walk and handle steps more effectively. Our focus is not only on knee strength, but supporting the muscles of the whole leg. The following are the basic programs we have at CT Physical Therapy Care.

  1. Activate the VMO with terminal knee extension exercise: If this muscle is strong, it improves the mechanics of your knee. Stand leaning against a wall and rotate your foot slightly closer to the wall away from your body. Put about a 10-inch ball between the knee and the wall. Squeeze the ball and repeat 20 times, three sets.
  2. Train the pelvic and gluteal muscles with inner and outer thigh exercises: For the inner thigh, squeeze a ball between your knees while seated. Repeat 20 times in three sets. For the outer thigh, wrap a band on your knees and open and close your thigh. Repeat 20 times in three sets. Making your hips strong distributes the load on the whole leg, thus minimizing knee strain. 
  3. Strengthen the calf and foot muscles with assisted heel raises: This exercise helps to dissipate the shock in the knee.

Step 2: Improve Knee Joint Motion

After a flare, the knee joint capsule and tissues become very stiff. The synovial fluid movement and blood flow are also diminished. Lack of knee motion and circulation increases symptoms in the knee. Start with exercises to improve knee motion, such as:

  1. Seated Knee Bend: Gently slide your heel toward your buttocks while seated, then extend your leg. Repeat 10 to 20 times, three sets.
  2. Seated Leg Extensions: Sit in a chair and slowly straighten your leg. Hold it for eight seconds before lowering it. Repeat 10 to 20 times for three sets.
  3. Seated Knee to Chest: Lift one knee towards the chest at a time. Repeat 20 times for three sets.
  4. Stationary bicycle when tolerated.

The more motion you have in the knee, the better your synovial fluid health. This fluid is a lubricant and the first line of defense to cushion your joint. It also minimizes erosion of your joint in the future.

Your aim should be to increase synovial fluid and blood flow. Good circulation means better oxygen and nutrient exchange in the tissues, which improves healing. Just make sure you are avoiding the intense activities that put a strain on recovering joints.

Step 3: Train Your Walking Function

The muscle acts like a spring that helps absorb the shock when walking. Weak muscles around the knee can increase joint strain. Again, we reiterate that your focus should be not only on the knee, but on the coordinated work of the whole limb. Here are the exercises to start with:

  1. Assisted side step up and down in a 3-inch step: Repeat 10 to 20 times, three sets each side.
  2. Assisted partial wall squats progressed to sit-to-stand exercises. Repeat 10 times, three sets.
  3. Assisted resistance exercise in stepper to improve weight-bearing function and motion.

There should be no pain with these exercises. You make an effort to gain, but not at the expense of pain.

Step 4: Improve Flexibility

Stretching is critical to maintaining mobility and preventing stiffness. Focus on key muscle groups affecting the knee. Tightness in these areas puts strain on your knees.

  1. Hamstring Stretch: Sit with one leg extended, then reach for your toes on the extended leg, keeping your back straight. Hold for 10 seconds, repeat 10 times, and then switch legs.
  2. Calf Stretch: Stand up facing a wall, and place one foot further behind you. Gently press your heel into the ground as tolerated. Hold for 10 seconds, repeat 10 times, and then switch legs.
  3. ITB Stretch: Stand to the side near a wall and put one hand on the wall. Move the leg farthest from the wall, crossing over the other leg. Keep your foot closest to the wall flat on the floor, and lean your hips towards the wall. Hold for 10 seconds, repeat 10 times, and then switch legs. 

Step 5: Improve Your Balance

Flare-ups can affect your balance and coordination. This attack increases your risk of falling, which can cause injuries. Regain these skills with simple exercises:

  1. Assisted Single-Leg Stands: Stand on one leg for 10–20 seconds. Repeat 10 times, then switch legs.
  2. Heel-to-Toe Walks: Walk in a straight line. Step with one foot directly in front of the other foot, then move forward 20 steps. Turn and repeat 10 times.
  3. Assisted Standing in a Balance Board: Use a balance trainer to improve.

Step 6: Consider Additional Aids

  1. Wear Well Cushioned Sneakers: Choose footwear with comfortable arch support and cushion to help decrease joint load. 
  2. Compression Sleeves or Braces: Provide stability and reduce swelling.
  3. Hot and Cold Therapy: Use ice packs for lingering swelling but hot packs for stiffness. Apply 15 minutes every hour and repeat, depending on your symptoms.
  4. Massage: Loosen tight muscles around the knee to relax tissues and improve mobility.
  5. Use Assistive Devices: Using a cane when necessary can prevent erosion of your inflamed joint.

Step 7. Make Lifestyle Adjustment

Enhancing your weight-bearing function isn’t just about exercise. You have to make lifestyle changes. Eating healthy with regular exercise helps you to be in good shape. An extra pound adds pressure to your knee joint, thus accelerating joint erosion.

Consult a Physical Therapist

Consult a physical therapist for a customized recovery plan or book an appointment with us. We can:

  1. Assess your current mobility and strength.
  2. Recommend exercises tailored to your specific needs.
  3. Monitor your progress to ensure safe recovery.

Prevent Future Flare-Ups

Recovery doesn’t end when your knee feels better. Focus on long-term strategies to manage osteoarthritis and prevent flare-ups. Be consistent with your exercises to keep your knee strong and flexible. Moreover, avoid high-impact activities such as running or jumping that may irritate your joints. Finally, follow an anti-inflammatory diet to support joint health.

Take Charge of Your Health

If you want expert guidance, please call us. It’s always best to seek professional care to take control of your knee osteoarthritis rather than taking risks with your body. At CT Physical Therapy Care, we specialize in helping you move with confidence. Please read our reviews to learn more about our clients’ experience with us.