094. Strength training treating knee osteoarthritis with Dr Claire Minshull

Have you ever wanted to improve your patients strength, but weren't sure about the best way to go about it? What exercises should you use? How many sets, reps and sessions per week should you ask your patients to complete? Strength levels often start to decline with pain or after an injury, from neuromuscular inhibition, swelling, inflammation or joint laxity (Hopkins & Ingersoll, 2000; Rice & McNair, 2010). Unfortunately strength doesn't always return as quickly as it disappears, and neuromuscular inhibition can carry on (Roy et al, 2017).

In this podcast with Dr Claire Minshull, we dive into the role of strength and conditioning in rehab, and explore:

• Why building strength is an important part of rehab

• How can you build strength effectively and efficiently?

• Do 8-12 rep sets or 3-5 rep sets build greater strength?

• How many sets of an exercise should your patient perform?

• How frequently do patients need to perform their exercises?

• Is maximal loading necessary in rehab?

• Which patients should use lower load exercises?

• Will strength training make endurance athletes slow and muscular, or improve running economy?

• "Functional exercises" vs strength exercises

• When should exercises target strength, and when can you use "functional exercises"?

• What is power training, and what exercises help to develop power?

• When should power training be used?

• What lifting cues can you use with beginning lifters e.g. in deadlifts?

• Patients with knee osteoarthritis:

  • What is an effective exercise strategy for patients with knee osteoarthritis (OA)?
  • What important factors do you need to incorporate in your pain education?
  • How can you start a strengthening program?
  • What exercises can you use?
  • What pain levels are acceptable during exercise?
  • How can you know if your exercises are appropriate for each patient?
  • What braces or supports can you use to make unicompartmental knee OA more comfortable and able to exercise?

Dr Claire Minshull also presented two online courses for Clinical Edge members to further develop your strength & conditioning skills and confidence. You can get access to these online courses with your free trial membership.

What is in Dr Claire Minshull's webinar?

• How to incorporate strength development in your rehab programs
• How to progress strength in rehab
• Exercise progressions and regressions to maintain a strength focus
• Case study examples taking you through how to apply S&C principles with your patients

Links associated with this episode:

• Download and subscribe to the podcast on iTunes
• Download the podcast now using the best podcast app currently in existence - Overcast
• Listen to the podcast on Spotify
• Improve your confidence and clinical reasoning with a free trial Clinical Edge membership, and get access to the online courses on S&C with Dr Claire Minshull
• Let David know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Like the podcast on Facebook
• Infographics by Clinical Edge
• Dr Claire Minshull on Twitter
• Website - Get Back to Sport
• Instagram - Get Back to Sport
• Versus Arthritis

Articles associated with this episode:

• Campos et al. 2002. Muscular adaptations in response to three different resistance-training regimens: specificity of repetition maximum training zones.

• Hall et al. 2018. Knee extensor strength gains mediate symptom improvement in knee osteoarthritis: secondary analysis of a randomised controlled trial.

• Jorge et al. 2015. Progressive resistance exercise in women with osteoarthritis of the knee: a randomized controlled trial.

• Latham et al. 2010. Strength training in older adults: the benefits for osteoarthritis.

• Teixeira et al. 2018. Effect of resistance training set volume on upper body muscle hypertrophy: are more sets really better than less?

• Uusi-Rasi et al. 2017. Exercise Training in Treatment and Rehabilitation of Hip Osteoarthritis: A 12-Week Pilot Trial.