We offer GLAD Newcastle classes for knee & hip osteoarthritis to help reduce symptom progression and pain.
GLA:D® Newcastle classes for knee and hip osteoarthritis
GLA:D®, or Good Life with Arthritis: Denmark, is an education and exercise program developed by researchers in Denmark for people with hip or knee osteoarthritis symptoms.
What is GLA:D?
GLA:D is a neuromuscular exercise and education program based upon the latest evidence in osteoarthritis research. GLA:D focuses on quality, control and coordination during exercise enuring that joints are optimally loaded and the right muscles are activated at the right time.
The GLA:D program was developed and rolled out in Denmark and has followed its over 30,000 participants. Research from these 30,000+ participants found;
- Reduction in pain maintained at 12 months (27% reduction of knee pain, 22% reduction of hip pain)
- Decreased use of pain killers (32% reduction in knee OA, 24% reduction in hip OA)
- Reduced use of sick leave (45% decrease for knee OA, 25% decrease for hip OA)
- Improvements in function and walking speed
- Improvements in quality of life and physical activity at 3 and 12 months
- 74% of patients scheduled for a total knee replacement decided not to go ahead with surgery
GLA:D for patients involves three sessions of patient education and 12 sessions of supervised neuromuscular exercise performed twice weekly for 6 weeks.
This program education and exercises provided can be applied to everyday activities. By correcting daily movement patterns and strengthening, participants can train their bodies to move in a way to reduce symptom progression and pain.
The patient education consists of three sessions given by a physiotherapist.
The sessions provided aim to give the patient knowledge of OA and the treatment of OA with a focus on exercise, its beneficial effects on symptoms and general health.
The third session is intended to give the participants a chance to hear from an expert patient, who has achieved improvements in their symptoms following GLA:D. All three sessions focus on engaging the patients actively and sharing experiences with each other.
The patients are strongly encouraged to participate in the group-based program with 12 sessions each lasting 60 minutes. Patients who for some reason do not wish to, or are not able to, participate in the supervised exercise can do the exercise program home based on detailed instructions by the physiotherapist or combine supervised and home based exercise.
After the 8-week program, the patient is encouraged to continue being physically active and to exercise, either with their physiotherapist or in their local community, to sustain the effects from the treatment in the long term. Individual strategies for the continuation of physical activity and exercise are discussed at the 3-month follow-up.
What is arthritis?
The ends of your bones are covered in cartilage which gives a smooth coating to the end of the bones and allows them to glide easily when moving. Cartilage is solid and flexible allowing it to spread loads over the surface and absorb shock. Cartilage has no blood supply so the nutrients are supplied by synovial fluid (a lubricating fluid inside the joint capsule).
In a healthy knee there is a balance between cartilage degeneration and regeneration. Osteoarthritis occurs when cartilage degeneration exceeds regeneration.
Osteoarthritis is often called “wear and tear” however this phrase has caused many people to believe that they can’t/shouldn't’t be active with osteoarthritis. This is not accurate as cartilage needs loads to regenerate.
Factors that can contribute to osteoarthritis include;
- Previous joint injury
- Overweight/obesity (ever extra kg increases joint load 3-5x)
- Overload eg: elite sport or heavy, repetitive work
- Muscle weakness
- Non-modifiable factors; age, sex, hereditary
Exercising and loading the joint promotes cartilage regeneration. When loads are applied the synovial fluid is pushed out of the cartilage (like squeezing a sponge). When loads are removed the synovial fluid containing nutrients is sucked back in (like a sponge). This flushing of fluid in/out assists cartilage regeneration. Inactivity and avoiding exercise is actually a risk factor for osteoarthritis.
Will any exercise do?
Everyone should aim to be physically active and do at least 30 minutes of activity at a level which increases their heart rate every day.
As well as staying physically active it is also important to do specific, targeted exercises with the correct amount of load on the knee such as GLA:D to best manage the hip and knee osteoarthritis.
It is important to keep your joints (hip, knee and foot) well aligned when you exercise to ensure that when the joint is loaded forces are distributed evenly across the joint.
Exercising without well aligned joints can lead to more pain.
Exercising for a short period well is more beneficial than prolonged, low quality exercise.
Is it okay to exercise when it is painful?
Yes. Pain does not mean damage!
It is not unusual to experience a slight increase in either muscle or joint pain when starting any new exercise or activity. This pain will reduce as your body gets use to exercising. Pain at an ‘acceptable’ level is okay as long as it settles within 24hrs.
What about severe osteoarthritis?
GLA:D is safe for people with severe arthritis and was similarly effective in both inactive and already active participants. Additionally imaging findings do not equate well to pain, symptoms or function.
Keen to find out more?
- Book in to a free osteoarthritis education session at Fitness Physiotherapy 49631140
- Check out these quick videos