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Massage And Osteoarthritis Of The Knee.

If you play a sport, or have suffered an injury, this article will certainly captivate your interest! As we age and/or sustain injuries the likelihood of osteoarthritis increases. Learn more about this debilitating long-term condition right here.

Disease is literally, dis-ease in the body. Anyone who pushes the body's boundaries and capitalizes upon its potential understands pain. If you spend time stretching the capabilities of your body, or pushing the limits your body can attain, chances are you will experience an injury or two along the way.

If you play a sport, or have suffered an injury, this article will certainly captivate your interest! In today's competitive world of both sport, and extreme sport, it is a well-known fact that with extreme anything, you run the risk of sustaining severe injuries.

Sometimes, injuries are directly related to such strenuous activity or can be caused simply by a single repetitive motion - dislocations, sprained joints, pulled muscles, and torn cartilage, ligaments, or muscle tissue are just a few of the risks people face.

What you may not know is that, over time, these extreme injuries or repetitive motions may be contributing to the onset of arthritis that can lead to a painful long-term condition known as osteoarthritis.i


In 2002 research conducted by the Arthritis Foundation surveyed over five thousand people discovering a whopping fifty-two percent of those people were unaware they were at risk for arthritis. Sixty-seven percent were reported as already at risk for the disease, and worse, fifty-three percent, more than half the total number of people surveyed, were already found to be exhibiting common symptoms of arthritis.

The same press release issued by the Arthritis Foundation stated arthritis is the nations leading cause of disability, and one out of every six Americans has some form of arthritis. They also predict that by the year 2020, the odds become one in five; roughly, 60 million people in the United States will suffer from arthritis in the future.ii

Do You Or Someone You Know Suffer From Arthritis?


Osteoarthritis (OA) is a chronic, or ongoing, condition that over time causes the protective layering of cartilage, and the articular capsule, to deteriorate.iii Alternatively, it may cause the growth of a bony protrusion in the joint. OA (osteoarthritis) most often affects weight-bearing joints like the knees and hips.

Mosby's Medical Encyclopedia lists one of the principal symptoms in OA as being a deep, painful aching in the joint, which may be exacerbated by exercise, activity, or weight-bearing movements. Additionally, a "grating" of the joint may occur. This may occur during ambulation or other movement, along with joint stiffness, especially in the morning.

Joints that ache in cold or inclement weather, gait changes, and range-of-motion limitations may also be some other symptoms. Emotional or occupational stress, poor posture, and obesity can all aggravate the symptoms.

Arthritis: The Six Most Frequently Asked Questions. Arthritis: The Six Most Frequently Asked Questions.
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OA may eventually lead to impaired functioning of the joint itself, especially weight-bearing joints, like the hips or knees.iv On an x-ray OA is recognizable by a reduction in the space between the joints and irregularities along the bone's edges, caused by a loss of cartilage.v

Normally functioning joints are sturdy, and should endure the average normal wear and As we age however, our bodies undergo a gradual wearing down; the protective layering between the bones may become thin and weakened.vii Injuries like a dislocation, or any sort of trauma that weakens the ligaments holding joints together, speeds up the rate at which cartilage may deteriorate, leading to arthritis, and eventually osteoarthritis.viii

OA is the world's most common form of arthritis. In America alone, OA accounts for 7 million doctor's visits annually and affects 16 million people in the United States.ix The Centers for Disease Control (CDC) report that OA causes more physical limitations than lung disease, heart disease and diabetes mellitus.x

OA affects men and women equally, but the root cause remains unknown. Doctors speculate that endocrine, genetic, or metabolic factors may play a role in the development of OA. OA tends to be asymptomatic in the second or third decades of life, but, by the fourth decade, symptoms may begin to appear as changes begin to occur in the joints and cartilage begins to wear down, or become dry.

Joints & Cartilage:

    Over time, joints may come out of place (subluxation), which can lead to more problems, especially if the hip, knee, or the spine is involved.

    In normally functioning synovial joints, where two bones come together to form a joint, each bone is covered by a protective layering of cartilage, and a joint capsule fills the space between the cartilage. The joint capsule contains two layers; an outer, fibrous ligament type layer, and an inner synovial membrane.

    Think in terms of layers,

    • Layer one is the bone
    • Layer two the cartilage
    • Three the articular capsule
    • Four the synovial membrane
    • Then lastly five the synovial fluid that lubricates everything.

    All five layers working to prevent the ends of the bones from making contact with each other, in OA these layers deteriorate resulting in a breakdown of the cells that make-up and form cartilage, known as chondrocytes.xi Eventually, the deterioration of chondrocytes may allow bones to begin to rub against one another.

The Synovial Joint
Click Play To Start The Video.

Prevention Is The Key

Because there is no cure for OA, researchers and medical personnel all agree prevention is the key.xii The sooner you begin caring for your joints, the better. The primary goal of doctors in treating patients with OA is to relieve the patient's pain, maintain or improve mobility, and minimize potential disability.xiii

Preventative measures make it easier to maintain healthy joints by helping to reduce the amount of pain and damage in a joint.xiv Effective treatments for pain management are highly recommended, your doctor can tell you which treatments are best for you.

Two of the highest ranked treatment options for those who suffer from OA, especially of the knee or hip, are pain management and prevention of joint disability.xv

Massage Therapy

In a brochure printed by the American Massage Therapy Association (AMTA) Brad Stuart, M.D., Hospice Medical Director for the Visiting Nurse Association & Hospice of Northern California is quoted saying,

"Massage therapy is a complementary therapy,
not alternative anymore. It's of tremendous benefit."

The Arthritis Foundation suggested on their web site that in conjunction with the aforementioned treatment options, mild, moderate exercise, combined with doctor prescribed range-of-motion isometric, postural, and strengthening exercises to maintain normal functioning of joints.

Other beneficial preventative treatments options include massage therapy, moist heat, paraffin dips for hands, and techniques for preventing stress or strain on the joints.xvi

While massage is contraindicated during the severe phases of OA, it is extremely beneficial when symptoms allow, such as when there is no inflammation, or acute pain.xvii While a joint with OA can retain mobility for years, progressive weakening of the muscles or pain induced disuse of a muscle can eventually cause the muscle to atrophy.

What Does Contraindicate Mean?
To indicate the inadvisability of something, such as a medical treatment.

Massage techniques like structural integration (Rolfing) that help restore the body's neutral posture, can assist in correcting postural dysfunctions that can exacerbate the pain. Massage can also assist in alleviating pain associated with OA, by eliciting the parasympathetic response (the relaxation response) in the body.

In a recent press release the AMTA listed information regarding a national survey sponsored by the American Hospital Association (AHA) illustrating a large number of consumers and health care providers are using massage therapy for pain management and for other important health benefits.xviii

Massage offers OA sufferers numerous benefits, including a reduction in muscle tension and increase in blood flow to the treated areas. The AMTA reports that 74% of medical practitioners feel massage is usually or always effective as a conjunctive therapy.xix

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Her techniques provide the perfect combination of gentleness and strength... Find out why Mara believes adding a weekly massage to your training schedule may actually benefit your workouts and wellness.
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In an unrelated article, Mary Beth Braun, once President of The American Massage Therapy Association said, "Along with massage therapy's continued popularity for relaxation, and stress relief, this year's survey findings show higher numbers of consumers turning to massage therapy for pain relief than we've ever seen before".xx

Ask an athlete, their coach, or a team's medical staff, and most will agree massage increases muscular performance. The process of manually kneading a muscle can increase or decrease neural excitability of the muscle, influencing muscle integrity, possibly resulting in decreases in both inactive and active stiffness, while simultaneously increasing range-of-motion.xxi

On December 11, 2006, Archives of Internal Medicine (AIM) published the results of the first clinical trial on the effects of Swedish massage on adults with osteoarthritis of the knee. The 16-week study was conducted by David L. Katz, M.D., associate adjunct professor in the Department of Epidemiology and Public Health, at Yale School of medicine and director of Yale's Prevention Research Center, along with Adam Perlman, M.D., executive director of the Institute for Complementary and Alternative Medicine at the UMDNJ-School of Health Related Professions.

Sixty-eight people opted to participate in the Yale study. Each participant was at least 35 years old with a diagnosis of OA of the knee joint. X-rays were used to confirm the diagnosis of OA in the knee joint. During the study, the sixty-eight participants were instructed to continue with current conventional treatments, such as prescribed medications.

Each participant was randomly assigned to either a massage group or a control group. The control group was restricted from receiving massage and instead incurred a preliminary eight-week delay in receiving massage, while the initial massage group received massage therapy from the start.

For four weeks, the massage group participants received two standard 60-minute Swedish massages, followed by four weeks of weekly 60-minute Swedish massages. After eight weeks of massage, research participants had improvements in flexibility, and range of motion, and felt a decrease in pain.

The Benefits Of Swedish Massage Therapy For Athletes.
There are numerous types of massage, but perhaps the most popular and commonly known is Swedish Massage.
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Dr. Katz stated that "massage is free of any known side effects and according to our results, clearly shows therapeutic promise". He also commented that "So-called 'alternative' treatments like massage are most important when conventional treatments are far from ideal. Dr. Perlman declared that "significant improvement in symptoms after eight weeks of massage persisted even after the study was completed."xxii

In conclusion, Katz and Perlman's research team were able to prove that the long gliding strokes (effleurage strokes) utilized in a Swedish massage are a successful tool for reducing pain and improving range of motion for adults with osteoarthritis of the knee.

Combined with the already known injury reducing benefits of massage therapy, the AIM study results confirm that regular treatment by a professional massage therapist can help reduce the pain and limitations brought on by osteoarthritis, and may even be able to delay its onset.


  1. Merck Manual Seventeenth Edition Centennial Edition
  2. Lynne Unglo Arthritis Foundation "Americans in Denial = a Nation in Pain"
  3. The Penguin Group New York, New York, "The Mosby Medical Encyclopedia Revised Edition copyright 1985
  4. The Penguin Group New York, New York, "The Mosby Medical Encyclopedia Revised Edition copyright 1985
  5. Batan Books, "Bantam Medical Dictionary Revised Edition" pg. 308 copyright 1990
  6. Merck Manual Seventeenth Edition
  7. Lippincott Wiliams & Wilkins "A Massage Therapist's Guide to Pathology" Ruth Werner copyright 1998
  8. Lippincott Wiliams & Wilkins "A Massage Therapist's Guide to Pathology" Ruth Werner copyright 1998
  9. Lippincott Wiliams & Wilkins "A Massage Therapist's Guide to Pathology" Ruth Werner copyright 1998
  11. Springhouse Corporation Springhouse, Pennsylvania " Professional Guide to Diseases Sixth Edition" 1998
  12. "How to Care for Yourself"
  13. Springhouse Corporation Springhouse, Pennsylvania " Professional Guide to Diseases Sixth Edition" 1998
  14. "How to Care for Yourself"
  15. Merck manual
  16. Springhouse Corporation Springhouse, Pennsylvania "Professional Guide to Diseases Sixth Edition" 1998
  17. Lippincott Wiliams & Wilkins "A Massage Therapist's Guide to Pathology" Ruth Werner copyright 1998
  18. "Massage therapy Increasingly Sought for Pain relief" Media Contact: Ron Percht Oct. 15, 2003
  19. "Demand for Massage Therapy" Use and Acceptance Increasing Statistics About Health Care & Massage Therapy
  20. "Massage Therapy Grows In Popularity" Press Release Date Oct. 24, 2005
  21. "The Mechanisms of Massage and Effects on Performance, Muscle Recovery and Injury Prevention". Sports Medicine. 35(3):235-256, 2005. Weerapong, Pornratshanee 1; Hume, Patria A 1; Kolt, Gregory S 2 copyright, 2007
  22. "Swedish Massage Benefits Osteoarthritis" Press Release Date Dec 11, 2006 Media Contact: Karen N. Peart