Hello friends of Ocean Therapy and welcome to our March newsletter.

It has been a busy couple of months what with returning to work and getting into the swing of things, however it has been lovely to return and see you all again and I am enjoying helping you all manage any pain, injuries, and for general maintenance treatments. Many of you have said how you enjoy reading the monthly newsletter and find the content interesting and informative so we hope to continue this trend with an update of my hip journey and for this month we have chosen to highlight Osteoarthritis. We know many of you suffer with this very debilitating condition and we thought we would like to offer you some advice with some top tips and general information which we hope can enlighten you.We have also added some useful patient information advice sheets as a link to this newsletter which we thought you might find helpful.

Firstly onto my hip journey…. I am now as I write this I am now 10 whole weeks past my surgery, the time has flown but not without lots of determination and discipline. This has enabled me to return to work at 6 weeks, all be it progressively however I am now back to my full time working hours within the clinic and have resumed the domestic and family role with equal measure! I do experience some fatigue at the end of the day and and my right leg aches with standing for most of the day but this is getting easier and I resume my lower limb strength. I continue with my daily Home exercise plan which I progress with each passing week and in the last week I have introduced some beginner pilates which is quite new to me (I must admit to being a bit of a yogy!) and in the last 2 weeks I returned to the pool for some much needed hydro work which I must admit has been a real blessing, it’s great to be back in the comforts of the water and have really enjoyed getting a few lengths in again. I have also returned to the gym so that I can use the static bike and make the use of the extensive array of equipment so that I can also work on the rest of my body and not neglect my upper body. One of my biggest wins though is being able to climb over a stile on my walks with my dog, it has opened up the routes that I can resume now which were a bit restricted with their being so many stile’s where I live near Ringstead, however I can now walk through new different mud and reach the beach that bit quicker (see photo of my Cckapoo ‘Lucy’ on the beach) plus I am back at the stables with Monty, resuming normal duties ( see image to the right!).

Some of you have said how well I am walking and managing at work but I cannot over emphasise how important keeping to a regular home exercise plan is pre and post surgery, (whatever surgery that is) It may seem a bit of a bother at the time but it will really pay dividends later on in your recovery and help you to return to a normal functional life. I cannot stress this enough, it really is amazing not to have the pre surgical pain and I know for me it has given me a new lease of life so please do what you can for yourself. In the Osteo arthritis section of this newsletter we have specially added some information on O/A of the hip. As always if you would like any specific questions please do not hesitate to ring our receptionist to request a call from Boris or myself.

Little bit of housekeeping, please note that follow up appointments with Samantha and Boris will, with regret, go up to £55 as of April 1st 2025, as always we thank you for your continued custom, it really is appreciated.

At sometime in your life, there is a strong chance you will experience sore, achy stiff joints, possibly even swollen and red joints at times. But what is this? Could it be arthritis? And, if so, what kind of arthritis? Maybe you didn’t know that there are different types of arthritis that can affect your joints, each of which has different causes and different outcomes.

Arthritis is the swelling and tenderness of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis (OA) is the most common form of arthritis. Some people call it a degenerative joint disease or ‘wear and tear’ arthritis. It most frequently affects the hips, knees and hands.

With OA, the cartilage (the hard, slippery tissue that covers the ends of bones where they form a joint) within a joint begins to break down and the underlying bone is exposed and begins to change. These changes usually develop slowly and get worse over time. OA can cause pain, stiffness and swelling. In some cases it also causes reduced function and disability – where some people are no longer able to do daily tasks or work. Quite often you hear of people having joint replacement surgery to correct it.While OA is often associated with aging, it can also develop due to injury, genetics, or lifestyle factors such as obesity and prolonged inactivity.

Rheumatoid arthritis (RA) is a disease which your immune system attacks your own joints, beginning with the lining of the joints. It is a type of inflammatory arthritis that is also classified as an autoimmune disorder. This means that the nervous system sends ‘incorrect’ messages to the immune cells to attack the body’s own joint tissues. In the case of RA, often the primary symptom is not joint specific but rather chronic fatigue, feeling feverish or lethargic.

General Arthritis

Other common types of arthritis include lupus (another autoimmune, inflammatory arthritic condition), gout (an extremely painful type of arthritis caused by a build- up, overflow of and/or inability to process uric acid) and fibromyalgia (widespread, chronic pain, insomnia and fatigue).

Although there’s no cure for arthritis, treatments have improved greatly in recent years and, for many types of arthritis, particularly inflammatory arthritis, there’s a clear benefit in starting treatment at an early stage. Treatments vary depending on the type of arthritis. The main goals of arthritis treatments are to reduce the progression of the disease and to aim for remission (in the case of RA) reduce symptoms and improve the quality of your life.
The most important treatment option is exercise therapy and being physically active.

O/A of the Hip

This is common condition that can significantly impact your daily life, making simple movements painful and reducing overall mobility.However with the right approach, including daily mobility work and strength training at least three times a week, you can slow its progression, reduce pain and regain confidence in your movement. BuildIng strength around the hip joint provides stability and reduces the load on the affected hip. Strength training will support the joint by strengthening the muscles that surround it, including the glutes, quadriceps ( the muscles at the front of the legs) and the core. It will also help to reduce the pain by improving joint alignment and efficiency.It will enhance stability to prevent falls and further joint deterioration. Exercises like bodyweight squats, hip bridges, step ups, and resistance band work are all excellent choices to build strength without adding excessive strain.

Common symptoms include the following.

1 Pain and aching felt in the hip.

Pain can refer into the groin and buttock region and down the thigh. The pain can feel worse after weight-bearing activity or towards the end of the day. In more severe cases the pain can wake people during the night.

2 Stiffness. The hip may feel stiff after rest (such as sitting for a while or on first getting up in the morning), but this usually eases as you get moving again. People with hip OA often notice that their hip may not move as freely or as far as normal.

3 Giving way. Weight-bearing joints such as knees and hips can give way at times and this is because your muscles have weakened. Sometimes people can visually see wasting (less bulk) in the muscles around the affected joint.

4 Weakness. OA is often associated with weakness in the muscles of the thigh and hip, generally due to reduced activity levels.

5 Crepitus. You may experience a creaking sensation when moving the joint; however, also keep in mind that this sensation often occurs in

normal, healthy joints also.

1 Lifestyle Changes

l Advice and education. This helps you to understand what is happening in your body and how you can help manage the condition.

l Weight management. Being overweight puts stress on weight-bearing joints
like your hips, which can increase your chances of developing OA or making your symptoms worse. Losing even a small amount of weight can make
a difference to the strain put on your joints. Get advice and support from your doctor or therapist. The best way of losing weight is to follow a healthy, balanced diet (a dietician may even be helpful). Gradually increasing the amount of physical activity you do can also help with weight loss.

l Pacing. Don’t tackle all of the physical jobs at once, try and break up difficult tasks throughout the day, with rest in between. Keep using your hip, but rest it once it becomes painful.

l Walking aids. It is also useful to consider using a walking aid such as a walking stick to help with your pain and walking. Your physical therapist can discuss this option with you. They will be able to provide you with a walking stick that is the correct height for you and ensure that you can use it correctly and safely.

l Footwear. It can be helpful to ensure that you wear suitable footwear such as a flat shoe or trainer that is supportive and cushioned. Some people also benefit from wearing insoles (orthoses) which your physical therapist can advise or refer you.

l Modifying your activities. Avoid sitting in prolonged positions, try modifying your home/workplace to reduce unnecessary strain, use a handrail for support when going up/down stairs, use a walking stick to reduce the weight and stress on the painful hip.

Joints need to be exercised regularly to keep them healthy. Exercise has been shown to help people with OA and can reduce the symptoms. You will need

to undertake a combination of aerobic exercise and specific hip exercises under the guidance of you physical therapist

2 Physical Activity

l Aerobic exercise. Any exercise that raises your heart rate and makes you short of breath. This type of exercise can improve your sleep, improve your general health, manage weight control and reduce ain by stimulating the release of pain- relieving hormones called endorphins. Swimming, cycling, and walking, are all good options to consider. Water based exercise is particularly helpful as the water reduces the load on your joints. Pilates and yoga can also be helpful. The type of exercise that suits you will depend on the level of your symptoms and any other health conditions you have. It is important to find an activity that you enjoy as you will be much more likely to keep it up.

l Specific strengthening exercises. These will be prescribed by your physical therapist they can start easy and progress to more challenging exercises are you become stronger and as pain allows. Specific hip exercises are undertaken to help both the strength and flexibility around the joint. Stronger muscles can support the joint and reduce the load thereby relieving symptoms and improving your function. Exercise is proven to reduce Symptom of pain and improve mobility in the joints. It can postpone the need for surgical intervention. Daily mobility exercises are essential for keeping your joints lubricated and maintaining your range of motion. When you move regularly, you hep reduce stiffness, improve circulation, prevent your muscles from becoming too tight or weak. Simple movements like hip or ankle circles, seated knee lifts, and gentle stretches can go a long way in keeping your joints functional.
Should surgery be required, exercise therapy before (pre-habilitation) and after surgery (rehabilitation) gives the best long-term outcomes. Exercise therapy and achieving an active lifestyle has added benefits for your cardiovascular health (often involved in certain arthritic conditions) and your mental health too. Dealing with a chronic pain condition can lead to stress, anxiety and depression. Therapy should address this through education, counselling and acquiring coping skills (be it exercise, meditation, yoga, massage or deep breathing). Although massage and other hands-on therapies may produce positive outcomes for pain, mobility and reducing stress, they should be considered as a complementary treatment to exercise therapy.

The aim of therapy is to manage your pain, improve function and reduce disability. Maintaining your independence is of the utmost importance. Social workers and occupational therapists can help with advice and devices for home and the work place.

Although you may have a team of medical professionals treating your arthritis, remember it is up to you to manage it long term. Every person and their arthritis is different – finding your balance between doing too much or too little, or knowing what to do should you have a flare-up can be a period of trial and error. Getting the right information, guidance and support from you local therapist will help set you in the right direction!

Take control of your Hip health!

Every case of osteoarthritis is unique, which is why having a personalised approach is essential. We here at Ocean therapy can help manage your symptoms and help you to either prepare you for surgery, or guide you through your rehabilitation. Boris from Outrageously Active can provide a tailored assessment and movement plan to help you regain your strength and mobility safely. Whether you are newly diagnosed or have been struggling with O/A for years, he can help guide you through an effective exercise plan that fits and compliments your lifestyle and capabilities.

Don’t let your osteoarthritis control your life. Prioritise daily movement, commit to strength training , and take the next step towards pain free mobility.

Book your assessment today on : 01305 831726

The information contained in this article is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical care or as a substitute for seeing your GP.