Moving Better, Moving Forward

A professional and experienced physiotherapist, Nadine is passionate about providing current best practices for first and second-line treatment of hip or knee OA. The options are so much better now then they used to be!

What should be one's course of action when diagnosed with hip or knee OA or when one is vulnerable to developing it? 

There is a very distinct path of care that research has long supported. It is time for the work that we do with our patients to reflect that path.

The path of care includes three lines of treatment, meant to be followed sequentially. Lines 1 & 2 are non-operative and should be fully explored and maximized before moving onto the final line of joint replacement surgery.

As our knee and hip OA treatment approaches become more consistent and streamlined, one can hope that those who need to access the final line of care can do so more quickly as those who are successfully managing their OA joints with the first two lines continue to do so.

Therapy Services

Are your services right for me?

Our playbook: How we help you

Hip and Knee OA Treatment Pyramid

For many years, good research has advised how hip and knee osteoarthritis should be managed. Guidelines have been very consistent in the following recommendations:

  • The first line of treatment for ALL patients with hip or knee OA is education, exercise and weight loss.
  • SOME patients may need more. That second line of treatment could include medications, aids and devices (such as braces and orthotics) and more individualized therapy.
  • In those FEW cases where the non-surgical first and second lines of treatment aren’t proving sufficient, the next step is to pursue surgical consultation. This is considered the third-line of treatment.

We know that too many hip and knee OA patients don't receive adequate exposure to the long-term tools to self-manage their arthritic joints. Luckily, the tide has really turned in recent years.



Knee OA - reducing pain, increasing mobility

When I began the GLAD program with Nadine, I could barely walk a block and stairs had become a formidable barrier. I needed to lose weight and moving so little made that objective much more difficult.

I am 77 and could not do as many repetitions as my more active classmates, but after a couple weeks, I could feel more fluidity in my knee joint and much less pain. In fact, most days now I do not need any pain medication. That is a big change - I was taking tylenol for arthritis every 8 hours.

The exercises are simple - and most can be continued at home - but having Nadine watching and making suggestions has been very important.

GLAD makes one feel that there is a way to control and manage OA. We do not need to be passive recipients of the discomfort.

Meg, Vancouver

Knee OA Treatment - GLA:D program has changed my life for the better!

In 2019 I became a client of Nadine’s after my family physician referred me to her for unresolved shoulder pain from a car accident. During the course of my shoulder treatment we got talking about other parts of my body that needed treatment. I have had surgeries on both knees for various issues and was told that knee replacement surgery would be in my future. I definitely wanted to avoid that! Nadine informed me about the GLA:D program and she suggested that I research the program, which I did. There was a GLA:D class that started in January 2020 and I join it.

The class size was kept small and it was very educational and fun. I learned a lot about pain and pain management. It was part of the program to be aware of which exercises caused pain, how long it lasted and what was the level of pain. Adjustments to the exercises could be made if necessary to keep the pain at a workable level. But we still had to do the work! Nadine has a wealth of knowledge and experience. She kept the classes engaging and informative. We learned about osteoarthritis and how to improve and maintain joint stability by doing the exercises on a regular basis. It is important to follow through with the program to build neuromuscular memory for proper joint alignment and stability. While I know this, I am not very regular in my current structured exercise program...

I have been able to maintain a regular program of walking approximately 5-6 km per day. I have been able to loose weight to lessen the load on my joints, which is extremely important. I am much more aware of my alignment when ascending and descending stairs and carrying objects.

The help and knowledge that I received from Nadine has changed my life for the better. I am able to participate in regular physical activity. I feel better and am currently living without hip or knee pain.

Thank you Nadine for your expertise and ability to deliver an excellent program.

Nancy W, Vancouver