My mission is to provide a point of current education and treatment options around first and second-line physiotherapy treatment options for hip and knee OA patients. I have been offering programs since their arrival to us and very much enjoy equipping patients with these tools to better self-manage their symptoms. With the recent growth of telehealth options, I am pleased that I can broaden my reach to include offering program participation to interested patients living anywhere in BC.

First Line Treatment

Exercise:  Exercise is a strongly-recommended core strategy in all cases of hip and knee OA, regardless of whether other health conditions also exist for a person or not. Exercise is most effective when it is structured, supervised and as specific as possible to each patient. Neuromuscular, cardiovascular and strength-based exercise programs can all be effective and should all be fully explored by those living with hip and knee OA.  Exercise tends to be more effective when combined with self-management interventions or weight loss programs.

Education:  Having current and accurate knowledge really helps one to live as well as possible with a health condition.  In my OA work, we talk about making choices in the face of pain.  We talk about why exercise is so important for OA joints and why is it realistic to achieve less pain and more function when living with this diagnosis.  In my experience, busting some of these common myths is extremely liberating for those living with hip and knee pain.

Weight Loss:   Extra body weight is known to have a negative impact on osteoarthritic joints. The good news, however, is that even small losses in body weight can have significant impacts on how one’s OA joints feel and function.  Extra body weight is also known to have an impact on the body’s Cortisol levels and overall inflammation.

Second Line Treatment

It is not uncommon to meet patients who are pursuing first and second line treatments at the same time.  In general, second line strategies are more individualized in nature and can be explored if the first line strategies are not proving effective enough over time. 

I have a good working knowledge of second-line strategies such as braces and orthotics and, particularly in my first-line program time with patients, I will often develop a sense of who may benefit further from some individual work with me post-group work.  In the second-line strategies that are not within a physiotherapist’s scope of practice, I am happy to suggest referrals of those who can advise further.   

Nadine Plotnikoff


Physiotherapist M.Sc. PT, C Gunn IMS, FCAMPT
Sport Physiotherapy Canada Diploma Holder
Registered International Sport Physical Therapist
Private Practice Co – Owner, Form Physiotherapy

Osteoarthritis-related certifications:
Certified GLAD Canada provider
Certified PEAK provider

 

A 30 year career gives time for a few chapters. In addition to my OA focus, my chapters have included a long and, hopefully, never-finished chapter in high performance sport and the opportunity to complete a Masters' thesis with a focus on shoulder injuries.

Establishing a private practice 17 years ago was a pivotal change in how I deliver my patient care. Our practice, Form Physiotherapy was one of the first in Vancouver to offer one-on-one treatment sessions where thorough assessment and treatment, clear goal-setting and patient education and empowerment could be prioritized.

A physiotherapy career is rich in learning and professional community. I have pursued the Canadian Physiotherapy Association's top designations for orthopaedic and sport physiotherapy and been lucky to have meaningful volunteer opportunities, including serving two terms as Sport Physiotherapy Canada's National Chairperson. Newer ventures include delivering learning opportunities to UBC School of Medicine Family Practice Residents.

Along the way, what drew me to becoming a physiotherapist remains the same. I simply really enjoy helping people to maintain better overall health by helping them remain or become active in ways that are meaningful to them.

It is in this context that the hip and knee OA patients have always existed within my caseload. Typically they have arrived at my office in search of strategies to improve their quality of life and perhaps avoid joint surgery. But with their expectations set very low. The recent arrival of a highly evidence-based treatment stream and first-line treatment programs, such as GLAD and PEAK, have, in my opinion, represented a paradigm shift in how we will manage hip and knee OA going forward. As I tell my patients now, if you're going to be diagnosed with OA, it's the best time to do so.

FEEDBACK

 

My OA therapy experiences!

I participated in the GLA:D program with Nadine last year for help with osteoarthritis in my right knee. I was impressed with her personal style and surprised by how effective the sessions proved to be. The combination of educational components and neuromuscular exercises delivered two valuable benefits.

First, they helped trigger a noticeable and sustainable improvement in my knee.

Second, they provided the tools for self-managing my arthritis. The biweekly in-class sessions helped me understand my condition and learn exercises specifically designed to avoid pain and improve mobility. Once the GLA:D program finished, it was easy to integrate the techniques into my daily exercise regimen. I've continued the routines at home using online resources and a few inexpensive pieces of equipment. I really appreciate having the tools I need to handle my arthritis on my own. Of course, there's no guarantee that my condition won't deteriorate over time. Yet even if that happens, the knowledge and techniques Nadine provided will still be very helpful in dealing with whatever medical or surgical treatments may become necessary.

Nadine is friendly, knowledgeable and professional in her approach. During the COVID pandemic, she provided very small classes in a safe environment. She focussed on each patient's particular needs and provided a solid foundation for self-managing osteoarthritis. I can highly recommend both her and the GLA:D program.

Chris A, Vancouver

My hip OA journey!

OA kind of snuck up on me and suddenly a hip XRay indicated bone-on-bone. I was referred to a well-reputed surgeon and was seen for a very brief consult that did not involve even a physical exam - as a nurse, this was a red flag in my mind. My surgery was scheduled to take place a few months later. In the meantime, my wonderful family doctor referred me to Nadine to see what might be done to manage my symptoms (pain, weakness) in preparation for surgery. Once I started with GLAD, Nadine helped me get to a place where I regained significant ROM and pain was more easily managed as my muscles began to better support my movement. I felt so good that I decided to seek a 2nd opinion from another surgeon about my hip and then learned that it's a 12-month wait list just for the consult. I have no problem with the wait and am hopeful that I may be able to delay the surgery indefinitely as I continue to work with my body as learned through GLAD. Thanks Nadine!

Kathleen B, Vancouver