Exercise and knee osteoarthritis: benefit or hazard?

Arthritis is one of the leading causes of disability worldwide and the disease burden is steadily increasing. Patients are known to experience pain, fatigue and impaired physical function with an associated detriment in body composition involving an increase in fat mass and a decrease in muscle mass. According the American College of Sports Medicine, 66% of arthritis patients are either obese or overweight.

Knee osteoarthritis (OA) is the most common form of arthritis and is a result of cartilage loss in the knee joint which causes friction between the bones. While knee OA pain can often be debilitating and exercise seems counterintuitive, there is compelling evidence for the substantial benefits of exercise in OA patients.

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Benefits of Exercising for Knee OA:

  • Reduced Pain and joint stiffness

  • Reduce comorbidities -

    • Osteopenia/Osteoporosis

    • Obesity

    • Cardiovascular disease

    • Type 2 Diabetes

    • Metabolic Syndrome

  • Improved quality of life and mental health

Paired with pharmacological interventions, exercise catering to the needs of the individual patient will ensure effective management of the condition and maximise a patient's independence and involvement in the community. A combination of both regular resistance and aerobic exercise is most beneficial.

While exercise is effective, here are a few exercise considerations for knee osteoarthritis:

Fear avoidance and uninformed pain beliefs

Many patients are fearful that exercise will exacerbate their pain and will worsen their joint condition. However, compelling research shows otherwise where active patients actually exhibit less pain, fatigue and inflammation. Gradually building up the intensity and duration of exercise bouts from a comfortable level will eventually result in these benefits while also minimising joint pain and damage.
For those who are deconditioned or new to exercising, it is common to experience discomfort in the muscles and joints during and after exercise and does not indicate damage to the joints. There is little cause for concern if the level of joint pain during exercise is similar to the pain experienced prior to exercising. It is also common to experience delayed onset of muscle soreness (DOMS) within 2 days of an exercise session while you are becoming accustomed to exercising.

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Flexibility and mobility concerns

Joint stiffness and pain can often be an issue for patients. It is therefore important to warm up sufficiently before exercising and to finish an exercise session with cool down exercises. Controlled, low intensity movements that take the joints through their ranges of motion and stretching should attenuate stiffness and a lack of mobility

Flare ups are perfectly normal and manageable

Episodes of significant inflammation and pain can often occur without notice and without a clear cause. This is a common experience and should not cause us to put our life on hold. It just requires some creativity to enjoy the benefits of exercise while keeping us confident in moving about! During a flare up, reduce the intensity and duration of your sessions and replace high impact exercises with low impact exercise modalities such as cycling or pool based exercises

Every patient will have different experiences regarding their function and symptoms but there is expert guidance and evidence based care available to you from an exercise physiologist! The experts at Balanced Bodies Lifestyle Clinic can walk alongside you in managing your condition so you are able to enjoy a healthy, independent and active life!