Getting a diagnosis of knee osteoarthritis doesn’t mean you have to give up the activities you enjoy. But it will require some effort to establish a routine of doing the types of exercises that will help to ease pain and stiffness.
With osteoarthritis, the severity of pain can vary greatly, and it may not match the physical findings on imaging studies. There are other factors at work besides the degree of cartilage degeneration in a joint. “Having arthritis doesn’t mean you’re always going to have pain,” says Cleveland Clinic physical therapist Dawn Lorring, PT, MEd, MPT.
“People with arthritis need to stay active and realize that exercise is good for arthritis,” she says. “Movement is what the body needs.” You also need strength and support to allow the joint to function at its best. Strong muscles will take some pressure off the joint.
Flexibility around the joint will also help reduce pain. Extra tension and tightness can cause the structures in the joint to rub, which can make pain more severe.
You can start simply by moving more. “Lower-impact types of activities can be very helpful with arthritis,” says Lorring. If you used to run for exercise and can’t do that anymore, try walking, biking or swimming. “There are lots of alternatives that are less irritating to the joint,” she says.
If you haven’t been very active, it’s time to start. Lorring recommends starting where your pain allows you to be. “You need to get your muscles working without causing more irritation.”
Just increasing your walking isn’t enough, though. Many people think that walking is sufficient as a strengthening exercise. But that alone won’t make lasting gains in muscle strength.
Flexibility and Strength
Lorring recommends a combination of exercises, starting with a warm-up that improves flexibility. An example would be using a stationary bicycle or stretching exercises that cause you to move the joint through a larger range of motion than you would normally move it with daily activities. “This allows the muscles to get a little looser,” says Lorring.
Follow this with muscle strengthening. Think of the muscles as shock absorbers for the knee. They can decrease the force applied through the knee and provide stability.
It’s not just the muscles around the knee that need strengthening. “You want your ankles and hips to be strong as well because they all work together to make the knee function properly,” says Lorring.
The knee moves in basically one plane of motion. It bends and it straightens. Side-to-side motion, such as going up and down stairs or getting in and out of a car, involves the hips and ankles. Strong hips and ankles are also essential for balance.
Keeping all of your joints functioning optimally is important because if you’re avoiding using a portion of your body, it can cause pain elsewhere. “Your body is very creative,” says Lorring. “It will find another part to do the job of the part you’re avoiding using.” That can lead to back pain or pain above or below the arthritic joint.
Find Exercises You Enjoy
Exercises can be simple (see box). The important thing is to find an exercise regimen that you enjoy enough to stick with long-term. Some people get the instruction and motivation they need by attending a class. Anyone can benefit from seeing a physical therapist, who can perform an evaluation and customize an exercise program just for you.
“Recognize that when you start a new exercise program you probably will have some muscle soreness or a bit of pain,” says Lorring. It should be mild and shouldn’t last long. “That’s your body adapting to the new activity,” she says.
When starting any new exercise program, make sure you are healthy enough for the activity. If you are uncertain, check with your doctor. Lorring notes that exercise has value beyond pain relief. “It can improve blood pressure, cholesterol levels and mental function,” she says.