Is osteoarthritis plus exercise a contradiction?

For anyone that has ever received the diagnosis of osteoarthritis (OA), apart from the usual medications that their doctor prescribed, it was probably suggested that they also make lifestyle changes like a healthier diet, weight loss and increased exercise. Using exercise as a way to improve arthritis might seem counterintuitive but in reality, it works.

Studies show that long term, regular exercise can improve joint function [1] and many OA sufferers report a reduction in hip or knee pain and an improvement in their symptoms after just 12 weeks of starting a low-intensity exercise regime [2]

The science behind movement

The human body has over 200 joints that keep us walking, running, jumping and moving around with ease. But joints don’t work in isolation. Instead, they work together with the surrounding muscles, tendons, bones, ligaments and nerves to produce the complex movements that we’re used to carrying out. So when a joint deteriorates or becomes damaged, the whole system is affected.

In osteoarthritis, the individual bones that make up a joint are where the majority of the damage is concentrated. Metabolic factors, wear-and-tear and old age all contribute to the destruction of a joint but the impact is felt far afield by the structures around it, like the neighboring muscles.

Thankfully, there’s something we can do to strengthen those muscles.

Exercises that make a difference

Building and strengthening muscles makes them more efficient and for those with osteoarthritis, this is particularly important because research shows that muscle weakness directly contributes to the development and progression of osteoarthritis [3]. So good muscle strength doesn’t just reduce the symptoms of arthritis, it can help stop OA from worsening.

Weight lifting, stretching and yoga are all examples of great exercises that you can use to strengthen the joints, improve your bone density and elongate your muscles. If you suffer from Osteoarthritis of the knee or hip (the two most common types of OA) it is important to stretch and strengthen the supporting leg muscles. Movement, in the form of regular exercise is the best way to do this. It causes your joints to compress and release, bringing blood flow, nutrients, and oxygen into the cartilage (a crucial part of the joint).

Weights

Loss of muscle strength is especially problematic for older individuals with OA whose pain and stiffness complicates their ability to move [3]. Lifting weights or resistance training can keep the muscles around the affected joints strong. It decreases bone loss and helps control joint swelling and pain.

At first, weightlifting may sound intimidating, but it can be done with proper preparation and minimal equipment that you can find around your house. No gym membership is required. For example, by using 16-oz. soup cans as a substitute for dumbbells, you can carry out exercises on both the upper and lower body [5].

Stretching and Yoga

To increase your flexibility and keep the muscles loose and limber, stretching and yoga are the place to turn. Stretching regularly helps to prevent the loss of mobility. Specifically, range-of-motion exercises improve joint mobility, reduce stiffness and help to prevent tightening of the tissues around the joint.

One of the best times to stretch is after a work-out, as part of a cool-down routine. This is when the muscles are most warm and pliable. You can start with just one or two exercises a day, three times a week, but try to work up to performing several, at least once a day [6].

Here are some common stretches to use:

Knee Osteoarthritis
  • Double hip rotation
  • Hip and lower back stretch
  • Inner leg stretch
Hip Osteoarthritis
  • Standing hip flexor stretch
  • Knee to chest stretch

Although weight lifting and yoga are generally safe and well-tolerated, before you hit the gym or join a yoga studio, remember that all exercise regimens should be individually tailored to prevent injuries or worsening of OA symptoms. Not all exercises are suitable for all individuals so before starting, be sure to have an evaluation by a physician, physical therapist, or other health professional experienced in the management of osteoarthritis.

What exercises should you avoid?

If your osteoarthritis is severe, be cautious about engaging in the following exercises:

  • Running, especially on uneven surfaces
  • Tennis, basketball, and other activities where you change direction quickly
  • Step aerobics and other workouts that involve jumping

 

Joint pain, stiffness and the inability to carry out your day to day activities are an unfortunate hallmark of osteoarthritis. But regular exercise that includes weight lifting, yoga or tai-chi are just a few things you can do to help ease the pain and reduce the symptoms.

References

1) Ambrose, K. R., & Golightly, Y. M. (2015). Physical exercise as non-pharmacological treatment of chronic pain: Why and when. Best Practice & Research. Clinical Rheumatology, 29(1), 120–130. http://doi.org/10.1016/j.berh.2015.04.022

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4534717/

2) Minor, M. A. (1994). Exercise in the management of osteoarthritis of the knee and hip. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 7(4), 198-204.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/art.1790070407

3) Latham, N., & Liu, C. (2010). Strength training in older adults: The benefits for osteoarthritis. Clinics in Geriatric Medicine, 26(3), 445–459. http://doi.org/10.1016/j.cger.2010.03.006

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3606891/

4) WebMD. Joints to compress and release, bringing blood flow, nutrients, and oxygen into the cartilage. Sharon Liao.

https://www.webmd.com/osteoarthritis/features/oa-knee-hip-exercises#1

5) 3 Simple Weightlifting Moves. Linda Malone.

https://www.arthritis.org/living-with-arthritis/exercise/workouts/simple-routines/weight-lifting-exercises.php

6) Harvard health. Exercise: Rx for overcoming osteoarthritis. September, 2007

https://www.health.harvard.edu/newsletter_article/exercise-rx-for-overcoming-osteoarthritis