The Exercise Effect
Physical activity and simple routines can make you feel better.
Although OA of the knee is often progressive and may require medical intervention, there are notable benefits from appropriate exercise. It not only reduces knee strain and pain as it strengthens muscles, helps control weight and increases mobility, but it also raises the spirits and improves self-confidenceso important in managing chronic pain.
Aquatic exercises and swimming are extremely beneficial. They put little stress on the joints while increasing joint flexibility and strengthening muscles.
Land-based physical activities such as bicycling can also ease pain and improve flexibility. The Cochrane reviews found that "there is platinum-level evidence that land-based therapeutic exercise has at least short-term benefit in terms of reduced knee pain and improved physical function for people with knee OA."
Manual physical therapy in combination with land-based exercise is also effective in easing discomfort. "In one study we did, a physical therapist moved people's joints to let them passively experience motion at different speeds and to different degrees," explains study coauthor Gail D. Deyle, D.P.T., professor at Baylor University Graduate School in Waco, TX. "The associated exercise program included joint range of motion exercises, muscle strengthening and stretching exercises, and riding a stationary bicycle. “We found that the benefits of this routine are equal to or greater than many of the other treatment options for knee OA that have a much higher risk for complications."
When you are planning an exercise routine, remember that the knee works in conjunction with the hip, ankle and back. You need to aim for well-balanced strength and flexibility. "Each time you take a step, a load is placed on the knee joints," says Laura Thorp, Ph.D., assistant professor of anatomy and cell biology at Rush Medical College in Chicago. "How much of a load depends not just on your weight, but also on the way you walk and the alignment of your leg." In an ongoing study, she is exploring whether an exercise routine that focuses on the hip muscles can decrease the strain on knee joints in people with OA of the knee.
According to Thorp, the study exercises "strengthen hip abductor muscles that help stabilize the pelvis. In people with OA of the knees, these muscles tend to be weak." The goal, she adds, is not only to relieve pain, but perhaps to halt progression of the disease.