Osteoarthritis (OA) is a common condition that affects many individuals, particularly in the knees. For those managing OA, exercise can be a vital component of treatment, offering substantial pain relief and functional benefits. However, starting and maintaining an exercise routine with OA can pose its own set of challenges. This article aims to demystify the process of exercising with OA, addressing common myths, outlining benefits, and providing practical advice to help you stay active and pain-free.

Understanding the Benefits of Exercise for Osteoarthritis

Research strongly supports the role of exercise in alleviating pain and improving function for individuals with osteoarthritis, especially in the knee. Regular physical activity has been shown to:

• Improve Strength and Mobility: Enhancing the strength of muscles around the joint can lead to better support and decreased stress on the affected areas.
• Decrease Pain: Exercise helps in reducing pain through the release of endorphins, natural chemicals that relieve pain and boost mood.
• Prevent Falls: Improved balance and strength can reduce the risk of falls, which is crucial for maintaining independence.
• Promote Overall Health: Regular exercise contributes to cardiovascular fitness, weight management, better sleep, and improved self-esteem. Additionally, it can reduce feelings of anxiety and depression.

Overcoming Exercise Challenges with Osteoarthritis

For many, the idea of exercising with osteoarthritis can be daunting. Initial movement might be uncomfortable, and there’s often fear that exercise might worsen the condition or pain. Adhering to a new exercise routine also requires finding time and adjusting to a new lifestyle.

Here are some strategies to overcome these barriers:

• Find Enjoyable Activities: Engage in exercises you find enjoyable to increase adherence.
• Set Achievable Goals: Start with small, manageable goals to build confidence and progress.
• Track Your Progress: Keep a record of your achievements to stay motivated.
• Social Support: Join a group or find a workout partner to enhance motivation and accountability.
• Use Wearable Technology: Track your activity and progress with devices designed to monitor your health metrics.

Debunking Common Myths

Several myths surround exercise and arthritis that may discourage individuals from staying active:

• Imaging Equals Pain and Function: It’s important to note that imaging results (like Xrays) do not always correlate with pain or disability. Many people with knee arthritis on X-rays report no pain or functional issues.
• “Bone on Bone”: The idea that “bone on bone” means nothing can be done is misleading. OA progression is not inevitable, and there are effective non-surgical interventions.
• Exercise is Damaging: Contrary to this belief, exercise is not inherently damaging. In fact, it can be quite beneficial. (See above section about benefits)
• Pain Equals Damage: Experiencing pain does not always signify harm. Learning to manage and differentiate between discomfort and potential injury is key.
• Rest is Always Helpful: While rest is important, complete inactivity can actually exacerbate symptoms. Regular, moderate exercise is essential.

Types of Exercise for OA

Incorporate a variety of exercises to address different aspects of physical fitness:

• Cardiovascular/Aerobic: Activities like walking, cycling, and swimming improve cardiovascular health and endurance.
• Muscular Strength: Strength training, using resistance bands or weights, builds muscle strength around the joints.
• Muscular Endurance: Repeated, moderate exertion enhances muscle stamina.
• Muscular Power: Exercises that involve short bursts of effort can improve overall strength and functionality.
• Flexibility: Stretching exercises increase range of motion and reduce stiffness.
• Balance and Proprioception: Activities like Tai Chi and certain balance exercises enhance stability and coordination.

Practical Exercise Guidelines

When starting an exercise program with osteoarthritis, consider the following:

• Start Slowly: Begin with easy exercises and gradually increase intensity. Use pain as a guide—aim for a discomfort level of less than 3 out of 10. If pain reaches 5/10 or more, it might be too much.
• Manage Flare-Ups: Expect occasional flare-ups and use methods like heat, ice, or medication to manage discomfort.
• Aerobic Exercise Recommendations: Aim for 20-60 minutes of continuous activity, 3-5 days a week. Activities like walking up to 70 minutes per week have not been shown to increase pain in those with advanced OA. There’s no need to strive to achieve 10,000 steps per day rule; 6,000 steps daily can be effective in reducing functional problems.
• Strength Training Recommendations: Perform strength exercises 2-3 times per week, including 2 sets of 8-12 repetitions.

By understanding these aspects of exercise and osteoarthritis, you can take proactive steps towards managing your condition effectively while enjoying the numerous benefits of staying active. Keep moving and stay pain-free!

Mark Temme, P.T. is the Director of Rehabilitation at OrthoSouth (Briarcrest and Southaven) with a clinical specialty in managing running injuries and lower extremity tendinopathies. He is an avid runner and triathlete and member of the Los Locos Racing Team.