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Choose Low-Impact Exercise for Joint Health

Exercise may help or harm joints damaged by osteoarthritis, but new research suggests that moderate, low-impact exercise after treating osteoarthritis with knee surgery may improve joint strength and functioning. This finding is supported by a review that found people with osteoarthritis who do not have surgery may also benefit.

Osteoarthritis, the most common type of arthritis in the US, is caused by the breakdown of cartilage. Millions of people have knee surgery each year to relieve osteoarthritis-related pain and disability, but weakness of thigh muscles (quadriceps) that persists after surgery can lead to decreased functioning of the knee. Exercise that targets quadriceps strengthening may improve joint strength and functioning after surgery and make it easier to walk and climb stairs.

Exercise after knee surgery improves strength and function

In a recent study, 200 people who addressed their osteoarthritis with knee replacement surgery (arthroplasty), in which they received an artificial knee joint, were randomly assigned to a quadriceps-strengthening exercise program or a neuromuscular-stimulation-plus-exercise program. In addition, both groups participated in physical therapy two to three times per week.

Both intervention groups had similar improvements in quadriceps strength and function at 3 and 12 months of follow-up, and these improvements were greater than in people receiving standard care (physical therapy only).

Quadriceps strengthening may also improve pain and functioning in people with osteoarthritis of the knee who have not had surgery, according to another review. Individualized exercise plans and long-term monitoring for people with osteoarthritis are important for success. High impact exercise such as running could be harmful for damaged joints, but moderate low-impact exercise such as walking or swimming can improve them.

“It is important to individualize exercise therapy for hip or knee osteoarthritis, particularly considering individual patient preference, and ensure that adequate advice and education to promote increased physical activity is provided,” said David Hunter, lead author of the review from the Division of Research, New England Baptist Hospital, Boston, Massachusetts. Hunter also states it is important for people to engage in exercise they enjoy which promotes long-term participation.

Tips for managing and preventing osteoarthritis

• Maintain a healthy weight. Excess weight can place a heavy burden on joints, and obesity and overweight are the most significant risk factors for developing osteoarthritis. Lose excess weight and maintain a healthy weight to reduce the pain and symptoms of osteoarthritis.

• Be aware of joint stress at work. Jobs that demand significant physical labor can put a strain on joints, and research shows that osteoarthritis is more common in people who have physically demanding jobs. Repetitive motions such as knee-bending can increase the risk of joint pain and damage. Try to reduce the stress on your joints at work and talk with a supervisor about how to minimize joint stress.

• Avoid sports injury. Sports-related injuries may increase the risk of developing osteoarthritis later in life. Take precautions to avoid sports injuries and avoid or minimize intense, high-impact sports that place a heavy force on joints.

• Engage in moderate, low-impact exercise for joint health. There does not appear to be an adverse effect of regular, moderate, low-impact exercise (such as walking or swimming) on joints. Talk with a doctor before starting any new exercise program.

(Arthritis Rheum 2009;61:174–83; J Anat 2009;214:197–207)

Jane Hart, MD, board-certified in internal medicine, serves in a variety of professional roles including consultant, journalist, and educator. Dr. Hart, a Clinical Instructor at Case Medical School in Cleveland, Ohio, writes extensively about health and wellness and a variety of other topics for nationally recognized organizations, Web sites, and print publications. Sought out for her expertise in the areas of integrative and preventive medicine, she is frequently quoted by national and local media. Dr. Hart is a professional lecturer for healthcare professionals, consumers, and youth and is a regular corporate speaker.

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