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Living with Osteoarthritis

An inexpensive, effective treatment for knee osteoarthritis that has no harmful side effects?

Both aerobic (endurance) exercise and strength training exercise have been shown to decrease pain and improve function in people with knee osteoarthritis.

Many people with knee osteoarthritis are fearful of starting an exercise program. People know that osteoarthritis (degenerative joint disease) is a result of wear and tear of the cartilage that covers the bones. It seems logical that exercise would lead to more wear and tear and worsen the condition.

How does exercise help people with knee osteoarthritis? Several theories have been proposed and there are varying levels of evidence for each theory. The more popular theories include (1) improved joint lubrication, (2) improved shock absorption, and (3) decreased joint loading because of decreased body weight.

Synovial fluid is the substance within joints that acts as a lubricant. It is thought that increased joint use during exercise increases the production of synovial fluid and thereby improves the lubrication of the joint surfaces, decreasing wear and tear.

One of the purposes of joint cartilage (articular cartilage) is shock absorption. As this cartilage breaks down a vicious cycle begins. Cartilage breakdown leads to less shock absorbing capability, which contributes to further cartilage breakdown. However, muscles that surround the joint also function as shock absorbers. Strengthening these muscles can improve shock absorption and limit further breakdown of joint cartilage.

One well established risk factor for developing knee osteoarthritis is excess body weight. An exercise program combined with healthful eating can lead to weight loss, which can lead to decreased joint loading through an osteoarthritic knee joint.
How does a person with osteoarthritis get started with an exercise program? If you haven’t exercised recently, it may be helpful to first get an annual physical exam. Your healthcare provider may recommend starting in a supervised exercise program where your vital signs and your exercise progression can be closely monitored. In some areas, the Arthritis Foundation offers the Lifestyle Improvement Series, which includes supervised exercise programs. Local health clubs may also offer exercise programs tailored for people with osteoarthritis.

If you have knee osteoarthritis, give exercise a chance. You have a lot to gain.