Yes! Moving More Can Ease Osteoarthritis Painby Jerilyn Covert Health Writer
Did you know your joints are nourished through movement? It’s true—and it’s a big reason why exercise is one of the best treatments for osteoarthritis (OA) of the knee. “Movement bathes the joint in synovial fluid,” explains Janet Bezner, Ph.D., spokeswoman for the American Physical Therapy Association, and associate professor of physical therapy at Texas State University. This viscous fluid is comprised of proteins, glucose, and fats, providing the nutrition your joint cartilage needs to ease pain and stiffness, says Bezner. Read on for expert advice on how to use movement to improve knee OA.
Add Aerobic Exercise
People with OA—in both their knees and hips—have a much higher incidence of cardiovascular disease, Bezner says. “They feel they can’t be active, so their cardiovascular systems take a hit,” Bezner says. But cardio exercise can help your joints and your heart. A lot. Whatever activity you choose to do (check out our suggestions on the slides to come!), start with 10 minutes of easy movement, then up the intensity little by little.
Walking is super-helpful for OA. One study found that just 20 minutes a day of walking helped subjects with knee OA maintain their walking speed after two years. In another, people with knee OA who walked at least 6,000 steps a day were less likely to develop mobility issues. Once you’re warmed up, progress to a brisk pace. While you’re aiming for at least 30 minutes a day, even five-minute walks can help when you’re just starting out, according to the Arthritis Foundation.
Cycling is a great way to exercise your knees without compressing the joint, says Bezner. (And as an avid cyclist with grade-four osteoarthritis in her right knee, she should know!) “You’re strengthening the muscles that support the knee and getting that nourishing synovial fluid,” she says. “But because your knees aren't supporting your body weight—the bicycle seat is—it’s not considered weight-bearing.”
Surprised? Many people mistakenly believe running causes knee OA or makes it worse, but not a lot of evidence supports that. In fact, JAMA Rheumatology cites a study from May 2020 that shows no link between strenuous physical activity and knee osteoarthritis by X-rays. If you listen to your body and don’t push it, there’s no reason knee OA has to stop you from running, Bezner says. Make sure you have a good pair of running shoes, and try to run on forgiving surfaces, like grass, gravel, dirt, or asphalt, which absorbs more impact than concrete does.
Cardio: Water Therapy
If exercising on land is too painful, try moving your workout to the water, says Oliver Rivera, P.T., a physical therapist at the Shirley Ryan Ability Lab in Chicago. The buoyancy of water helps alleviate any strain or pressure on joints while providing enough resistance to strengthen your muscles. “Any exercise you do on land, you’ll benefit from doing in the water,” Rivera says. Try any strength move—squats, leg curls, heel raises—or just walk laps, says Rivera. Bonus: Water has a therapeutic effect on the body, temporarily reducing pain signals.
Add Balance and Mobility Moves
As we grow older, we naturally start to lose our sense of balance and “proprioception” (meaning the awareness of the position of your body), says Rivera. That can lead to poor joint control, especially problematic for those with knee OA. Exercise that improves balance—like tai chi, Pilates, and yoga—can help. Flexibility and mobility exercises, like gentle stretching, can also help ease pain and stiffness and keep you moving in all the ways you need to.
Mobility: Chair Yoga
Some of Rivera’s patients with knee OA have seen good results with a type of yoga that you can do while seated. Because there’s no getting up or down from the floor, chair yoga is easy on your joints and still provides all the anti-stress, strength, and flexibility benefits of traditional yoga. In fact, when scientists did a randomized controlled trial examining the effects of chair yoga on knee OA, they found people who did chair yoga twice a week for two months saw reductions in pain and fatigue, and improvements in gait speed.
Flexibility: Gentle Stretching
After your workout when your muscles are warm is a perfect time for a gentle stretch, says Bezner. Stretching can help you maintain and improve flexibility in the joint, reports the Arthritis Foundation. Stay still during the stretch—don’t “bounce,” says Soo Kim, M.D., medical director of musculoskeletal medicine at Johns Hopkins School of Medicine in Baltimore. The extra force may injure your already vulnerable ligaments and tendons. Hold the stretch at the point where you just start to feel it, and stay for 30 seconds. Repeat once or twice if you can.
Try This Hamstring Stretch
You can stretch any of the muscles that attach to your knee, such as your hamstrings, quadriceps, calf muscles, and hip flexors. Here’s a hamstring stretch you can try, says Bezner. Stand with your feet hip-width apart and hold onto a sturdy object (like a chair or wall) for support. Place the heel of one foot on a slightly elevated surface (like a step). Slowly bend the opposite knee to feel a slight stretch in the raised leg. Want a deeper stretch? Bend forward a little.
Balance: Close Your Eyes
When you take away your vision, you’re forced to focus on your body’s position, Rivera says. “It’s one way to help improve your recognition of where your knees and feet are”—which can help you better control your joint. Rivera has his patients try this first while standing on both feet with a wide stance. Those who are able can increase the challenge by moving their feet closer together, and finally by standing on one leg. Start by closing your eyes for 15 seconds, and gradually work up to 90 seconds as you improve. But if you’re afraid you might fall, don’t try this on your own.
If you’re new to exercise or your OA symptoms are keeping you from staying active, a physical therapist can help by customizing a plan for you, Rivera says. It starts with a full assessment—the therapist will chat with you for 15 to 30 minutes, about your pain level, medical history, and goals. You may be asked to perform movements and range-of-motion tests, to pinpoint weak areas. Count on one to three sessions a week, for two to eight weeks—or maybe longer if your OA is severe, says Rivera.
Follow the Two-Hour Rule
OA causes damage to the weight-bearing aspects of the knees, says Bezner. “When you bear weight on those joints, it can hurt. However, that isn’t a reason not to exercise.” Pain that lasts less than two hours after exercise is OK, says Bezner. If it lasts longer—or seems unusual or extra severe—take it easier next time. Tylenol (acetaminophen) can help with pain. If you experience swelling, try this: Place a warm, wet cloth over the joint, then an ice bag on top of the cloth for 15 to 20 minutes, says Bezner. (The cloth’s warmth and wetness promote the cold transfer from the ice!) If post-exercise pain is frequent or you’re concerned, see a physical therapist.