Exercises to Help Manage Osteoarthritis
But first, exactly what is Osteoarthritis?
Osteoarthritis (OA) is a chronic, musculoskeletal disorder characterised by degeneration, or ‘wear and tear’ of the joints. OA is one of the leading causes of pain and disability. In normal joints, cartilage covers the surface of joints where the bones meet, allowing for shock absorption and smooth movements. In OA, the cartilage of the affected joint wears down until very little or none remains, causing the opposing bones to rub together. Extra new bone (called ‘bony spurs’) may also form around the joint surface. This degeneration causes pain during movement and restricts joint range of motion. The most common joints affected by OA include: hip, knee, spine, big toe and hands.
How can exercise help?
All clinical guidelines recommend exercise in the management of OA. Exercise is as effective in relieving symptoms associated with OA as pain medications and anti-inflammatory drugs, but has fewer side effects. Exercise can help to:
Increase muscle strength around the affected joint(s)
Reduce joint stiffness
Improve range of motion of the affected joint(s)
Prevent functional decline
What exercise is effective for OA?
Many types of exercise are effective for people with OA. Choice of exercise should take into account your age, functional ability, secondary health conditions and personal preference. You should aim to exercise 4-5 times per week for at least 30 minutes.
Strength training can be performed by applying resistance with weights, elastic tubing or bodyweight. The thigh, hip and calf muscles, which are important for daily function, are often weak in people with OA. Start lightly by completing 2-5 repetitions and using pain threshold as an index of intensity. Gradually increase to 10-12 repetitions of an exercise as pain threshold increases.
Aerobic exercises may include walking, cycling, or using a rowing machine, cross trainer or seated stepper. High impact exercises, such as jogging or skipping, place high loads on joints and should be avoided.
Aquatic (water) exercise can be particularly useful for people who are overweight or those with severe diseases. The water buoyancy minimises the load on the joints and reduces pain on weight-bearing.
Other types of beneficial exercises may include tai chi, balance and stretching to improve flexibility and joint range of motion.
Things to remember
You may experience some discomfort in the affected joint during exercise - this is normal and does not indicate a worsening of OA! Significant pain or swelling following exercise may indicate the need to revise the exercise program
Begin an exercise program slowly and progress gradually - focus on low intensity and low duration initially
Always stretch within a pain-free range of motion
Duration of an activity should be emphasised over increased intensity
Consult an Accredited Exercise Physiologist (AEP) for a tailored exercise program that is safe for your individual needs