Up to 16% of older adults suffer from knee osteoarthritis (OA), which is the most common form of arthritis in the United States (Fitzgerald & Sukso, 2013). Knee OA is often described as the “wear and tear” related to age and excess use. It is different from rheumatoid arthritis in that knee OA results in a break down of cartilage while the former is inflammatory and considered an autoimmune disorder. Symptoms of knee OA include pain, stiffness, swelling, decreased range of motion, and tenderness. Incidence rates are expected to rise with the increase in obesity, advancing age, and sedentary lifestyles (Fitzgerald & Susko, 2013). If you are one of the many people suffering from knee OA, then you might find yourself avoiding exercise and putting on additional weight. Although this is an understandable reaction, it is important to continue to move your joints. Below I outline the scientific reasoning behind continued exercise and weight management related to knee OA.
“Despite increased public awareness of the importance of exercise and physical activity, only 27.8% of those with knee osteoarthritis (OA) engage in regular moderate or vigorous physical activity” ( Fitzgerald & Susko, 2013).
With nearly 70% of osteoarthritic patients foregoing exercise, it is clear that many see it as unnecessary, too difficult, or too painful. In fact, the most commonly reported symptom of knee OA is pain. Since pain is often associated with OA, it makes sense that one would decrease physical activity. Although activities that frequently exacerbate and cause knee pain should be limited, all physical activity should not be stopped. The American College Of Rheumatology and The American Academy of Orthopaedic Surgeons strongly recommend exercise as treatment for OA discomfort (Fitzgerald & Suskso, 2013). Furthermore, one study concluded that exercise is appropriate in all stages of knee OA and that exercise may reduce the progression of the disease (Roddy et al., 2005).
In one of the “first recommendations for exercise in hip and knee OA to clearly differentiate research evidence and expert opinion” the consensus was the following (Roddy et al., 2005):
1.) Strength training and aerobic exercise can improve and reduce pain from OA
2.) There are few contraindications to using exercise to treat OA; less than 12% of individuals experience pain exacerbation.
Programs to treat knee OA typically include low-impact aerobic exercise, quadriceps strengthening, and balance and flexibility training (Harvard Health, 2012). As always, contact your physician before engaging in any physical activity.
The relationship between weight and knee OA pain is clear: the more weight you carry, the more knee pain you are likely to have. Studies have shown that a pound of weight lost is equivalent to a fourfold decrease in knee stress, and a decrease of 5 pounds is often associated with significant relief in knee pain (Harvard Health, 2012). Dr. Patience White, vice president of public health at the Arthritis Foundation, says that overweight and obese individuals that cut 10% of their body weight can expect a 50% reduction in knee pain (Harvard Health, 2012). Furthermore, those that keep on additional weight suffer from inflammatory protein production that accelerates cartilage degeneration in the knees (Harvard Health, 2012).
Weight loss often includes a focus on exercise and nutrition. Typical nutritional guidelines for osteoarthritis include an increase in fish, beans, flax seeds, walnuts, green leafy vegetables, canola and olive oil, green tea, and margarine and butter. Guidelines also recommend a reduction in processed foods, omega-6 fatty acids (eggs and red meat), fried foods, and fruit juice (Harvard Health, 2013).
The relationship between one’s weight, exercise, and knee osteoarthritis is often overlooked or misunderstood by many people. The first reaction to knee pain is often to avoid exercise, especially movements that require the knee to function with different tensions and various ranges of motion. This superficial understanding of what’s best for the body can lead to improper care. The process can become overwhelming and frustrating: knee pain –> exercise reduction–> weight gain due to continued dietary habits and a sedentary lifestyle–> continued knee pain. Fortunately, it doesn’t have to be that way. Exercise and nutrition are great places to start before taking more drastic measures. If you found valuable information in this article, then please support me by subscribing and liking/ following me on Facebook and Instagram.
Fitzgerald, K., & Susko, A. (2013). The pain-relieving qualities of exercise in knee osteoarthritis. Open Access Rheumatology: Research and Reviews, 81. doi: 10.2147/oarrr.s53974
Harvard Health Publishing. (2012). Managing osteoarthritis of the knee. Retrieved from https://www.health.harvard.edu/pain/managing-osteoarthritis-of-the-knee
Harvard Health Publishing. (2013). New ways to beat osteoarthritis pain. Retrieved from https://www.health.harvard.edu/pain/new-ways-to-beat-osteoarthritis-pain
Roddy E, Zhang W, Doherty M, et al. (2005). Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee – the MOVE consensus. Rheumatology (Oxford) 2005;44(1):67–73.