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Exercise for Osteoarthritis: Strength Training, Stretching, and two Surprising Exercises
Do you have osteoarthritis (OA)? Your knees, hip or back hurt either all the time, or with certain movements. You’re stiff when you get up in the morning. Maybe you went to the doctor or physical therapist, they send you to get an X-Ray or MRI, and saw that there’s no cartilage. You have bone-on-bone arthritis. They might have even mentioned something about a hip replacement or knee replacement surgery.
On the one hand, you don’t want to go under the knife, but on the other, the pain may be tolerable now, but in a few years, you may be a candidate for that surgery, and at that point, the pain may be much worse.
What to do?
That’s what we’ll talk about in this article: exercise for osteoarthritis (both physical and mental).
But first, a little background:
But because of the sheer number of clients that we see with OA, I’m never really satisfied with just “good enough.” The standard recommendation is to just do low impact exercises. And while they avoid making OA worse, they don’t really make it better. I want to know the best possible thing you can do in the shortest period of time.
This led me to hire a scientific researcher to do a very comprehensive review of the science that exists out there that would help my team and I help our clients with OA. He just had one rule: he could only look at scientific/medical journals on this. He couldn’t read mainstream books, he couldn’t read magazines, and he couldn’t watch Youtube videos. These had to be scientific/medical journals.
After a month of research, he came up with pretty much the most comprehensive set of strategies when it comes to dealing with osteoarthritis that are available to a personal trainer (exercise, nutrition and supplements).
It came up to 24 pages of notes, but I won’t make you read all 24 pages. Here, I’ll give you the bullet points – both what we know, as well as what we don’t know (which is important to acknowledge for the sake of scientific and intellectual honesty).
To say that I’m excited about what this research means for our clients with OA would be an understatement. We already had a successful OA program, but with what my team and I have learned from this research, this really supercharges the results that we can get with our arthritic clients. It allows us to write a much better exercise program for any given client. If you want help with your own arthritis, we have created a brand new program, called “Joyous Joints.”
Without further ado, here are some of the most interesting notes from the entire research:
PREDISPOSITION TO OSTEOARTHRITIS
- What are some of the biggest risk factors for osteoarthritis?
- Obesity: this one’s obvious just because there’s more weight compressing the joints
- Knee alignment. According to one study, a valgus knee alignment (being bowlegged) increases the risk of OA
- Sex: women have a 70% higher chance of having OA compared to men, according to this study.
- Job: if your job involves repeated bending you’re at a higher risk of OA.
HOW TO EXERCISE FOR OSTEOARTHRITIS
The “big 4” categories of exercise for arthritis:
This is pretty much what’s been recommended for OA forever. You ask any physical therapist what to do with osteoarthritis, and the first thing that they’ll tell you is that strength exercise can help with OA by improving muscle strength. And they’re right. But in my opinion, there’s a right way to strength train, and a wrong way to strength train for OA. The wrong way: strengthening exercises for all muscles indiscriminately. The right way: identify which muscles are too weak relative to their opposite muscles (quadriceps and hamstrings; hip flexors and glutes, etc.), and only increase muscle strength in those that are weak. Don’t increase the muscle strength in muscles that are already too strong/dominant, until you’ve brought the ratio back to a more desirable ratio. To identify weak muscles, it’s important to assess, because (say it with me) if you’re not assessing, you are guessing.
Yes, strengthening exercises help, but only if you do them properly. Doing them properly means to strengthen the muscles that are too weak.
And if you want to learn how to strengthen the muscles that are too weak, just check them out on Youtube.
One study found stretching to be effective for OA by improving range of motion and decreasing pain. Makes sense, because stretching IS range of motion exercises. Another study found that stretching exercises help to reduce pain by 15.6% in 80 days. Pain was assessed using a questionnaire.
As for which range of motion exercises you should do to help relieve pain in the affected joints really varies joint by joint. But all you have to do is simply go on Google or Youtube and search for “stretches/range of motion exercises for…” followed by the affected joint.
You’ve heard of strength training and you’ve heard of stretching. But I’ll bet you’ve never heard of proprioceptive exercises. Just what are those? Proprioceptive exercises are ones that enhance your sense of joint position. An example of a proprioceptive exercise for the knee is to stand on one leg, and pick up something off the ground. That’s one example. There are many other proprioceptive exercises.
- In one study, one group did proprioceptive exercises for 8 weeks, and one group was the control group (they didn’t exercise). After that 8-week period, the joint pain of the proprioceptive group decreased by 53%. In the control group, their pain increased a little bit.
- In another study, participants were divided into 2 groups. The first group just did strength training. The second group did strength training plus proprioceptive exercises. After 8 weeks, the group that did strength training plus proprioceptive exercises had less pain, compared to the strength training-only group, as well as greater improvements in other parameters of function.
What is traction? Traction is gently pulling apart 2 bones from each other. For instance, if the arthritis is in the knee, it’s pulling apart the shin bone and thigh bone. If the arthritis is in the hip, it’s pulling apart the thigh bone from the hip bone/pelvis, etc. This part of the research had me most excited, because of all the exercise methods, this one is the fastest way to help relieve pain in the affected joints.
- In one study, participants were divided into 2 groups. The first group received standard physiotherapy treatment: superficial heat therapy, deep heat therapy, and electric therapy. The second received the same treatment as group 1, but with 20 minutes of traction added to it (the level of tension of the traction exercise was 6% of the participants’ body weight, and it was held for 20 minutes). In the second group, they found that:
- The average joint space went from 2.7 mm to 3.6 mm.
- The minimum joint space went from 1.0 mm, up to 1.9 mm.
- The cartilage thickness improved from 2.4 to 3.0 mm
- Type II collagen increased in the joint space.
- What do all these numbers mean?
If you want to read the rest of this article, visit: Exercise for Osteoarthritis: Strength Training, Stretching, And 2 Surprising Exercises
About the Author
Igor Klibanov is the author of 7 books on exercise and nutrition, and the CEO and founder of Fitness Solutions Plus. He is a sought-after wellness speaker, having delivered over 400 presentations to some of Canada's largest corporations. Get a free PDF version of his book, STOP EXERCISING! The Way You Are Doing it Now - http://www.fitnesssolutionsplus.ca/stopexercising