Workout a pain in the knees? Switch it up
Osteoarthritis sufferers can ease pain in hips and knees by changing their workouts
If you’re of a certain age, you probably know all about the aches and pains of osteoarthritis. A progressive disease found most often in the hips, knees, hands and spine, osteoarthritis is characterized by joint stiffness and pain caused by the breakdown of cartilage and bone in the joint. Felt largely by the over-50 crowd, it’s been linked to the wear and tear associated with living an active life.
Yet there’s little science to suggest a lifelong love of exercise will lead to sore knees and hips. In fact, exercise is considered a valuable part of any treatment plan designed to relieve pain and improve the function of affected joints.
As important as exercise is in managing osteoarthritis, there’s no universal prescription guaranteed to make aching joints feel and move better. So while it’s clear that some exercise is better than no exercise, opinion varies as to whether hitting the pool, gym, track, bike or yoga mat is the best option. Of course, that doesn’t stop friends, neighbours, co-workers and even physicians from sharing their views on the type of exercise they feel will make the pain go away, including suggesting that you give up the activities you love in favour of those you don’t.
Understanding that individual experiences shouldn’t be mistaken for a universal truth, a team of researchers reviewed 103 published studies, featuring the results of 9,134 study subjects, on the effectiveness of different types of exercise on improving pain and function in osteoarthritic hips and knees. The studies were separated into groups depending on the type of exercise used in the protocol — aerobic exercise (swimming, running, cycling), strength training (body weight or weight training exercises), mind-body/flexibility exercises (yoga, Pilates) and mixed exercise (more than one type performed in a single workout) — and evaluated on how effective they were in reducing pain and improving function and quality of life.
Assessing benchmarks from the start of a regular exercise routine to eight weeks later, all of the exercise protocols demonstrated a positive effect on joint function and pain compared to the non-exercise controls.
But when comparing one type of exercise to another, aerobic exercise and mind-body exercise proved the most effective at decreasing joint pain and improving joint function. Less effective was strength training, with mixed exercise providing the least amount of positive benefit.
Why do some types of exercise work better than others at making knees and hips feel 10 years younger? The researchers have a hunch.
“Although the underlying mechanism remains unclear, the effect of both aerobic and mindbody exercise may be attributable to the potential of these exercises to influence altered central elements such as central pain sensitization, sleep disturbance and mood disorders,” they said.
Whether there’s enough science to rule out any one type of exercise from the spectrum of options prescribed to reduce osteoarthritis pain is questionable.
But what’s interesting about this review is the lack of effectiveness of mixed exercise. Given the limited amount of detail regarding the mixed exercise routines included in the studies, it’s difficult to state unequivocally that workouts like HIIT (high-intensity interval training) or Crossfit are ineffective at making osteoarthritic joints move and feel better. Combined with the fact that exercise adherence is linked to exercise enjoyment, giving up your favourite mixed routine in favour of aerobic or mind-body options isn’t necessary. But if you’re unhappy with the results of your workout, adding a few more aerobic workouts or yoga classes to your routine might be worth the effort.
On the plus side, it’s clear that staying physically active improves joint health. That’s great news for exercise junkies who have been told to rest their aching joints, or for those who have been advised to give up their favourite aerobic activity in favour of something less stressful on the joints.
Still, you need to pay attention to your body and what makes exercise tick for you, even in the face of growing evidence that some types of exercise are better for your aching joints than others.
If you’re always sore after an aerobic workout, try yoga.
If yoga or strength training makes your joints ache, hop on a bike. Ideally, your preferred exercise routine dulls joint pain and improves joint function, which means greater range of motion and less stiffness in the morning. Given that all forms of exercise are osteoarthritis-friendly when compared to no exercise at all, there’s no shortage of options.
One final caveat: give your joints time to get used to a new form of exercise before discarding it as ineffective.
Sometimes a little discomfort arrives ahead of relief, so be patient. That said, pain is different than discomfort, so don’t ignore your body’s red flags.
The end goal is not only finding an exercise routine that helps your joints move more and hurt less, but one you’ll stick with for more than eight weeks.