Exercise for Osteoarthritis (OA)


Introduction

We tend to search for ‘quick fixes’ for our aches and pains, but it is important to try achievable lifestyle changes before we resort to medical and surgical interventions. There are numerous treatments for worn-out knees and hips which don’t require you to see a doctor. Read on to learn more about osteoarthritis and how to manage it with exercise.


What is osteoarthritis (OA)?

OA is a common cause of pain and altered joint function in adults.(1) The knee is the most common joint affected.(2) OA was previously considered to be the result of ‘wear and tear’, but current research suggests that underlying inflammation affects all components of the joint, including joint surface cartilage, nearby bone, the joint capsule and surrounding soft tissues.(3) Damage to the joint organ manifests as worsening pain, tenderness, reduced range of motion, bony swelling, joint deformity and instability.(4) Fortunately, long-term regular exercise can improve joint pain and function.


Exercise as treatment for OA

A large review of the scientific literature concluded with reasonable confidence that adherence to an exercise program improves knee pain and function in OA. Generally, exercise should be low-impact, including a mix of aerobic fitness work and strength training.(5, 6)


Aerobic exercise

Low-impact aerobic exercise includes activities such as walking, cycling, rowing, swimming and other water-based activities. The Australian Department of Health recommends that adults are “active on most, preferably all, days every week” due to exercise’s positive long-term effects on your general health.(7)


Strength training

Evidence also suggests that resistance training (with bands and weights) and Tai Chi are beneficial in OA management.(8-11) These forms of strength training can improve balance, bone density and muscle mass, reducing the risk of falls, osteopenia (brittle bones) and sarcopenia (muscle wasting).(12-16)

Recommendations

We recommend trying a variety of exercises to manage your OA. Settling on a routine of enjoyable aerobic and strength training on most days will benefit your general health and improve symptoms of OA.


Support available at ReCreation Medical Centre

If you are looking for a tailored exercise program, our sister clinic, Surecell, offers exercise physiology, personal training and gym facilities, as well as medical support. Feel free to contact our friendly staff using the details below.


References

  1. Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med. 2010;26(3):355-69.

  2. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2163-96.

  3. Loeser RF, Goldring SR, Scanzello CR, Goldring MB. Osteoarthritis: a disease of the joint as an organ. Arthritis Rheum. 2012;64(6):1697-707.

  4. Zhang W, Doherty M, Peat G, Bierma-Zeinstra MA, Arden NK, Bresnihan B, et al. EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis. Ann Rheum Dis. 2010;69(3):483-9.

  5. Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee: a Cochrane systematic review. Br J Sports Med. 2015;49(24):1554-7.

  6. Tanaka R, Ozawa J, Kito N, Moriyama H. Efficacy of strengthening or aerobic exercise on pain relief in people with knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil. 2013;27(12):1059-71.

  7. Brown WJ, Bauman AE, Bull FC, Burton NW. Development of Evidence-based Physical Activity Recommendations for Adults (18-64 years). Report prepared for the Australian Government Department of Health, August 2012.

  8. Wang C, Schmid CH, Iversen MD, Harvey WF, Fielding RA, Driban JB, et al. Comparative Effectiveness of Tai Chi Versus Physical Therapy for Knee Osteoarthritis: A Randomized Trial. Ann Intern Med. 2016;165(2):77-86.

  9. Yan JH, Gu WJ, Sun J, Zhang WX, Li BW, Pan L. Efficacy of Tai Chi on pain, stiffness and function in patients with osteoarthritis: a meta-analysis. PLoS One. 2013;8(4):e61672.

  10. Jan MH, Lin JJ, Liau JJ, Lin YF, Lin DH. Investigation of clinical effects of high- and low-resistance training for patients with knee osteoarthritis: a randomized controlled trial. Phys Ther. 2008;88(4):427-36.

  11. Vincent KR, Vincent HK. Resistance exercise for knee osteoarthritis. Pm R. 2012;4(5 Suppl):S45-52.

  12. Mat S, Tan MP, Kamaruzzaman SB, Ng CT. Physical therapies for improving balance and reducing falls risk in osteoarthritis of the knee: a systematic review. Age Ageing. 2015;44(1):16-24.

  13. Howe TE, Shea B, Dawson LJ, Downie F, Murray A, Ross C, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2011(7):CD000333.

  14. Kristensen J, Franklyn-Miller A. Resistance training in musculoskeletal rehabilitation: a systematic review. Br J Sports Med. 2012;46(10):719-26.

  15. Frontera WR, Meredith CN, O'Reilly KP, Knuttgen HG, Evans WJ. Strength conditioning in older men: skeletal muscle hypertrophy and improved function. J Appl Physiol (1985). 1988;64(3):1038-44.

  16. Nilwik R, Snijders T, Leenders M, Groen BB, van Kranenburg J, Verdijk LB, et al. The decline in skeletal muscle mass with aging is mainly attributed to a reduction in type II muscle fiber size. Exp Gerontol. 2013;48(5):492-8.


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