Can exercise help with osteoarthritis knee pain relief?
Osteoarthritis could be a perfect excuse not to exercise, but in reality, an exercise program developed and supervised by a professional who is specialized in patients with pain caused by osteoarthritis of the knee could help decrease pain while improving your flexibility and fitness level. It is recommended that you add simple exercises to your routine; specifically exercises that will help strengthen your quadriceps, hamstrings and glutes, the muscles that help your knee function.
See below for some recommended exercises.
Read what our experts have to say
Hustle, hit and never quit against knee pain
4 strategies to keep you at the top of your game
Are your knees causing you pain? Is it challenging for you to participate in the activities you love? To manage discomfort, you’ve tried icing it, you’ve taken pain medication, but it still persists. Now what?
When you have osteoarthritis of the knee, you want a solution you can rely on. Live the life you want; do not let knee pain stop you. Here are 4 strategies that can help you play that tennis match, ride your bike or keep up with your kids.
Staying as mobile and active as possible can reduce your knee pain, help you to stay independent and improve your quality of life. Many individuals are afraid to exercise because they believe – mistakenly – that it could cause further damage to their knee. Most of us do not get enough exercise in our daily lives and so we develop aches and pains. Your body needs to move. The important thing is to set realistic goals, do some form of exercise that you enjoy, and to do it regularly. Exercise does not have to be complex, often a combination of simple stretching, strengthening and low-impact fitness exercises are best.
Injections of hyaluronic acid (found naturally in a healthy knee joint) help to improve the lubrication and cushioning of the knee joint caused by damage to the joint (cartilage). It is also known as a viscosupplement, a clear gel-like substance that helps the knee bones and cartilage to move smoothly. It closely mimics healthy synovial fluid to lubricate joints, much like how oil lubricates your car engine. Clinical trials support that a treatment can decrease pain and improve your functional mobility, with no serious adverse effects.
Being overweight may make the symptoms, including pain, you experience as a result of osteoarthritis of the knee worse or harder to manage because your knee joint is under additional stress. By losing any surplus body weight, through exercise and a healthy diet, you can help ease the pain. While there is no definitive anti-arthritis diet, it is important that you eat a healthy, balanced diet for your general health. If your diet contains more energy (calories) than you burn, your body will convert the extra energy to fat and you will gain weight. If you are going to eat fewer calories, it is important not to lose out on the vitamins, minerals and other key nutrients for healthy living. You may want to seek the expertise of a registered dietitian to help you.
A lightweight, low profile knee brace can be worn during your daily activities and exercises to provide some knee pain relief and improve functional mobility. Specific braces can apply corrective forces to the knee to take pressure off the affected area of the joint. Studies have demonstrated braces can reduce the pain associated with osteoarthritis of the knee, and your reliance on medication and the associated negative side-effects. Bracing is commonly used in conjunction with other treatments, such as exercise, weight loss, and viscosupplementation or other injection therapies.
By understanding your knee pain, you will be better equipped to find solutions that will empower you to participate in the activities you love, quickly and easily.
We strongly encourage you to consult with your doctor or physiotherapist for more information on these strategies and determine the best clinically proven treatments to keep YOU at the top of your game.
Darryl Yardley, PT, FCAMPT
Manager, Therapy Services, Brant Community Healthcare System
Consultant, Hip Preservation Group
Assistant Professor, Business & Entrepreneurship in Physical Therapy,
Chair, Private Practice Division, Canadian Physiotherapy Association
Director, EnCORE Research Inc.
Entry to Practice Essentials (Canadian PCE Study Guide)
Weight loss is key for reducing knee pain
Osteoarthritic knee pain can be debilitating, causing both physical discomfort and mental-emotional stress. There are a number of different approaches that can help ease the pain. Losing body weight to reduce the load on your weight-bearing joints can play a major role in relieving pain and preventing further joint damage. Even a small amount of weight loss can make a big difference. Losing one pound of weight has been shown to reduce the stress load on the knee by four pounds1. This means, for example, that if you were to lose five pounds it would be like having 20 less pounds for your knees to support with each step, and 20 less pounds of wear and tear.1
Losing weight can seem like a very difficult and challenging task. There are many theories and strategies with conflicting and contrasting ideas that can make sorting out exactly what to do to lose weight rather confusing. To help simplify things and bring you some clarity, there are some key points that you should focus on.
Calories do matter
Energy balance, or calories taken in versus calories burned, is central to weight loss.2 Most people underestimate how many calories they consume each day, so gaining awareness of your calorie intake is a great place to start. Track your calorie intake each day for one week, including on the weekend, to see how many calories you are actually consuming. There are many websites or apps on your smartphone that you can use to make tracking simple and easy (e.g. MyFitnessPal). Be sure to include all food and drinks!
Use these calculations to get yourself into a caloric deficit
Use formula below to calculate your basal metabolic rate (BMR).3
|Men:||BMR = (10 × weight in kg) + (6.25 × height in cm) - (5 × age in years) + 5|
|Women:||BMR = (10 × weight in kg) + (6.25 × height in cm) - (5 × age in years) - 161|
Now, multiply your BMR by your activity level to figure out the number of calories you need to take in to maintain your current weight.4
|Little to no exercise||BMR x 1.2 = Daily calories needed to maintain current weight|
|Light exercise (1–3 days per week)||BMR x 1.375 = Daily calories needed to maintain current weight|
|Moderate exercise (3–5 days per week)||BMR x 1.55 = Daily calories needed to maintain current weight|
|Heavy exercise (6–7 days per week)||BMR x 1.725 = Daily calories needed to maintain current weight|
|Very heavy exercise (twice per day, extra-heavy workouts)||BMR x 1.9 = Daily calories needed to maintain current weight|
To start losing weight, you need to be eating fewer calories than what your body requires to maintain your current weight. A good goal is to aim for a 500-calorie deficit per day, which equals a 3500 calorie deficit per week, which equals 1 lb of weight loss per week.
Focus on eating whole foods
A diet rich in whole foods provides you with maximal nutrients and minimal calories. On the contrary, highly processed and packaged foods are very high in calories and excess sugar, and low in nutrients. Some examples of whole foods include fresh fruit, vegetables, chicken, fish, beef, turkey, eggs, nuts, seeds and healthy fats like avocado, olive oil and coconut oil.
Pay attention to your protein intake
Protein intake is very important for weight loss as it reduces your appetite, boosts metabolism and helps improve weight loss hormones.5 Increasing protein intake to 30% of calorie intake has been shown to be very effective for weight-loss.6 To calculate this for yourself, you can multiply 0.075 by the number of calories you want to be consuming.
The type of diet isn’t that important – consistency is key
There are so many different types of diets that it is hard to know which one to follow. When research was done to examine some of the most well-known diet approaches, it was confirmed that many diets work for weight loss, from low-fat all the way to low-carb. It was also shown that the common thread for success between each of these dietary approaches was that they all ensured that the dieter was in a caloric deficit.2 This is why the best diet for you to lose weight is one that puts you in a caloric deficit and one that you can maintain over time.
You can’t out-exercise a bad diet
People tend to overestimate the amount of impact exercise has on weight loss and under-estimate the amount of calories they take in. For example, a 60-minute walk at a moderate pace for a 180 lb person burns approximately 200 calories, and one chocolate bar (e.g. Snickers bar) is 245 calories.7 People will often go for a long walk and then treat themselves to a snack when they get back or later in the day that will then negate the caloric expenditure of the walk.
Watch out for weekend spoilers
Many people are able to stay on track and be in a consistent calorie deficit during the week but then treat themselves too much on the weekend, undoing their week of work. For example, you can be in a deficit by 2,500 calories during the week, then easily eat an extra 2,500 calories on the weekend.
Using these strategies will give you a great foundation to begin the weight loss process. As with any changes to your everyday health routine, it is important to consult your doctor to make sure that you are following the appropriate guidelines for your individual needs.
1) Messier P et al. Weight Loss Reduces Knee-Joint Loads in Overweight and Obese Older Adults With Knee Osteoarthritis. Arthritis and Rheumatism. 2005; 52(7).
2) Aragon A et al. International society of sports nutrition position stand: diets and body composition. Journal of the International Society of Sports Nutrition. 2007; 14:16.
3) Mifflin MD, St Jeor ST, Hill LA, et al. A new predictive equation for resting energy expenditure in healthy individuals. The American Journal of Clinical Nutrition. 1990; 51 (2): 241–247
4) Harris Benedict formula for women and men. GottaSport.com. Retrieved on 2017-09-17.
5) Pesta DH et al. A high-protein diet for reducing body fat: mechanisms and possible caveats. Nutr Metab (Lond) 2014; 11:53.
6) Weigle, DS et al. A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations. The American Journal of Clinical Nutrition. 2005; 82(1): 42-48.
7) https://www.snickers.com/nutritional-info. Consulted November 3, 2017.
Exercises to help provide osteoarthritis knee pain relief
Start with one set of 3 or 4 repetitions, working up on 8–10 as you get stronger, building up to three sets.
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