Dear Mayo Clinic: I’ve been diagnosed with osteoarthritis, and my doctor says I need to start exercising. I want to, but the pain in my hips and knees makes even a walk around the block difficult. Are there activities that might work for someone like me?
A: Your doctor is right. Exercise is important for people with osteoarthritis. In the long run, regular exercise can lower pain, ease stiffness and increase mobility. As you’ve found, though, exercising when you have osteoarthritis is not always easy. Fortunately, there are a variety of exercises that most people with osteoarthritis can do.
Osteoarthritis occurs when the smooth surface of the cartilage that cushions the ends of bones in your joints deteriorates. There may also be changes to the ends of the bones of the joint that can lead to pain, as well as degeneration of the tendons and ligaments that support the joint, which can cause joint instability. In a joint affected by osteoarthritis, there may be inflammation of the joint lining, which also can contribute to pain and stiffness. It most commonly affects joints in the hands, knees, hips, feet, neck and lower back.
Exercise eases the symptoms of osteoarthritis, in part, by strengthening the muscles around your joints. It also helps maintain bone health. Exercise gives you more energy throughout the day to accomplish your routine tasks and makes it easier to get a good night’s sleep.
Exercise also helps you get to – and stay at – a healthy weight. That’s critical for people with osteoarthritis. Excess weight increases the wear and tear on your joints, especially your knees and hips.
Lack of exercise may make osteoarthritis worse. When the muscles around your joints are not strong, the joints are more susceptible to becoming overloaded during daily activities. That can add to wear and tear changes in your joints and increase pain and stiffness.
Even when you know the benefits of exercise, finding ways to exercise when you are in pain can be a challenge. Focus on exercises that will not strain your joints but will strengthen the muscles around the joints.
Water-based activities, such as water aerobics or walking in water, often are a good choice, especially if you have knee or hip pain. Biking and walking are reasonable options, as well, but make sure you use supportive footwear. If pain gets in your way, take it slow. Try to work up to about 20 to 30 minutes of exercise at least three times a week. Break it into shorter amounts of time if that helps keep your symptoms in check.
It’s also important to include strengthening exercises, such as weight training and range-of-motion exercises, in your regular workout routine. Strengthening exercises target the muscles that support your joints. Range-of-motion and stretching exercises help relieve stiffness and improve joint function.
Before you begin any of these exercises, talk to your doctor. Based on your symptoms and other health considerations, he or she can help you create an exercise plan that fits your needs. Or, your doctor may recommend you work with a physical therapist.
Dr. Shreyasee Amin is a rheumatologist at the Mayo Clinic in Rochester, Minn.