Arthritis – No one wants stiff, achy, painful, joints. If you’re familiar with these symptoms and they’re worse in the morning, it could be osteoarthritis, one of the most common joint problems men and women experience as the years go by. If you were to x-ray the knees of people over the age of 60, four out of ten would have x-ray evidence of osteoarthritis. Osteoarthritis may be “silent” for a period of time. You can have evidence of it on x-ray, yet not have noticeable pain and stiffness, at least not initially. Fortunately, if you have a mild case of osteoarthritis, you can continue to experience normal joint function and enjoy a good quality of life, particularly if you watch your weight and keep your joints moving through exercise.
Exercise and Osteoarthritis
Many people are reluctant to exercise with osteoarthritis, believing that lifting weights will make the pain and stiffness of osteoarthritis worse – but science says otherwise. A meta-analysis of adults with osteoarthritis showed that strength training reduced the pain of osteoarthritis by 35%. It’s a common belief that when your joints are stiff and achy that you should rest when exercise is often the key to subduing the symptoms. Exercise of any type increases blood flow to the muscles and supportive tendons and ligaments and reduces stiffness. If you have osteoarthritis, you might have noticed that the symptoms are worse when you first wake up and tend to improve as you move around. That’s the power of exercise!
Those Achy Knees!
One of the most common forms of osteoarthritis is arthritis of the knee. You might think that strength training could aggravate the symptoms of people with knee pain and stiffness, especially exercises like squats and lunges. Yet, a number of studies show that people who strength train note improvements in pain/stiffness and disability. It makes sense! One of the factors that worsen the disability of knee osteoarthritis is weak quadriceps. In fact, studies show that decreased force production in the quadriceps is associated with worsening of physical function in people with knee osteoarthritis.
In addition, research shows that weak quads are a risk factor for developing osteoarthritis. So, strength training may be beneficial for preventing osteoarthritis of the knees as well. Supporting this idea was a study of more than 2,000 men and women between the ages of 50 and 79 years of age. It showed that greater quadriceps strength was linked with a lower risk of progressing to symptomatic knee osteoarthritis.
Exercise, in general, is good medicine for mild osteoarthritis of the knee. A Cochrane study that analyzed 54 trials looking at exercise and knee pain found that exercise enhances knee function and reduces pain. Plus, you can enjoy the other health benefits that exercise offers.
As you might know, osteoarthritis is marked by the loss of cartilage within a joint. Cartilage is tissue that absorbs shock, within the joint itself. As cartilage loss and damage worsens, the joint space narrows and, bone spurs may form as well. At one time, researchers believed that osteoarthritis was a degenerative disease but, more recently, they discovered the presence of white blood cells that produce inflammatory chemicals within the joint space of people with osteoarthritis. So, osteoarthritis may have an inflammatory component as well.
As osteoarthritis progresses, it can almost completely destroy the joint and even extend into the soft tissues, like the ligaments. Also, if you’ve had a significant knee injury in the past, especially a ligament tear, you’re at higher risk of developing knee osteoarthritis. It’s likely that such an injury throws off your biomechanics and creates repetitive trauma that causes the joint to deteriorate.
A knee injury isn’t the only risk factor for osteoarthritis. Genetics are a factor as well as being overweight or obese. Carrying extra weight places more force on the knees and can speed up the development of arthritis. Other risk factors include occupations that place repetitive stress on the knees, such as carpenters who squat down and hold that position for long periods of time. Women also have a higher risk relative to men. In fact, the risk for women is 2.6 times higher than men.
There’s another way strength training is beneficial for osteoarthritis. Weight training helps with weight control and loss of weight takes stress off of the joints. Losing weight is a tried and true way to lower your risk for knee osteoarthritis as well as reduce arthritis symptoms.
What about Other Forms of Arthritis?
Osteoarthritis is the most common form of arthritis – but it’s not the only one. There are a variety of inflammatory forms of arthritis, including rheumatoid arthritis. Since exercise has an anti-inflammatory effect, strength training may help here too. Many rheumatologists recommend strength training for their patients. The key is to use good form on every exercise you do and start with lower weights and gradually work up to more challenging ones.
If you have arthritis, it’s important that you warm up before lifting weights. As you might expect, form is crucial since bad form can throw your alignment off and create muscle imbalances that place stress on your joints and muscles. If you have joint pain, check with your health care professional before tackling a demanding weight-training program.
The Bottom Line
Strength training to build up strong quads may lower the risk of osteoarthritis in women and may help relieve the symptoms in men and women who already have it. It’s a natural approach to easing the symptoms of arthritis and keeping your joints as healthy and lubricated as possible. The take-home message? Stay active to keep your joints healthy!
References:
Arthritis-Health.com. “Strength Training Can Crush Arthritis Pain.
Clin Geriatr Med. 2010 Aug; 26(3): 445–459. doi: 10.1016/j.cger.2010.03.006.
Medscape Family Medicine. “Strength Training for Treatment of Osteoarthritis of the Knee: A Systematic Review”
Arthritis and Rheumatology. “Reduced quadriceps strength relative to body weight: A risk factor for knee osteoarthritis in women?” November 1998.
Practical Pain Management. “Knee Osteoarthritis Impacted By Quadricep Strength”
Br J Sports Med 2015; 49:1554.
Am J Epidemiol. 1988;127(5):1019.
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