KNEE PAIN
As a Physical Therapist, I interact with a wide variety of patient populations with various diagnoses, the most common of which is often osteoarthritis. This is an orthopedic diagnosis given to patients who present with pain and stiffness that demonstrate joint space narrowing on imaging studies indicative of thinning or degeneration of joint surfaces. Very commonly, these diagnoses pertain to those experiencing symptoms in their knees and hips but any joint surface could potentially be affected.
For many people who want to live active, healthy lifestyles, this can be a harrowing diagnosis as traditional recommendations would be to modify activities and avoid the loading of the affected joints.
But these recommendations are likely antiquated given the findings of most recent research on the subject. Specifically, available literature has demonstrated consistently that strength training does not result in further joint degeneration and likely has a joint protecting effect. In these studies, strength training resulted in improvements in strength and demonstrated greater preservation of joint space than range of motion/stretching exercises alone.
Other studies have demonstrated improvements in function, strength and pain with resistance training protocols as compared to control groups and other intervention groups (stretching/range of motion). Additionally, research investigating the effect of knee strength before and after total joint surgery indicates that greater strength prior to surgery resulted in improved outcomes following surgery.
So we know that strength training is likely beneficial for the osteoarthritis population, but where should the average person start? This is where most people will get derailed from their goals. They want to make a lifestyle change but aren’t sure where to start. This barrier to entry can result in patients never starting their exercise journey or giving up due to aggravation with unsuccessful trial and error of exercise. If you have a background in exercise (whether you have worked in the field or have led an active lifestyle), I would recommend gradually introducing exercises that challenge your muscles throughout a large range of motion (and no, walking, cleaning your house and gardening does not fit this description). For those that do not have a background in exercise, finding a personal trainer or Physical Therapist can help you get on the right path without as much trial and error.
The pursuit of strength training in the osteoarthritis patient population can have profound benefits and likely result in long term health changes for the better. If you or someone you know is struggling with arthritis related pain and limitations to their function, don’t hesitate to discuss this subject with your healthcare provider.
-Aaron Ulvestad PT, DPT, OCS, CSCS
“Strength is never a weakness and weakness is never a strength”
Mark Bell
