The Arthritis Antidote (Part 2)
Dear Colin: I’m 54 years old and recently diagnosed with knee osteoarthritis. It hurts to climb stairs, kneel to pick up my grandkids and garden (which kills me because I love it). My doctor has given me knee injections and prescribed an anti-inflammatory, but nothing’s really helped. I don’t want surgery. What else can I do?
– Helen D.
As suggested in my last blog, there’s a lot you can do to fight osteoarthritis (OA) but you will need to work at it. Key points:
- Research suggests that safe, effective exercise can be just as or even more powerful than drugs in treating OA;
- Traditional OA treatments that emphasize a “passive” approach do not address the main problem, which is lowering joint forces;
- Obesity is a major OA risk factor, so effective exercise and nutrition should be part of any treatment plan, and;
- Taking control of your OA means adopting a safe exercise and eating plan.
It takes time and effort to learn how to exercise safely. It’s all too easy to exercise in a way that worsens OA symptoms because your body will default to dangerous positions without realizing it.
Research shows that people with OA have weakness in the hips and thighs, which mean these muscles won’t adequately absorb forces when you engage in daily activities (e.g., climbing stairs). Consequently, forces on your joints increase because they are “unprotected” by weak muscles. By safely strengthening your hip and thigh muscles, they will better absorb forces in your lower body, thus protecting your hip and knee joints. You’ll then be able to do more with less pain!
An important RT exercise is the squat (shown), not just because it strengthens the hips and thighs but also mimics daily functional tasks (e.g., getting out of a car). To protect your knees, research shows that you shouldn’t exceed ~50° of knee bend (shown). If you do, forces on the knees increase and can worsen symptoms.
Notice the hip position: they are behind the heels to minimize knee forces, so your first motion should be moving the hips back so the knees don’t move in front of your toes. The torso is upright to increase work of the hip and thigh muscles, but with minimal arching of your low back.
It’s important to realize that the squat should be done this way even if you don’t have OA. In other words, minimizing knee stress is always a good thing! People often do full squats, which places excessively high loads on the low back and knees.
This is only a place to start. People with OA (or any other joint disease) should coordinate with their doctors and physical therapists to set up a customized program based on need. This is probably the best way to fight OA in a cost-effective way, as insurance (including Medicare) will cover all or most of the cost.