email to a friend
printer-friendly version| Safe Exercise for Arthritic Joints by Mark B. Allen, MPT - May 2007 Excess weight increases the likelihood of osteoarthritis, especially in the knees. Under optimal conditions, articular cartilage lubricates the joint and absorbs shock to the moving bones. Osteoarthritis is a degenerative condition in which this cartilage erodes, causing pain and limiting motion. The rate of cartilage breakdown is partly genetic, but wear and tear over time plays a huge role in the progression of arthritic degeneration. Excess body weight, repetitive activity, and prior injury can all expedite the breakdown of articular cartilage. Non-surgical treatment for arthritic joints focuses on strengthening and stretching the surrounding musculature to minimize rubbing of the irritated bone ends. The goal is to balance muscle action and stabilize the joint, making up for some of the loss of cartilage function. The following exercises are useful for individuals with arthritic knee and hip conditions. Muscle fatigue during and after exercising and tightness when stretching are expected. Sharp pain during activity or increased pain in the joint itself is an indication to stop. Please consult with your physician before beginning any exercise regimen. Cycle or Swimming These are optimal cardiovascular exercises due to their limited weight bearing and higher angular velocities. I recommend a recumbent stationary bike (one with a back rest and more reclined position) after surgery or for those with significant pain. Begin with 10-15 minutes of continued light exercise and add 5-minute intervals as endurance improves. Resistance can be added as long as pain does not develop.  Hamstring StretchesPut leg out straight on bed. Slowly bend forward from the hips, lowering chest toward leg until light stretch is felt in the back of the thigh. Hold 15 seconds, repeating three to five times on each leg.  Leg PressThis is performed with equipment at the clinic or gym. Please consult an exercise professional about equipment if you are not familiar with it. Keep feet shoulder-width apart and keep knees in straight alignment from hips to feet (fight the tendency to let knees come together). Slowly push feet against plate, lifting weight until knees straighten. Slowly return to starting position. Putting feet lower on plate will work knees more; putting feet higher on plate will work hips more. Repeat two to three sets of 10 repetitions.  Wall SlidesWith heels 10-12 inches away from wall, lean back flat against wall with knees straight. Slowly bend knees and slide down wall until knees are bent about 60 degrees (about 1/3 of a squat). Hold 5-10 seconds and slowly slide back up to starting position. Repeat two to three sets of 10 repetitions.  Standing Hip AbductionAgain standing with hands on counter for support and balance, slowly lift leg straight to side and lower. Be careful not to lift so far that the trunk bends sideways. Keep motion straight to side, not coming forward as leg lifts. Repeat two to three sets of 10 repetitions.  Standing Mini-SquatsUsing counter for balance, stand on right foot with left foot a few inches off ground. Slowly bend right knee to about 20-30 degrees (about 1/4 of a squat) and return to straight-leg starting position. Repeat two to three sets of 10 repetitions. Keep these shallow to prevent sharp pain.  Quadriceps stretchStand holding back of chair or counter for balance. Bend knee, putting toe on chair behind you. Slowly bring trunk erect until light stretch is felt in front of thigh. Hold 15 seconds, repeating three to five times.  Straight Leg RaisesTighten thigh muscles as if flattening back of knee against bed. Then slowly lift and lower leg, keeping knee straight. Repeat two to three sets of 10 repetitions.  BridgingLie on back with both knees bent and feet flat on bed. Tighten buttocks on both sides and slowly lift hips off bed. Slowly lower to starting position. Repeat two to three sets of 10 repetitions, being careful not to arch your back as you lift.  Side-lying Hip AbductionLie on side with top leg straight at the knee. Slowly lift top leg about six inches and lower with control. Repeat two to three sets of 10 repetitions. If back pain is felt, avoid this exercise.  Straight Leg RaisesTighten thigh muscles as if flattening back of knee against bed. Then slowly lift and lower leg, keeping knee straight. Repeat two to three sets of 10 repetitions.  Calf RaisesStand with hands on kitchen counter for balance, feet about shoulder-width apart. Slowly lift heels, bringing weight up on balls of feet. Lower slowly. Begin with weight equally distributed on both feet. More advanced patients can lift their body weight with one leg at a time. Repeat two to three sets of 10 repetitions. Icing the involved joint for 10-15 minutes after exercise, or any time there is pain, is recommended to minimize inflammation and swelling. Heat is preferable before exrcising to loosen the soft tissue for stretching. Please consult your orthopedic surgeon if conservative measures do not relieve symptoms.  Mark B. Allen, MPT is the director of physical therapy at Orange County Orthopedics and Sports Medical Group in Irvine, California. In addition to his private practice, Mark is the current team physical therapist for the United States Waterski Teams. He is also a consultant for several professional, collegiate and youth athletic programs. |
Most Active
Recent Topics
