Did you know that exercise is as effective as a non steroidal anti-inflammatory medication, like Aleve, in reducing pain in knee osteoarthritis(OA). Moreover, it is two to three times more effective than Tylenol in reducing knee pain! The challenge in exercising when you have OA is finding the optimal dosage. When you grab the bottle of Aleve the directions on the label simply tell you how to use it and it’s done. The art of physical therapy is listening to the client's story, assessing their function then implementing an appropriate exercise program. 

What is an appropriate exercise program for knee OA? The types of exercises utilized would be a combination of aerobic exercise, resistance training and neuromuscular control. Aerobic exercises are designed to improve cardio-respiratory fitness, like walking, cycling or running. Resistance exercises are intended to improve muscular strength. These exercises involve moving  your limbs against resistance provided by your body weight, gravity, bands, weighted bars or dumbbells.

And lastly neuromuscular control exercises focus on improving your body’s coordination, awareness and stability while performing specific activities like squatting, stairs and standing on one leg.

Interestingly, what may provide pain relief and improved function for one person may be the complete opposite for another. This is an area a skilled physical therapist can problem solve to identify your optimal exercise.

How much exercise should you do? Finding the optimal dosage of exercise can be a challenge. Factors such as inflammation, pain severity, deconditioning and lifestyle habits all must be weighed when deciding upon a starting point of exercise. I like to begin conservatively with clients who have no history of exercise, or appear to have a high level of irritability in their symptoms. This way they can begin to move, and get stronger without a flare up in their condition, which may set them back a few weeks. 

Research indicates three or more bouts of physical activity were more effective at addressing symptoms and impairments in individuals with hip and knee OA when compared to fewer than two sessions per week. In addition, the World Health Organization recommends 150 minutes of moderate physical activity or 75 minutes of vigorous exercise per week. Exercise is crucial for joint health (see previous post), yet these recommended dosages may not be tolerable in folks with OA. Again, a skilled physical therapist can help to devise a progressive exercise program to build towards not only feeling better but moving better and more!