Many people are starting to notice the signs of arthritis in their knees or hips at a younger age and it is important to know exercise recommendations and guidelines for knee and hip arthritis so you can prevent or post pone surgery. There is a lot people can do with their exercise and lifestyle habits to positively support the osteoarthritis that has started in their knee and hip joints.
First off, if you are participating in any high impact sport like running, tennis, or any other high impact jumping sport, it is time to stop them or cut back drastically. It ultimately is a choice whether you continue do them for the love of the sport knowing it will speed up the need for a knee or hip replacement or decide to choose other low impact exercise which will prolong the need for surgery. High impact force on the knee or hip joint most definitely leads to and exacerbates osteoarthritis eventually decreasing how long your joints will last.
The next step is to look at your weight as your body weight directly affects the daily force we place upon our hip and knee joints. Whether you have a lot to lose or a little to be at a healthy weight, the reduction of even 5 to 10 pounds will substantially help your joints. When we exercise in weight bearing mode, the load we put through our knee joint is 4-6 times our body weight; therefore, a 10 pound weight loss would decrease the pressure on your knee by at least 40 pounds!
Cardiovascular Exercise Options for Knee and Hip Arthritis
Now we are going to take a look at the specifics of selecting the best exercises for knee arthritis or hip arthritis. As an ACE Medical Exercise Specialist with 15 years of experience specializing in arthritis exercise programs and joint replacement exercises, I have learned the most effective exercises. Let’s start by first assessing the best choices for cardiovascular conditioning.
Cycling on stationary bicycles or even outside if you feel safe, is the best cardiovascular option because it is non weight bearing while still offering range of motion at the joints. Walking is good as long as you monitor distance and overall volume determined by any discomfort you feel at the end of the walk or later in the day. Pole walking is also excellent as nordic poles take the load off of your knee and hip joints.
Strength Exercises for Hip and Knee Arthritis
There is one main principle you want to understand once you have knee or hip arthritis and that has to do with the importance of minimizing the load placed on your knees and hips. So, if you do any weight lifting or heavy lifting in the gym as for example in squats, this load is going to increase wear and tear on the joint, increase inflammation in the joint, and potentially cause you pain. It is absolutely okay to do some strength training; the key is to limit the load and volume of exercise you do and select some strength exercises that are non weight bearing.
The most important muscle to strengthen if you have knee arthritis is your quadriceps. There are several key strength exercises for hip arthritis as it depends on when and if you need surgery, where the incision will be made: anterior, medial, or posterior. It is pretty safe to say that the gluteus maximus and medius muscles are extremely important and if you knew your surgeon was going to perform an anterior incision hip replacement, then you would also need to strengthen the hip flexor or Illiopsoas muscle.
The exercise guidelines for performing strength exercises for your knee and hip arthritis are as follows:
- Only ever exercise through your pain free range of motion
- Non weight bearing is best, but weight bearing exercises that do not cause pain are okay as well.(*Weight bearing increases wear and tear)
- Muscular endurance strength is best (low to moderate resistance for 12-15 repetitions)
- Quadricep strength is most important for knee arthritis
- Gluteus Medius and Maximus strength is most important for hip arthritis
- Ensure rest days between exercise, strength exercises maximum 3 days a week
- Strengthen the stabilizing muscles of the joints is important as well as your core muscles
Flexibility, Range of Motion, and Stretches for Knee and Hip Arthritis
In the Joint Replacement Course for personal trainers that I teach, I always ask the trainers, “What is more important, strength exercises or stretching exercises for your arthritic and joint replacement clients?” It is a trick question, but it is purposely asked and sometimes debated because we all have biases and it is an important point to make. The answer is both are equally important.
Range of motion or flexibility and stretching exercises are crucial for people with hip and knee arthritis because the very nature of arthritis causes the range of motion at the knee or hip to decrease. Our ability to walk, stand, and do daily tasks is greatly affected when the range of motion at our joints is altered by even a degree. At one point there was a lead instructor who decided to change her training programs for people with arthritis and joint replacements to 50% stretching and 50% strength whereas most had been about 75% strength and 25% stretching. She noted this 50/50 split produced great results for her clients.
All of you will experience tight muscles in different places, but there are a few common stretches I will recommend as part of the stretching exercise guidelines for people with hip and knee arthritis. If you have knee arthritis, it is very important for you to stretch the hamstrings, calf, quadriceps, and your Illiotibial Band. If you have hip arthritis, you will want to stretch your hip flexor muscle, your gluteus maximus , hamstrings, quadriceps, and again your Illiotibial band.
Important Exercises for People with Knee and Hip Arthritis
In addition to the specific joint exercises mentioned above, there are important exercises everyone with knee or hip arthritis should be aware of due to overall body changes as the joint deteriorates. When your joint range of motion decreases, this will change your posture or your ability to stand and walk how you once did. This can alter your posture and balance. To summarize the other important exercise recommendations you should add into your weekly arthritis exercise program, here they are:
- Deep abdominal and core muscles
- Back extensor muscles
- Tibialis Anterior or Your Shin Muscles to prevent falls
Yes, there are some changes that need to be made to your exercise and lifestyle if you have the early stages of knee or hip arthritis, but they will preserve your joints and postpone the need for surgery. Remember that osteoarthritis is the wear and tear of your joint and wear and tear comes from age, overuse, load, and injury. This means that if you have the early stages of arthritis, you want to be aware of the total volume of movement on your joints in a day and the load you are exposing them too every day.
On an exciting and personal note, I have personally witnessed my mom make small, but highly effective changes in her lifestyle habits and exercise routines to postpone the need for surgery. I call her the ‘never-op’ girl as there is nothing like a bit of fear to motivate you to change and just so you know the surgeon said she was one of the worst cases he had seen. Let me share a few of the steps she has taken to let her keep living without having to have surgery yet:
- She always walks with poles especially for longer walks
- She has a stationary bike and bikes every morning for 30 minutes
- She gave up stairs in her building due to the impact on her knees
- Her weight is light and low so very little load is on her knees
- She eats anti inflammatory foods like pineapple
- She changed her footwear to be supportive
- She stretches every day and never sits or stands too long
- She takes supplements like Hyluronic Acid and others
- She did have to give up her road bike outside due to balance and safety
- She asks for a wheelchair or assistance in airports as walking too far will cause a flair up
- She has a wheelchair parking pass
- Icing whenever you have pain, swelling, or heat in your joint
There you have a few ideas to help you manage your knee and hip arthritis and possibly prolong the life of your joints and the time before needing surgery if that is your goal. Small changes to your exercise routine and lifestyle can make a big difference to limiting the fast progression of your osteoarthritis.
If you want to learn specific exercises for knee or hip arthritis, I have prepared an online exercise program you can do from the comfort of your home or at your gym. You can learn more about the knee arthritis exercise program here or the hip arthritis exercise program here.