OSTEOARTHRITIS REHABILITATION
OF KNEE AND HIP
The old slogan, “Move it or lose it,” goes
double, or perhaps triple, for people with osteoarthritis
Years
ago, arthritis was treated with rest and immobilization. Scientists have since
learned that locking up the joints actually makes them worse.
There’s a huge body of literature
demonstrating that keeping the hips and knees moving, and the muscles around
the joints strong, contributes greatly to protecting the joints and staving off
additional damage caused by arthritis,
People
with knee and hip osteoarthritis have limitations, Which exercises can you do
to make the most of your mobility without increasing pain or risking injury?
Exercises to Avoid With OA of the Knee or Hip:
·
Running and jogging.
“The difference between how much force goes through your joints jogging or
running, as opposed to with walking, is sometimes more than tenfold your whole
body weight,
·
Jumping rope.
·
High-impact aerobics.
·
Any activity where, at
any time, you have both feet off the ground at once, however briefly.
Exercises to improve OA of the Knee or Hip
Cardiovascular Exercise
Good
cardiovascular exercises for people with knee and hip osteoarthritis include
walking, swimming, and cycling. “Really, it’s anything that you can tolerate
that gets your heart rate going,
If
you can take a brisk walk, it can keep you mobile and help to reduce pain. If
walking for exercise is too painful, try a recumbent bicycle. “These bikes
extend the angle of the joint so that the knee and hip aren’t flexing so much
with each rotation, so that it might cause less strain and pain,
If
even the recumbent bike is too much, the swimming pool is your friend. “It
feels great on the joints!” “You must
find a pool that is heated, because cold water is very painful for arthritic
joints. The only downside to swimming is that it doesn’t give you the delay of
bone loss that is a key benefit of weight-bearing exercise.”
Muscle Strengthening Activity
You might think that lifting weights would be
bad for arthritis, but some studies show that the opposite is true. By
strengthening the muscles around the joints, strength training helps to take
some of the load off the arthritic joints and relieves pain. The job of
connective tissue is to hold things together, so you’re losing stability in the
joint, part of what’s causing the pain. When you strengthen the muscles
surrounding and supporting the joint, you can relieve some of the symptoms,
Flexibility and Range of Motion
There
are a number of specific exercises that you can do, designed to be easy for
people with osteoarthritis, to increase your flexibility and range of motion
around your knees and hips.
“We
want to do activities without force that bring the hips and knees through the
full range of motion in a general, unforced manner, allowing the joint to
lubricate itself and help to heal the damage; you can do these stretching
exercises in a pool, or on a mat near a wall for support.
Before
starting an exercise or flexibility training program, check with your Physiotherapist.
Depending on your ability and comfort level, try these exercises 2 to 3 times
per week and gradually work up to doing the exercises daily.
Hip Exercises
·
Leg
swings. Simply hold onto the
edge of the pool, or the wall if you’re on land, and gently swing your leg out
to the side, alternating sides. “The pool is particularly good for this,
because the buoyancy assists you and you get a better range of motion,
and you also have resistance from the water that makes your muscles do
more work,
·
Leg
extensions. In the same position,
extend your leg gently backward, alternating legs. As with all range-of-motion
exercises, “If your hip is very tight, and you try to bring it behind you and
it doesn’t move backward very well, you can end up overarching your back and
causing back problems by doing it incorrectly.
Knee Exercises
·
Straight
leg raises. Sit in a chair,
straighten one leg, and raise it straight out in front of you. Alternate legs.
·
Leg
curls. If you are nimble
enough, lie on the floor on your stomach, and gently bend your heel back toward
your buttocks, making sure to keep your hips on the ground.
All
of these exercises should be done without weights. “In general, it’s not a good
idea to put a weight on the ankle and bend and straighten the knee. That puts a
lot of torque on the knee that can exacerbate arthritis. Instead, if you want
to add weight, it’s better to use something like the full leg press machine,
which has you lie down and push a plate up. With those, your full body weight
is somewhat unloaded from the joint.”
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