Hi, I’m Dr. Molly with Your Goals Physical Therapy. Are you looking for what the best exercises are for knee arthritis to keep you active?
You are trying to avoid surgery, you’re trying to avoid having the injections, whether that’s cortisone or in any of the other injections they can give you to help combat arthritis in your knees. This is going to be perfect.
I work with adults, active adults all the time that have knee arthritis and are able to get back to dancing, back to running, back to biking, back to their favorite aerobics classes despite having knee pain.
In this video I’m going to talk to you about what knee arthritis is, what causes it, and then how you can use exercise to stop the discomfort from it. So let’s get started.
First, knee arthritis is the wearing down of your knee joint and one of the symptoms of it being worn down, is inflammation.
Just as we move through life, you age, things just shift and change. But when we’re specifically talking about our knees, the cause of the arthritis is that your cartilage gets broken down. So the two bones touched come together.
You have cartilage, which is your shock absorber, and over time between compression forces some friction, that cartilage gets broken down. You end up with osteophytes, which is development of bone, which then helps further grind that down.
It can grind through your meniscus and the other ligaments inside your joint. This causes your knee to become more unstable, which then progresses the knee arthritis.
If you have been told by your doctor that you have arthritis in your knee to an extent that is just a normal part of aging. If they’re telling you about it and they’re telling you that it’s severe, they’re really telling you that there is more breakdown of that joint then would be ideal for your age. The overall process of your knee breaks, like the bone and the cartilage and all this kind of wearing down over time, that is a normal aging process.
The trick here is that pain is not part of it. There are people that have very degenerated knees that have absolutely no pain.
If there’s pain though, it’s telling you that something rather severe is going on. There’s something that is currently, actively unstable in that joint that’s causing undue wear and tear and undue stress on that joint. It is something that should be looked at. I feel like there’s this emphasis as if arthritis should just not be there at all and that you have done something dramatically wrong if you happen to have arthritis. That’s just not true.
We all have a little bit of arthritis because that’s a little bit of a breaking down and that is a normal part of aging.
What is not normal is that that breakdown is now causing you pain and causing you to not want to do your favorite activities. That is what needs to be addressed.
What can make knee arthritis worse or make that grinding down process happen at a higher rate?
That would be tight muscles. If your muscles around your knee joint are tight, that means that they are causing increased compression on that joint. They’re making those two bones come closer together. Then as you bend and straighten your knee, it just causes grinding.
Another thing that can be causing increased breakdown of that knee joint would be instability. There could be numerous reasons your knee is being constantly shifting side to side or pushed inside, outside, inside, outside with each step or there’s a rotation for whatever reason at your knee joint, that is not the direction that your knee is supposed to go.
Your knee is only supposed to hinge. Front and back is only supposed to hinge front and back. If there’s anything that’s causing it to rotate, if there’s anything that’s causing it to move side to side, certainly with every step that motion is what’s causing the increased wear on your knee joint.
This is where knee arthritis gets very confusing because the causes for a lateral shift or side-to-side shift or a rotation would be coming from your ankle or your hip. It could be your knee that’s giving you the symptoms, but the actual culprit of the symptoms could be your hip or your ankle.
It’s kind of like the middle child syndrome, right? It’s either the older kid or the younger kid, but that middle one’s the one getting blamed and so your poor knee. Anyway, those are the things.
Then what makes the best exercise – the best exercise? Well, that’s where it gets tricky. There really is no series of exercises or one specific exercise that is ultimately going to combat knee arthritis because there can be several causes.
In my mind that’s good because that means I get to pick what I want to do, I don’t have to just do some boring routine because it’s the only thing that will work and I really don’t want to do it. You get to actually pick this.
I’m going to talk about the kind of styles of exercise that do very, very well. A lot of people think that when they’re going to work out for knee arthritis is that walking. I would argue that walking sometimes irritates knee arthritis way more than it has the benefits for the arthritis.
Walking has benefits for other things, but if we’re just talking about arthritis for your knee, walking sometimes can make that worse.
For many people walking almost becomes unbearable if they have knee arthritis. That is because of the things that I talked about before.
One, when you walk, your foot hits the ground and you’re adding compression.
Two, if you’re walking and there’s something going on with your hip or your ankle, then you’re going to be getting some form of motion in your knee that it’s not supposed to be there because it’s going to rotate or it’s going to go side to side, which again kicks up the arthritis.
What I tend to suggest for people, if they just want a general genre of exercises to help their knee pain, my go-to is actually Pilates. The reason I like Pilates is because typically it’s something that’s done on a flat surface.
You can do them on reformers, you can do it on the floor. There’s also lots of versions of Pilates that you can do. They’re typically classes. Lots of people can do them at home. They require very little equipment because just moving your own body is hard enough. When you’re talking about Pilates, the whole concept is that you are able to control your body through a full range of motion.
You get flexibility and overall strength, which are two key things that you need for arthritis. It also works on stability of multiple joints and single joints.
That’s why I tend to just talk about genres of exercises for knee arthritis. Pilates is a great way to get started. There’s no impact. Again, you can find classes or you can do private ones or you can find things on the internet that have a series that you can follow.
The other thing is yoga and there are varying levels of yoga. You do not have to do Bikram, it’s hot yoga where it’s 400 degrees in there.
You can do a nice relaxing stretch yoga, you can do power yoga, you can do all sorts of yoga, there are a variety of yogas at this point. The idea behind yoga is the same. Similar to Pilates where you’re working on controlling your own body through a range of motion and they also tend to let you pick your own pace.
There’s always modifications and you can always opt out or completely change exercise for the time being. They tend to be slower activities again with no impact. You’re not doing a lot of compression or jumping or hard stepping or anything. It’s not going to be rough on your joint and it still allows you to strengthen and, and stretch those joints.
Now if you’re kind of a purist and you prefer to do one thing at a time, then my suggestion is an overall stretching program.
Stretching your hamstrings, stretching your quads, stretching your, your glutes. That would be perfors. Calf, calf stretches, those are great and the reason being that they help create more space for your knee joint, specifically your hip flexors and your hamstrings really help open up your knee joint.
There’s not as much compression then there is strengthening. You could go to a regular gym and just find strengthening equipment. You could do body weight strengthening. Anything that does not hurt while you’re doing it can only be helping you.
I would avoid it if you’re trying to help your knee arthritis. I would be avoiding any activities that cause extra compression. Don’t jump, don’t step really hard. If you’re going to be walking, you want to practice walking with less impact on the ground.
Which tends to make walking harder because if you’re used to just letting your foot slam on the ground, now you’re going to be using more muscles while you walk. Things like the elliptical are great or the bike tends to be knee arthritis friendly.
Now if you have tried many, many things and you’re just utterly confused and you really were looking for very specific exercises that are going to help your knee arthritis, the fastest way to get the answers to that is to talk with a movement specialist because that person can look at you, see how you’re moving, see what muscles are tight, see where the compression’s happening, see where the instability in your knee is.
The fastest way to dive into all of that to find out specifically the best exercises for you to get better, is to talk to a movement specialist. They’re going to help create a program just for you that helps you achieve the goals you are looking for.
Not only that, when you start a program that’s going to be level one, your goal may be level 15. How do you find the exercises that get you from where you are now to where you want to go without aggravating anything or causing a greater imbalance?
That’s why having an extra set of eyes and somebody else to help walk you through that process of what good pain is, bad pain, how much flexibility you should have, what good stretches feel like, what it feels like when you actually go through that exercise correctly. All the other aspects of just starting a program with something that already hurts and feels like you may cause more damage if you’re moving it.
This is exactly what I help people do every day. If this is the type of care that you’re looking for right now so that you can get back to your aerobics class or to your dance class, then I’m going to leave a button below that says, ask about cost and availability. When you click the button, you’ll fill out a quick form, my office will get back with you and answer all the questions you need accordingly.
Now if you are really hesitant, and you would much rather just have a conversation first before you commit to anything, before you find out how much anything costs, then I’m going to leave a button below that says, talk to a pt. In that you’ll fill out a quick form and they’ll set up a time for you and I to chat for about 20 minutes. You’ll be able to ask me all the questions you need to make sure that this is something that you would like to go forward with before you have to make that commitment.
Until then, I hope that you’re having a lovely day and I look forward to helping you get back to your favorite activities. Bye.
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