Exercise and osteoarthritis

Exercise is good for our health. In people with osteoarthritis, regular exercise can help reduce pain and improve function. But it is precisely during exercise that people with osteoarthritis experience the most limitations. It is therefore important to find the form of exercise that best suits you and your condition.

Guidelines

According to the exercise guideline, it is recommended to exercise moderately intensively for at least half an hour a day. Moderate intensity means, for example, brisk walking or cycling. With osteoarthritis, it is important to stay within the pain threshold while moving and not to go through the pain. This not only concerns pain during the load, but also afterwards, because the pain reaction often only occurs after one or two days. It therefore requires knowledge and experience to deal with this properly. Your doctor can help you with this.

Bodyweight

If you are overweight or obese, it is important to lose weight. You can achieve this through a combination of dietary adjustments (see also leaflet on nutrition and osteoarthritis) and increasing your physical activity. Low-impact activities such as cycling, swimming, walking or Nordic walking are particularly well tolerated by patients with osteoarthritis. By integrating exercises or exercise activities into your daily life, for example cycling to work or walking the dog, it is easier to keep up. An exercise bike or an e-bike can also offer a good solution. Sitting a lot can actually make your osteoarthritis symptoms worse. In addition, sitting too much is not good for your overall health and increases your risk of chronic conditions such as diabetes and cardiovascular disease.

Exercise for osteoarthritis

A clear loss of muscle mass is already seen in mild osteoarthritis. It is therefore important to do exercises to strengthen the muscles. Exercise therapy provides a clear improvement in pain and functioning in patients with osteoarthritis. In addition, exercise therapy reduces the number of patients requiring surgery.

Guidelines

Most guidelines recommend a combination of exercises aimed at mobility, muscle strength and endurance. In addition, targeted strength exercises appear to be more effective than stretching exercises, stability training and Tai Chi.

Supervised exercise programs

You can start an exercise program independently or under supervision. It is important that you are motivated and that it works well for your personal situation. Exercise therapy under supervision or in a group appears to be more effective than when exercises are performed at home on their own. The frequency, duration and intensity of an exercise program also have an effect on the outcome.

Most supervised exercise programs are 12 weeks in duration. Guided sessions are combined with independent practice at home. Attention is also paid to information and advice and an exercise plan is drawn up together with you. The aim is for you to continue the exercises independently afterwards. In case of severe pain, hydrotherapy (exercise in the water) can be started in the initial phase. This is possible, for example, at our location in Haarlem.

Keeping up

It is important to keep up with the exercises. When the exercises are stopped, the benefits disappear within 6 months. To keep you motivated and to bring about a lasting change in behavior, it is important that you set goals, evaluate them regularly and consider your environment.

The FITD principle

Exercise therapy must meet minimum requirements to be effective and follows the FITT principle (Frequency, Intensity, Type and Time).

Frequency
  • Muscle-strengthening exercises at least twice a week.
  • At least 5x a week at least 30 minutes of moderately intensive exercise (such as walking)
Type
  • Strength training: exercises of the major muscle groups and functional exercises (climbing stairs, getting up from a chair). Exercises that cause pain should be avoided.
  • Aerobic training: activities with a relatively low joint load such as walking, Nordic walking, cycling, swimming, rowing and cross trainer.
  • Other forms of exercise: also consider coordination and balance exercises, stretching exercises and mobilizing exercises.
Intensity
  • Strength training: 2-4 sets of 8-15 reps at 60-80% (beginners 50-60%) of maximum strength.
  • Aerobic training: 60% (40-60% for beginners) of maximum heart rate. Start with 10 minutes and gradually build up the duration of the effort from there.
Time
  • Ideally, a treatment period of 8-12 weeks with a few follow-up sessions (eg after 3 and 6 months). After that it is important to keep practicing independently!

Please note: training must be within the pain threshold for all forms of exercise. This means that both during and after exercise you can have a maximum pain score of 3-4 on a scale of 0 (no pain) to 10 (the worst pain imaginable).

Smart watches and activity trackers

Nowadays, there are more and more devices on the market that can monitor your activities. Think of heart rate monitors, step counters, smart watches (fitbit, apple watch) and apps on your mobile phone. These wearables or activity trackers, as they are also called, can have an important added value in osteoarthritis.

By combining the activities that your smartwatch registers with a pain score, you can gain insight into which forms of strain have a beneficial effect on your complaints and which forms of strain actually exacerbate your complaints. Registering your activities can also have a motivating effect and encourage you to keep moving.

What do we work with?

At ArtroseKlinieken we work with a platform (Healthy Chronos) in which you can register your pain score and where your smartwatch can send your exercise data, of course with your permission, to your physiotherapist or sports doctor. This way they can help you optimize your activity pattern. Your own data forms the basis of your exercise program.

Preoperative training

Even if you are going to have surgery, it is important to do strengthening exercises. This way you can go into the operation as healthy as possible. Research shows that a good training schedule prior to surgery can lead to a faster recovery, improvement of your physical functioning and a reduction of complaints in the months after surgery. Also, a good exercise schedule can help delay surgery if you are not ready for it.