Osteoarthritis Health Center

Knee and Hip Exercises for Osteoarthritis

The old slogan, “Move it or lose it,” goes double, or perhaps triple, for people with osteoarthritis.

“Just like for anyone else, physical activity is important for overall health,” says Steffany Haaz, PhD, a health behaviorist at the Johns Hopkins Arthritis Center. “But it’s even more important for people with arthritis because there’s disability associated with the condition, both the disability associated with the disease and the disability that happens when a joint doesn’t get exercised. First, you move less because it’s painful, then you start to lose the ability to move. It can become a vicious cycle.”

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,” says Linda Arslanian, DPT, MS, director of rehabilitation services at the Brigham and Women’s Hospital in Boston.

Of course, it’s not as simple as hopping on the treadmill or hitting the weight room. A healthy 30-year-old might be able to exercise however he pleases, but 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?

“That’s the trick,” says Arslanian. “Some exercises actually can make knee and hip arthritis worse. Those are the ones that create a huge amount of impact loading on the joints -- the ones we call ‘high impact’ activities,” she says.

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,” says Arslanian.
• Jumping rope.
• High-impact aerobics.
• Any activity where, at any time, you have both feet off the ground at once, however briefly.

Fortunately, that leaves a lot of activities that areOK for people with knee and hip osteoarthritis and that can help keep you mobile. There are three key areas you need to focus on: weight-bearing cardiovascular activity, to keep your bones strong and your heart healthy; muscle strengthening activity, to relieve strain on the joints; and flexibility and range of motion, to help prevent falls and keep your joints mobile.

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,” says Haaz.

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,” Haaz says.

If even the recumbent bike is too much, the swimming pool is your friend. “It feels great on the joints!” Haaz says. “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.”