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Interestingly, running has not been shown convincingly to be a risk factor
for knee arthritis. Some studies have suggested an association but an equal
number of studies have not. One of the best studies to date has shown that if
you keep your mileage under 30 miles a week, the risk of osteoarthritis of the
knee is pretty low.
That being said, once arthritis does develop in the knees, then other types of
exercise should be considered. Now the purpose of this article is to discuss
only the aerobic component of an exercise program. Patients with arthritis need
to include aerobic, strengthening, as well as stretching in a comprehensive
program.
One option is an elliptical trainer. While these are most often found in fitness
clubs, they are available for home purchase and use. An elliptical trainer
provides a movement that is midway between a bike and a stair climber. The feet
stay on the pedals and the movement is a smooth elliptical (oval) motion so
there is no impact. Some models have attachments for a back and forth arm
movement so that there is a total body workout. The angle of pedals as well as
the resistance to pedalling can be adjusted. This provides an excellent
cardiovascular, low-impact workout. The elliptical trainer is my personal
favourite.
Another option is swimming. Swimming provides the best cardiovascular workout
and is completely non-impact. The primary concern with swimming is that patients
with shoulder problems may have more pain and aggravation of their shoulder
symptoms with certain strokes. In addition, patients with low back arthritis may
also notice their symptoms worsening with certain manoeuvres. If your problems
are only knee related, swimming is a great choice.
A stationary bike is another good form of aerobic conditioning. It is a
no-impact workout. People with knee problems should use a very low tension and
start out slowly. Otherwise worsening of knee symptoms can occur. Quad
strengthening and hamstring stretching should also be performed if a stationary
bike is used.
Cross-country ski machines are not quite as popular as they once were. And
that’s too bad because this is a wonderful piece of equipment. This device
provides a workout for both the upper as well as the lower body. The feet move
in a back and forth gliding motion (make sure you get a good quality machine
that moves smoothly rather than in a jerky fashion). No pounding or other impact
accompanies this type of exercise. The attachments for the arms provide a brisk
workout for the upper body also. Resistance can be changed for both the legs as
wells as the arms.
One note of caution… people with low back problems should exercise caution since
back symptoms can get worse.
Treadmills are also an alternative. For people with knee problems though, these
may not be a good choice. There is impact. Very high end treadmills have a
softer more forgiving deck. If you notice that the treadmill makes your knee
pain worse, you’re probably better off using something else.
Stair climbers are probably not a great idea. The reason is that the motion of
bending and straightening the knee with loading from the rest of the body often
times will hurt. This is particularly true for people who have significant
arthritis between the patella (kneecap) and the femur (upper leg bone).
With all exercise equipment, it is critical to get clearance from your physician
before embarking on a vigorous program. Also it is a good idea to use a heart
monitor to make sure your heart rate stays within the range appropriate fro your
age group. Obviously, a lot depends on the condition you’re in before you start.
About the author
Dr. Wei (pronounced “way”) is a board-certified rheumatologist and
Clinical Director of the nationally respected Arthritis and Osteoporosis
Centre of Maryland (http://www.aocm.org). He is a Clinical Assistant
Professor of Medicine at the University of Maryland School of Medicine
and has served as a consultant to the Arthritis Branch of the National
Institutes of Health. He is a Fellow of the American College of
Rheumatology and the American College of Physicians. For more
information on arthritis and related conditions, go to:
http://www.arthritis-treatment-and-relief.com/knee-arthritis.html.
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