If you are one of the millions of Americans bothered by hip or knee arthritis, this article is for you. And if you would prefer not to rush into popping pills, having injections, or pursuing surgery, this article is really for you. The following paragraphs are for people who want to take control of their health and quality of life.
You may think, “But there is no cure for arthritis.” We disagree. The Cambridge Dictionary defines a cure as something that makes someone who is sick healthy again. A cure refers to making you, a whole person, healthy again not correcting or reversing some change in your joint. With this definition in mind, there is no better cure for your hip and knee arthritis than exercise.
Many different types of exercise have been proven to be helpful for arthritis. Aerobic exercise, stretching, yoga, tai chi, aquatics, and balance training are all proven forms of exercise. This article details one of the most effective forms of exercise for people with hip and knee arthritis: strength training.
A Common Misconception About Arthritis and Exercise
You may think, “But my knee [or hip] hurts too much to exercise.” Or someone may have even told you,” Exercise will make your arthritis worse.” These claims are flat-out wrong! If you accept them as true, you are playing the victim. Victims wait around for their lives to change. Successful people create the changes they want in their lives. If you don’t want to be a prisoner to your arthritis pain, now is the time to get moving with an exercise program.
A Proven Approach: Strength Training for Arthritis
From the available research, it is clear that strength training is beneficial for people with arthritis. A 2019 review of 103 different clinical trials found 4 different types of exercise benefit people with hip and knee arthritis. These were aerobics, mind-body exercise (yoga or tai chi), strength training, and stretching. A regular strength training routine was proven beneficial for decreasing pain, improving function, and restoring quality of life.
In 2016, a panel of worldwide medical experts reviewed the best evidence looking at exercise for people with hip arthritis. Compared to all other forms of exercise, these experts found strength training to be the best for decreasing pain, improving function, and regaining mobility.
Recommendations include performing one to three 45-minute sessions each week. You can use exercise equipment at a local gym or fitness center. For most people, it is practical to start strength training at home without all the fancy equipment. The 6 home exercises that follow focus on strengthening your core, hips, and thigh muscles. They are a great starting point for you.
Band Knee Extension
Your quadriceps muscle or “quads” on the front of your upper thigh is crucial for walking, climbing stairs, and standing up from a chair. The quads of people with hip and knee arthritis are weaker and smaller than people without arthritis. Weakness places additional stress on your arthritic joints. Stronger quads reduce joint stress and decrease your pain. Band knee extension is a great exercise to start working your quads.
Loop a resistance band around your lower leg. Attach the other end to the leg of a chair or your bed. Sit up nice and tall with good posture. Extend your leg straight to activate your quads. Do this quickly. After you have your knee fully extended pause for 2 to 3 seconds. Then slowly lower your leg over a 5-second period. To review, raise the leg fast, hold for 2 to 3 seconds, and then lower it back slowly. This will give you the best results. Perform 10 to 15 repetitions for 2 to 3 sets.
Band Knee Flexion
Your hamstrings in the back of your thigh are also critical for balance and walking. Stand to perform this exercise. Loop a resistance band around your lower leg. Attach the other end to the leg of a chair or your bed. Keep a nice tall posture. Bend your leg behind you but keep your knee directly under your hip. All movement occurs at your knee. No movement occurs at your hip. Bend the leg fast, hold for 2 to 3 seconds at the top, and then lower it back slowly. Perform 10 to 15 repetitions for 2 to 3 sets.
Partial Wall Squats
Many people cringe at the word “squat”. You may have even had another healthcare professional tell you to never squat. Unfortunately, it is impossible to go through life without squatting. Every time you sit down or get into your car you are squatting. You might as well get better at it and learn to do it in a way that minimizes stress on your joints.
Stand with your back against a wall. Place your feet 12 to 18 inches out from the wall. With your arms crossed over your chest, slowly squat to a depth you are comfortable with. Start small and as you get strong you will go a little deeper. Be sure your knees stay in line with your hips and ankles. Don’t allow your knees to cave in. Hold the down position for 2 to 3 seconds, and then push up fast back to a standing position. Perform 8 to 12 repetitions for 2 to 3 sets.
Bridge
Your glutes are the key muscles that extend your hips to stand up or climb a flight of stairs. The bridge is a great glute exercise to start with. Begin by lying on your back with your hips bent and your feet lined up with your shoulders. Perform the bridge by lifting both your hips from the floor. A common mistake is to excessively arch your lower back. Hold the bridge position for 2 to 3 seconds then return to the starting position slowly over 5 seconds. Perform the lift fast but lower your body back down in a slow and controlled manner. Perform 10 to 15 repetitions for 2 to 3 sets.
Clam Shell
Your abductor muscles on the outside of your hip are important for stability when you walk, run, or climb stairs. When these muscles are not working properly, you walk with a side-to-side lean or lurch. This will increase joint stress and increase your risk for falls.
Lie on your side with your hips and knees slightly bent. Keep your feet together. Pace a resistance band around your thighs just above your knees. Start the exercise by rotating the top hip to bring the knees apart. Hold this position for 2 to 3 seconds and then return to the starting position slowly over 5 seconds. Be sure to remain completely on your side with one hip stacked on the other. Allowing the pelvis to roll back during the movement is the most common mistake with this exercise. Perform 10 to 15 repetitions for 2 to 3 sets.
Hip Abduction
Lie on your side with the bottom hip and knee bent. Keep your top knee straight. Maintain your top hip in neutral or slight hip extension. Point your toes forward to orient your hip properly. Initiate the movement by lifting your top leg about 30 degrees. Hold this position for 2 to 3 seconds. Then, slowly lower the leg to the start position over 5 seconds. Perform 10 to 15 repetitions for 2 to 3 sets. For those who struggle with this exercise, try standing instead of lying.
This exercise activates your gluteus medius to a greater level than the clamshell. However, it is also more challenging to perform correctly. Similar to the clamshell, it is important to remain completely on your side with one hip stacked on the other. Allowing the pelvis to roll back during the movement is the most common mistake. Also, as your muscle tires, your leg will drift forward into hip flexion. Maintaining your leg lined up or slightly behind your upper body is important.
Hip and Knee Arthritis: Get Started with Strength Training
The hardest part of any exercise program is getting started. Commit to performing these exercises a few times each week. You will see small changes after a few weeks. Expect to see the best results after consistently exercising for 6 to 12 weeks.
If you don’t feel like you can do it alone, call your physical therapist. The physical therapists at BSR are committed to helping you move without pain. Exercise is the first treatment for arthritis before resorting to drugs, injections, or surgery. We want to help you take control of your health and quality of life.
