Exercise & Arthritis

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Q1: Because of osteoarthritis in my knees and hips, exercise hurts. Any

suggestions for activities that can keep me in shape without causing

pain?

Q2: I have had both knees replaced and would like to find some

low-impact exercises that I could do to help me build muscle and

maintain a healthy weight. What do you recommend?

A: While having osteoarthritis or artificial joints does put some

restrictions on the physical activities you can engage in safely, there

are still several types of exercise that can help you stay in shape

without added pain. Osteoarthritis, a degenerative joint disease, is the

most common form of arthritis and occurs when the cartilage — the part

of the joint that cushions the ends of bones — breaks down. As the

condition worsens, movement becomes painful and joints swell.

Osteoarthritis most commonly affects the knees, spine, hips, fingers and

feet. According to the Arthritis Foundation, osteoarthritis affects an

estimated 20.7 million Americans, and more often women than men.

Knee replacement — implanting artificial joints to replace your natural

joints — can be the choice for someone whose arthritis is so painful or

advanced that functioning normally on a day-to-day basis becomes

extremely difficult. More than 245,000 knee replacements are performed

each year in the United States, and as baby boomers age, that number

will no doubt grow even larger.

The usual treatment of osteoarthritis includes anti-inflammatory

medication, “but it certainly helps to maintain weight and

cardiovascular fitness,” says Dr. R. Lucie of the ville

Orthopaedic Institute in ville, Fla., and head team physician for

the NFL’s ville Jaguars. Extra weight adds to the stress on the

joints. And long periods of immobility can cause the joints to stiffen

and the surrounding muscles to atrophy, he says.

For people with osteoarthritis or artificial joints, Lucie recommends

low-impact routines such as swimming and water aerobics, which eliminate

most of the stress on the knees and are an excellent means of staying

fit. Next on the list of exercise options are walking and stationary or

regular bicycle riding. But be cautious with “power walking,” which may

cause too much pounding on the knees. Lucie also suggests trying an

elliptical trainer. The leg motion — a kind of long oval pattern made as

your feet, resting on platforms, gently go up and down, is much less

stressful on the joints than running or high-impact aerobics — both of

which are not advised.

Experts also recommend resistance training to build muscle as well as

gentle stretching before and after your routine. Remember to always

check with your physician before embarking on a new fitness regimen. Any

exercise routine should be set up in consultation with both your

physician and a physical therapist, certified athletic trainer or

certified personal trainer who is knowledgeable about the issues of

arthritis and joint replacement. Another resource to consult is the

Arthritis Foundation Web site at www.arthritis.org, where you can find

advice on exercise, nutrition and more.