Exercise

[JOALAN6758]

I am 52 and have wide spread arthritis I
Need a knee replacement, I want exercise but swimming hurts my knee and most gums
won't take me. What can I do.

[Arthritis Action]

There is no evidence that exercise can worsen osteoarthritis so gyms are being unfair if they won't take you. Exercise and losing weight are the two most important things that you can do to help yourself if you have osteoarthritis and will delay the need for surgery, so try speaking to your gym manager, or perhaps ask your GP for a letter to say that you are safe to exercise.

Dr Wendy Holden
Medical Advisor to Arthritis Action and Consultant Rheumatologist

Arthritis Action

56 Buckingham Gate
London SW1E 6AE

020 3871 7120
www.arthritisaction.org.uk

[Matthew Rogers]

It is very common for people with arthritis to experience symptoms in their knees, so you are not alone in this. There is a common misconception that if you have arthritis, exercise is somehow bad for you. In reality, this could not be further from the truth. You should always start off slowly and gradually build up but, research shows that becoming more physically active is extremely beneficial for those with arthritis. Strengthening the muscles in the front of the upper leg (the Quadriceps) has been proven to reduce the pain of knee arthritis in many people. Simple stretching exercises can help to improve the flexibility of the joints. Doing general exercises that helps to keep the heart and lungs healthy can reduce the progression of the condition in many cases and in some improve things considerable.

The charity Arthritis Action (https://www.arthritisaction.org.uk/livi ... exercises/) provides a number of free, very easy to follow exercise factsheets that you might want to try to start off with. For those who need a little more support, most GPs will have an agreement with a local health centre (the scheme is usually called ‘Exercises on referral’) that will offer you access to subsidised personal trainer sessions to build your confidence.

For people with knee pain specifically, there is an exercises programme called ‘ESCAPE-Pain’ (http://www.escape-pain.org/) that has 12 years’ worth of high quality research supporting it. This programme has been proven to reduce pain, improve your ability to perform daily activities and help with some of the psychological symptoms of arthritis such as low mood. It also includes self-management education sessions to enable you to understand your condition and take control. You can even download a free App from the App store to allow you to try it out at home. I highly recommend it.

If you feel that you need support from a medical professional, manual therapy such as osteopathy has also been proven to help in many cases, especially for knee arthritis. Find out more at https://www.iosteopathy.org/osteopathy-for-health/

There are also more resources on the http://www.nhs.uk/livewell/fitness/Page ... shome.aspx website. You can find an excellent YouTube video about preparing for hip or knee surgery at https://www.youtube.com/watch?v=xAL_TrQdtTY&t=7s

When beginning a new exercises programme, you should always start off easy and gradually progress as your ability and confidence improves. You might find it a little difficult at first, but if you persist you will see the benefit of keeping active.

[Tracy Corbett]

I agree with everything Matthew Rogers has set out and won't "reinvent the wheel", but can I just add:

- regarding swimming, yes that can be difficult for people with knee pain. If you have a suitable pool nearby, you could try walking laps instead. The water will reduce the impact on your joints, but will also provide some resistance which can help with your strength and cardiovascular fitness. Also, indoor pools tend to be quite warm which can also be pain relieving.

- it might be worth asking your GP to refer you to your local physiotherapist for an assessment. Your physiotherapist can assess you to identify any strength imbalances and can prescribe specific, targeted exercises which can help with pain and with daily function.