As of: January 28, 2024 8:34 a.m
For a long time, intensive exercise was considered taboo for osteoarthritis in the knee. But studies show that exercise can delay artificial joint replacement and prevent osteoarthritis. Which sport is suitable?
Osteoarthritis is a chronic, progressive joint disease in which the joint cartilage becomes increasingly damaged. Surrounding ligaments, muscles and the joint capsule are often also affected. Osteoarthritis is particularly common in the knee joint. Then we speak of gonarthrosis.
VIDEO: Which exercises help with osteoarthritis in the knee? (5 mins)
Development of gonarthrosis: diverse causes
The causes of the disease are varied: Anatomical misalignments, such as axial misalignment of the legs (e.g. X- or O-legs), mechanical overload or a previous trauma can promote arthrosis in the knee. But inflammatory joint diseases such as rheumatoid arthritis or weakness and imbalance in the surrounding muscles can also precede gonarthrosis. The risk of developing the disease increases with increasing age and body weight. Women are affected more often than men.
Strong and balanced muscles protect against osteoarthritis
The surrounding muscles that move the knee play an important role in the development and protection against osteoarthritis. They should be strong and balanced among each other. Then the movement of the knee also runs particularly smoothly. The extensors, flexors and external and internal rotators are important for this. If they are trained too weakly or unevenly, there is a risk of cartilage wear due to the increased or incorrect load.
Common: Strong extensors and weak flexors
The only extensor of the knee joint is the quadriceps, which can be easily felt on the front of the thigh. The kneecap is embedded in his tendon. The flexors are located on the back of the thigh.
In many people, the quadriceps are significantly more trained and developed than the flexors of the knee joint. This is not surprising, because the quadriceps enable us to stand upright; they work against gravity all the time when standing. The flexors, on the other hand, are usually less challenged.
Study shows: exercise reduces the risk of developing osteoarthritis
Researchers from Chicago followed almost 1,200 people at risk of osteoarthritis in a ten-year study. They divided these into four groups: occasional athletes, active athletes, athletes and non-athletes.
The result was clear: 13 percent of all test subjects developed osteoarthritis during the study period. In comparison, the casual and active athletes had a lower risk of developing osteoarthritis. Among non-athletes, the risk of osteoarthritis was 15 percent, above average. Only the athletes could neither reduce nor increase their risk of osteoarthritis. This means that intensive and strenuous sport does not protect the knee from developing osteoarthritis, but does not promote it either.
Osteoarthritis in the knee: Strong muscles instead of a prosthesis
Strong and balanced thigh muscles are not only important for protecting against osteoarthritis. It is also important if you already have osteoarthritis in your knee. Strong thigh muscles can then prevent you from having to rely on an artificial knee joint or delay the timing of this.
This is shown, for example, by American research results that were presented at the annual meeting of the Radiological Society of North America (RSNA) in 2023. The researchers examined 134 patients with gonarthrosis, half of them with an artificial knee prosthesis and the other half without, and were able to determine: Weak muscle groups increase the risk of a knee prosthesis. However, a good ratio of extensor and flexor muscles reduces the risk.
Exercise relieves pain from osteoarthritis
Naturally you try to protect a painful joint. However, this is only recommended in the acute stage of inflammation when it is red and swollen. Those affected should start with light exercise and carefully approach the right intensity. Total protection is poison: Over time, a lack of movement makes sick joints even stiffer and more painful because the surrounding ligaments shorten and become inflexible. Exercise, on the other hand, strengthens the supporting muscles and promotes blood circulation. In addition, the important synovial fluid is only pumped through the cartilage when there is movement, i.e. loading and unloading. It nourishes the cartilage and keeps it supple.
Knee osteoarthritis: Test surrounding muscles
To accurately assess the surrounding muscles, doctors often carry out a manual muscle strength test, measure the muscle circumference or carry out a device-assisted isokinetic strength measurement.
A good test to find out for yourself how your own knee-stabilizing muscles are doing are the following two exercises:
For the flexors: Bridge while lying down – lying on your back on the floor, your feet up with your knees bent, then lift your butt and thighs so that your torso and thighs form a line and your knees are bent at around 90 degrees / you can also do it with one leg, leaving the second leg stretched For the stretcher: Squats – with approx. 90 degree bend in the knees / sitting and getting up from a chair without the help of the arms. The knees should not be pushed forward, but should remain behind the tips of the feet.
If both exercises are fully possible, that’s a good sign. If you notice weakness or difficulty performing the exercise, this could be a sign that the muscle group is too weak.
Knee osteoarthritis: exercises for the surrounding muscles
Strength training is the best way to strengthen the muscles around the knee. It can be used both for prevention and for existing osteoarthritis. It is important that the knee joint can still be fully extended. If this is not the case, mobilization must take place first.
Both the lying bridge and the squats (if necessary with the help of a chair) are particularly suitable exercises. To do this, repeat both exercises up to 30 times per minute.
This sport is allowed if you have osteoarthritis
In principle, almost all sports are permitted if you have osteoarthritis in your knee. Important:
Every sufferer has to find their own individual measure. There should be no pain when exercising. It is advantageous if the sport was practiced before the illness. Then the body knows the movement patterns and dangerous situations can be better recognized and avoided.
These sports tend to be problematic if you have osteoarthritis
Caution is advised in sports where the knee is typically exposed to strong shear forces or there is an increased risk of injury, for example:
Tennis, squash or football, particularly fast games, martial arts, downhill skiing, windsurfing and surfing
It is possible to (re-)enter such sports, but only recommended if the knee has already been stabilized and the surrounding muscles have been strengthened.
Experts on the topic
Head Physician Center for Rehabilitation Medicine and Interdisciplinary Sports Medicine
BG Klinikum Hamburg
Bergedorfer Straße 10
21033 Hamburg
Specialist in orthopedics and trauma surgery
Eidelstedter place 1
22523 Hamburg
Further information
Multimodal therapy can help with chronic knee pain – with targeted exercise, physiotherapy and psychotherapy. more
A special device is designed to detect noises in the knee that indicate osteoarthritis. Doctors hope to be able to detect and treat joint wear earlier. more
Stiffen the joint or insert an artificial joint? Which therapy makes sense for osteoarthritis in the ankle? more
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Visit | 01/30/2024 | 8:15 p.m