“Bad knees” is a broad term. The culprits behind joint pain tend to be:

• Osteoarthritis
• Old injuries
• Repetitive or overly forceful movements during sports or work
• Posture problems
• Inactivity

In general, avoiding motions that cause discomfort, will not erase the pain, at least not in the long term. In fact, limiting your movements can weaken muscles, affect your posture, setting off a cascade of further problems.

Our joint cartilage needs motion to stay healthy. A special fluid, called Synovial fluid is stored in cartilage like water in a sponge. When the joint is used, the Synovial fluid excretes from the cartilage and delivers nutrients and lubrication to the joint.

How exercise can help

Exercise strengthens muscles and stronger muscles provide better support and stabilization to joints, which in turn reduces pain. Exercise also releases endorphins, the body’s natural pain killers.

Exercise is considered the most effective non-drug treatment for reducing pain and improving movement in osteoarthritis.

What kind of exercise

In general, running and plyometric (i.e., jumping) exercises should be avoided because of being of high impact.

Three kinds of exercise are important for people with joint pain: exercises involving range of motion, also called flexibility exercises; endurance or aerobic exercises; and strengthening exercises. Each one plays a role in maintaining and improving your ability to move and function.

Range of motion: Range of motion refers to the ability to move your joints through the full motion they were designed to achieve. Range-of-motion exercises include gentle stretching and movements that take joints through their full span. Doing these exercises regularly – ideally every day – can help maintain and even improve the Range-of-motion of your joints.

Aerobic/endurance: a regular routine of low-impact aerobic exercise improves cardiovascular fitness, reduces fatigue, helps control body weight and can improve mood and quality of sleep.

Strengthening: Strengthening exercises help maintain and improve your muscle strength. Strong muscles can support and protect joints better.

Importance of body weight

Excess of body weight may present additional stress for your joint, especially for hips and knee. Easing the pressure on joints by losing some pounds may not only reduce pain in affected joints, but also help you feel and move much better.

Any exercise routine should typically be preceded by a 10 minute warm-up activity, which increases blood flow and literally warms up the body, making muscles more flexible. After a workout, some people may need to apply some ice to reduce swelling and relieve discomfort.
If any pain is felt during exercises, stop and seek advice from a healthcare professional or an appropriately qualified trainer before continuing.

An individual with chronic pain should always work with a health care provider or an exercise specialist to design an exercise plan that meets his or her specific needs and physical challenges.

References
• American Geriatrics Society Panel on Exercise and Osteoarthritis Exercise prescription for older adults with osteoarthritis pain: consensus practice recommendations.J Am Geriatr Soc. 2001;49:808–823 American College of Rheumatology 2012
• Hochberg mc et al. Recommendations for the Use of Nonpharmacologic and Pharmacologic Therapies in Osteoarthritis of the Hand, Hip, and Knee. 2012, American College of Rheumatology
• Rahnama n et al. Effects of Strengthening and Aerobic Exercises on Pain Severity and Function in Patients with Knee Rheumatoid Arthritis. Int J Prev Med. 2012 Jul; 3(7): 493–498.
• Iversen M et al. Managing Hip and Knee Osteoarthritis with Exercise: What is the Best Prescription? Ther Adv Musculoskelet Dis. 2010 Oct; 2(5): 279–290.

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