Marian Minor, Physical Therapist, Ph.D.: In all of the physical modalities for treatment of osteoarthritis of the hip or knee, exercise really is the one that is the most effective at managing and reducing pain.
Dr. Roy Altman: It seems like a paradox, but people with osteoarthritis need to be active. That is, they need to improve muscle tone around the joint -- it actually protects the joint.
Dr. Roland Moskowitz: If you strengthen the muscles and stabilize the joint, you decrease the instability of the joint. Instability breeds more instability. Eventually, that's going to make more osteoarthritis. So that you're stabilizing the joint by strengthening the muscles and actually will lead to less pain and disability.
Marian Minor, PT, Ph.D.: And we know that people who have OA of the hip and the knee can successfully use walking as an exercise to improve their general health and to lessen the effects of arthritis, but they also might try getting some experience with swimming or bicycling -- other forms of exercise that will let them maintain the exercise habit.
Dr. Moskowitz: What I tell patients -- don't jog because that's an impact loading. Swimming -- an excellent exercise for knee or hip disease. You've got the buoyancy to help you, you've got the act of sort of assistive motion, help of the water, and you're not putting weight on the joint that's involved.
Marion Minor, PT, Ph.D.: You can break your exercise session up into 10 minutes, three times a day and you get the same benefit as if you exercise for 30 minutes all at once. We used to think that isometric exercise, or the kind of strengthening that you did when you didn't move the joint, that you just held the joint in one position and tightened the muscles around it, was the best and the safest thing. However, now we know that isometric exercise can really increase the joint pressures, so now we're recommending strengthening with dynamic, or moving, activities. We find that people who are exercising and continue to exercise for longer than, say, six months, are exercising because they like the groups they're with, they enjoy being with the people. If we can help people put the social component into their programs, we'll be able to help them maintain good habits longer.
Therapist: What we want you to do is straighten out your leg...
Marian Minor, PT, Ph.D.: We know that if a physician or a health care provider encourages someone to exercise, that's very important. If that same professional asks them when they seem them again, "How are you doing? What are you doing? Let me see -- how is it working?" So they get some continuity of that advice and they get some reinforcement that this is important, that's a powerful tool to helping people stay up with an exercise program. And then the final kind of exercise is one that we didn't used to think about for arthritis patients but we know now is important for everyone, and that's the cardiovascular, or the aerobic, exercise.