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What exercise is best for people with knee arthritis?

Q. What kind of exercise is best for people with knee arthritis?

A. Knee osteoarthritis is a gradual wearing away of cartilage cushioning the joint, which causes the bones to rub together, leading to pain, swelling, and joint stiffness. Some people with arthritis tend to avoid exercise if they’re in pain, or out of fear of worsening the cartilage loss. But exercise is actually a key part of physical therapy for arthritis. “We do find that when people start to get active under supervision, they start to have less pain,” says Dennis Nutini, a sports medicine physician and medical director of Spaulding Outpatient Center in Brighton.

Nutini says that it’s important to get an individualized exercise plan from a clinician, because knee arthritis is highly variable and recommendations depend on which part of the knee joint is affected, how severe the deterioration is, how much pain you feel, and your own personal exercise habits.

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People with arthritis are often advised to avoid high-impact exercise such as running. Activities such as swimming, water aerobics, biking, or using an elliptical or ski machine can all give you a workout with less knee stress. But Nutini says that he avoids asking patients to limit exercise they enjoy if they tolerate it well without pain. Another approach is cross-training -- alternating between different activities over the course of a week or month to avoid a single one that could stress a joint. Physical therapists can also prescribe specific exercises for strength and flexibility that can help you manage arthritis.

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