Physician Q & A

Knee Exercises

Watch our short videos of exercises for people with OA of the knee.

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Dr. Nicholas DiNubile is an orthopaedic surgeon specializing in sports medicine. He has a private practice in Havertown, PA, and is Clinical Assistant Professor of the Department of Orthopaedic Surgery at the Hospital of the University of Pennsylvania. He has also authored FrameWork: Your 7 Step Program for Healthy Muscles, Bones and Joints.

Q: What kind of effect does exercise have on OA of the knee?

A: If all the benefits of exercise could be put into a single pill, it would be the most widely prescribed medicine in the world. In terms of joint health, exercise has a dual effect: lubrication and nourishment of the joint surface. Specific leg exercises can build the important muscles around the thigh. When you have arthritis, the joint’s internal shock absorbers are failing. So it relies much more on the external shock absorbers: the muscles.

Q: How can SYNVISC® help?

A: SYNVISC has been so helpful to me in managing my patients with knee arthritis. SYNVISC allows people to get more active, in a very safe and pill-free way. I tell my patients, if we can get them pain relief, that’s when we can start doing things that have longer-term benefits to your knee. Like exercise and strengthening your knee. Like losing weight. Every pound you lose, your knee thinks you lost five. So if you lose ten pounds your knee will start feeling better. And even small amounts of weight loss have been shown to lessen or even halt the progression of osteoarthritis. SYNVISC gives me the opportunity to comfortably activate patients who, prior to SYNVISC, were caught in a vicious cycle of pain and inactivity.

Q: Is it normal to experience pain during exercise?

A: When you have arthritis, one of the common complaints is that it hurts too much to exercise. But exercise done right shouldn’t be painful. With certain exercises, you have to stick with them and build strength and flexibility back into your joints — with the end result being improved function and less pain. There may be a little discomfort, but once people know they’re not doing harm, they can usually work through it.

Q: With arthritis, joint stiffness is a common complaint. Are there exercises that can help with stiffness and motion loss?

A: Depending on your type of arthritis, you may need to avoid certain exercises and add some different ones. For instance, range-of-motion exercises, like gently straightening or bending the leg, focus on the mobility of an arthritic joint. They’re different than stretching exercises, which actually lengthen the muscles or tendons. Range-of-motion exercises maintain or regain mobility and decrease joint stiffness and flexibility.

Q: Are some exercises better than others?

A: Overall, exercise is wonderful for arthritic joints, but all exercise is not created equal. For example, in terms of cardiovascular or aerobic exercise, if you have arthritis of the hip, knee or ankle, you should avoid higher impact activities like running and jumping. Walking is good, but some individuals with more advanced arthritis have difficulty even with that. So for them I recommend water aerobics or swimming, or even using a stationary bike or elliptical machine. Strength training is also important for arthritis, but one must be careful not to overload the joint. Check with your doctor or physical therapist about safe and effective exercise routines that are ideal for arthritis sufferers.

Q: Does exercise help during every stage of OA?

A: Absolutely. If you have early-stage osteoarthritis, exercise is important in terms of maintaining joint health and even preventing progression. If you have late-stage OA, it’s still a good idea. It will improve your function and even reduce pain levels if you stick with it. Even if you need knee replacement surgery, you’re going to do better if you’re in better shape. You’re going to come out of the surgery and recover quicker, with a better overall result.