There is a popular opinion that exercise wears out knee cartilage faster, much like driving further can wear out tyres. Many health providers advise their patients that a diagnosis of mild arthritis should mean that they should stop strenuous physical activities, especially running. But is this true?
There are recent studies which suggest that continuing physical activity in fact has a positive effect. Some of this effect is due to a reduction in weight, which can dramatically reduce stress on joints. However, the cartilage itself requires movement and loading to remain healthy, and studies have shown that cartilage quality in osteoarthritic patients is in fact enhanced by exercise. Cartilage actually deteriorates faster when it is not loaded!
A study in 2015 from Finland showed that in postmenopausal women who underwent a progressively implemented high-impact and intensive exercise program had improved cartilage quality on MRI analysis when compared with a control group. Another study in 2011 which looked at the volume of cartilage loss in patients with arthritis following an exercise program. Although the number of patients was low, it showed a small decrease in the volume of cartilage after 6 months, but most pronounced in patients with a higher BMI. The majority of patients did not show a decrease in cartilage volume.
The typical course of arthritis in most people is episodic. There are periods of increased pain, and periods of less or no pain. I recommend reducing physical activity during exacerbations of arthritis and using simple pain relievers during this period if necessary. During periods of little or no pain, patients should remain active and participate in any physical activity which they enjoy; it is far easier to regularly perform an enjoyable activity than one which is a chore.
In patients with degenerative meniscus tears, many patients respond well to an exercise program, with an effect comparable to that of surgical removal of the tear.
Research on the best type of exercise has in fact shown no difference in the benefit between types of exercise in terms of their benefit on joint health. High intensity vs low intensity, and cardio vs resistance exercise – there is no difference. Just choose something you enjoy!