There are elderly people in every family. After a lifetime of hard work, now that their children and grandchildren have grown up, they have not had time to enjoy the blessings, but various diseases have begun to “find” them. High blood pressure, diabetes and this kind of okay, the most unbearable for the elderly, but also the greatest impact on the quality of life, is the knee problems. This is especially true for middle-aged and elderly women. Most of them have osteoarthritis in their knees from menopause onwards, and some of them even earlier.

Younger people may not appreciate the pain and inconvenience that comes with having bad knees at an older age. Many of my patients often tell me that they wake up in the middle of the night with pain and can’t move their knees at all when they wake up in the morning.

It is difficult to go to the toilet at home, not to mention traveling. You can imagine how the quality of life and well-being of middle-aged and elderly people with bad knees are affected by the severe pain they have to endure even when squatting on the toilet.

It can be said that osteoarthritis of the knee is a disease that almost every elderly person gets. Just as there are wrinkles on the face, our knees will, sooner or later, age and become diseased in different ways. And, we all age, and one day, you, me, will face such a problem.

For that matter, osteoarthritis of the knee. I believe that no one wants to come up and have surgery to replace the joint. So everyone will choose conservative treatment. Today, let’s talk about, osteoarthritis of the knee, the most important aspect of maintenance or conservative treatment, no one: exercise.

Here comes the truth

1. Is it better to rest or to exercise?

The answer is very clear.

Even if your knee is worn out, it’s better to be active than inactive!

Don’t think: “Bad knees are worn out, so I’ll just rest and try to reduce wear and tear”. I have met many people with bad knees who avoid activity as much as possible to prevent knee pain. Almost without exception, they find that their joints are getting stiffer and their legs are losing strength, while the pain is not reduced by inactivity, but rather it hurts more to walk.

Virtually all textbooks, guidelines and professional orthopedic surgeons, both foreign and domestic, recommend that

Patients must remain active to maintain and increase joint mobility and periarticular muscle strength as much as possible.

Authoritative studies have found that, in patients with osteoarthritis of the knee, the use of individualized and moderate exercise not only does not aggravate joint pain, but rather relieves joint pain and discomfort and even significantly improves the function of the knee joint.

In addition, exercise, not only prevents joint stiffness and muscle atrophy, but also plays an important role in weight control, cardiovascular health and the prevention of coronary heart disease.

Of course, exercise must be “appropriate”!

I know that many scientific articles recommend appropriate exercise, but they may not tell you exactly what kind of exercise is appropriate. Today, I’m going to tell you what kind of exercise is safer and how much exercise is “appropriate” for people with bad knees, even those with different levels of severity. How much exercise is “appropriate”?

2. What specific exercises are appropriate?

Although, different people with different conditions, there are individual differences. But I will still give advice that is applicable to the majority of people.

Please keep in mind.

Swimming, walking and cycling are low-impact or no-impact forms of exercise [1], and many people with arthritis can safely perform these exercises.

In fact, although swimming, walking and cycling are already relatively safe, people with bad knees may need to make some adjustments before performing these activities, such as longer warm-up and relaxation exercises than the general population.

In addition, as people get older, muscle function itself will slowly decline, coupled with the involvement of lesions, so many people with bad knees, the muscle strength around the knee is very weak. This makes the knee more unstable and more prone to wear and tear. Therefore, deliberate thigh muscle strength exercises are very important.

Therefore, we would generally recommend that

Patients with bad knees, in addition to maintaining daily aerobic exercise such as walking, swimming, cycling, etc., should also perform a safe and effective thigh muscle exercise exercise such as squatting against a wall and straight leg lifts in a flat position.

For the wall squat, not necessarily to squat to 90 degrees of the knee, all exercise to not cause pain shall prevail. If the squat to 90 degrees feel pain, then stand up point, the knee joint to maintain a certain angle also has the effect.

Finally, there is a point that needs to be solemnly stated.

Exercise, is not limited to the exact physical exercise program, but also the usual easy chores and life activities that are good for the joints.

It is true that some patients are not interested in formal exercise programs. But it’s not just formal sports that are effective. In fact, middle-aged and older adults with bad knees are encouraged to engage in moderate-intensity lifestyle physical activities: including easy housework, shopping, gardening, cleaning sidewalks and driveways, babysitting, caring for the elderly, leisurely walks, and in-pool exercise [2].

Now, you know which exercises are safe and effective. So how much exercise and how often, to be considered appropriate?

3, the amount of exercise, how is considered too much?

As we all know, although not exercising is not good, but exercising too much is also not good, it can increase wear and tear and disease. So, how do we, the people, determine whether their activity is excessive?

Although people are different and the severity of their condition is different, many scientific articles will not tell you how much exercise is considered excessive, but today I want to teach you an authoritative, but particularly simple way to judge, that is.

“2 hours of pain principle”

The [2-hour pain principle], was proposed by the American Arthritis Foundation and the Arthritis Self-Management Course [3, 4] to until arthritis patients usually exercise moderately. Although different time frames have been proposed in the literature, the “2-hour pain principle” is currently more commonly used.

The 2-hour pain principle means that.

If a patient has pain in the diseased joint for 2 hours or more after exercise, this means that he or she is overactive.

We, the people, can apply this 2-hour pain rule to help us assess whether we are exercising too much. If the pain reaches 2 hours after exercise, it means that it is time to reduce the amount of exercise.

4, pay attention to “rest”

Although we are reminded to exercise, but in the end I still want to remind you of the importance of “rest”.

Friends with bad knees, should deliberately arrange rest breaks during the day. These breaks give our joints a chance to catch their breath and repair themselves, thus avoiding pain and inflammation.

Of course, rest is more than just “stopping”; alternating heavy and light tasks is another way to relieve stress on the joints. Many people with bad knees deliberately alternate between sitting and standing activities to reduce joint strain. If it’s a job that requires sitting all day, we can get up and walk around and stretch the joints periodically. If the job requires standing in one place for a long time, put a piece of wood on the floor and alternate between the two feet on the wood to reduce strain.

We all have elderly people in our homes. One day, we will all grow old and have knee problems of one kind or another. I hope this article will be of help to you and those around you. For more interesting and useful medical science knowledge, you can follow Dr. Lu Yao, an orthopedic surgeon.

Finally, 2019, may everyone be happy, happy and healthy.