Is Cycling Good For Arthritic Knees?

Here in the UK as well as around the world, people with arthritis regularly suffer from excruciating pain. When arthritis develops in the knee joint, in addition to the pain an eventual deterioration of the joint that occurs, this ultimately leads to disability. The pain of the knees from arthritis can begin suddenly, but it is far more likely to develop slowly over time. Nevertheless, once it starts arthritic joints worsen progressively and inexorably.

There is no known cure for arthritis; however, there are various treatment options which vary depending on the type of arthritis, and these include but are not limited to physical therapy and exercise and pain relief gels. Cycling is often considered a viable therapeutic exercise alternative for patients with knee arthritis. However, individuals suffering from the arthritic pain of the knee often feel that exercise is the last thing they should do. The question then becomes how effective is cycling at treating arthritis of the knee?

ARTHRITIS BY ANY OTHER NAME

Arthritis is an umbrella term that is often used to describe any one of more than 100 disorders that affect the joints. Arthritic disease is characterized by pain, swelling, and decreased the range of motion of the affected joints. Any type of arthritis can cause severe knee pain and a loss of motion. Nevertheless, the two most common ones involved in knee pain are osteoarthritis and rheumatoid arthritis.

Osteoarthritis of the knee is an extremely common rheumatologic disease. By most estimates, over 30% of the female population experiences osteoarthritis to some significant degree. The disease is characterized by severe pain, stiffness, and decreased the range of motion of the knee joint. Essentially, osteoarthritis is acquired through wear and tear of the cartilage joint caused by years of daily motion. However, the disease can develop suddenly as a direct result of an injury.

Osteoarthritis of the knee occurs when the cartilage cushioning the joint wears down to the point that the two opposing bones being to rub and erode into each other. Although initially, the pain is minor and intermittent, it eventually becomes continuous and occurs even while at rest. The most relevant risk factors for osteoarthritis of the knee include obesity and a sedentary lifestyle.

Rheumatoid arthritis of the knee is a chronic autoimmune inflammatory disease. Rheumatoid arthritis is characterized by a systemic painful swelling of the joints. Multiple other symptoms typically develop such as fatigue, slight fever, reduced appetite and sudden weight loss. Extra-articular symptoms, which usually occur when the disease is already established, mainly affect the skin, blood vessels, heart, lungs, eyes, and blood.

The most frequent initial symptom is morning joint stiffness which occurs after nighttime rest and involves a considerable difficulty in movement. The evolution of the disorder is very variable, since in some people the progress stops spontaneously, while in others it progresses throughout life.

In the absence of timely and adequate treatment, an arthritic disease can cause, in advanced stages, important physical limitations, as well as a marked deterioration of the quality of life. The best therapeutic results are achieved when an early diagnosis is made, and treatment is established in the initial phases of the disease.

Bill is definately not letting his Arthritis get in the way of enjoying his cycling at 73 years of age!

THE EFFECTS OF CYCLING ON ARTHRITIC KNEES

In the case of osteoarthritis, the American College of Rheumatology has recommended that exercise is included as a fundamental method of treatment. All the evidence suggests that patients with osteoarthritis of the knee are able to safely perform aerobic exercise and obtain a beneficial effect, improve functional status, and significantly lower pain and the risk of disability. The pertinent question then is what is the optimal intensity, frequency, and duration of said exercise and the modality that can be performed to produce the greatest functional improvement to the joint while producing the least amount of pain.

Most aerobic trial studies on subjects with osteoarthritis have used walking as the primary modality for exercise; however, recent kinesiological studies suggest that the forces generated on the knee while cycling are no greater than they are for walking. Furthermore, studies have consistently shown that low-intensity aerobic exercise can be as beneficial to improving functional status of the arthritic knee as high-intensity exercise. Are you experiencing Pain after cycling and exercise? Find out here what you can do about it.

In one recent study performed out Beaver College in Pennsylvania concluded that after only 10 weeks fo stationary cycling, patients with osteoarthritis of the knee manifested improvements walking speed, pain relief, and in aerobic capacity. Furthermore, no acute pain was reported by any patient after daily sessions of cycling. These results suggest that when performed properly, such as elevating the bicycle seat to minimize knee flexion and pedal load, cycling can provide patients with osteoarthritis inexpensive, year-round accessibility to therapeutic forms of exercise.

In the case of rheumatoid arthritis, the American College of Sports Medicine suggests that adults accumulate at least 30 minutes of moderate intensity physical activity every day of the week. Apart from the general health benefits of exercise in the general population, exercise has repeatedly been demonstrated to have specific health benefits in patients with rheumatoid arthritis.

When comparing the effectiveness of high and low-intensity exercise, a recent study found that low-intensity exercise was just as effective in increasing aerobic capacity, muscle strength, and joint mobility and function while creating no detrimental effect on the disease and its progression. Furthermore, the periods of compression and decompression achieved through the mechanical forces and regular loading of cycling can aid in the prevention of fragility of cartilage.

All in all, cycling exercise significantly improves both, the range of motion and joint flexibility, therefore reducing movement limitation in patients with arthritis of the knee. Arthritic patients are generally less physically active than the general population; thus it is imperative that we understand the patients’ perceptions and prejudice regarding exercise. All forms of aerobic exercise are able to improve overall function and muscle strength without any confirmed detrimental effects. It is our duty to inform patients of the potential benefits of cycling in the treatment of arthritic disease.

REFERENCES:

Felson, David T. “Osteoarthritis of the knee.” New England Journal of Medicine 354.8 (2006): 841-848.

Michael, Joern W-P., Klaus U. Schlüter-Brust, and Peer Eysel. “The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee.” Deutsches Arzteblatt International 107.9 (2010): 152.

Steinbrocker, Otto, Cornelius H. Traeger, and Robert C. Batterman. “Therapeutic criteria in rheumatoid arthritis.” Journal of the American Medical Association 140.8 (1949): 659-662.

Firestein, Gary S. “Evolving concepts of rheumatoid arthritis.” Nature 423.6937 (2003): 356.

Karper, William B., and Blanche W. Evans. “Cycling program effects on one rheumatoid arthritic.” American journal of physical medicine 65.4 (1986): 167-172.

Deanna Westby, Marie. “A health professional’s guide to exercise prescription for people with arthritis: a review of aerobic fitness activities.” Arthritis Care & Research: Official Journal of the American College of Rheumatology 45.6 (2001): 501-511.

Arthritc Knees (Oesteoarthritis)