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Welcome to the very first post of 2016! We have writing for us today, Mrs Jillian Eyles, a researcher and physiotherapist at the Institute of Bone and Joint Research. Jill has had many years of experience in clinical physiotherapy at the Royal North Shore Hospital and has recently taken a strong interest in research about knee and hip osteoarthritis.

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We all know we should exercise for our general health, what you may not know is why exercise is so important in the management of knee osteoarthritis and which type of exercise is best.

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How will exercise help my knee osteoarthritis?
People are often concerned that exercise will cause further damage to their osteoarthritic knee. Rest assured this is a myth! In fact, clinical research has proven that exercise is an effective treatment for knee osteoarthritis and the benefits include:

- Reduction in knee pain
- Improved ability to move around normally
- Improved quality of life
- Reduction in the knee feeling like it is ‘giving way'
- Improved mood
- May assist in weight loss (if required)
- May even help slow down the disease process

So, what is the right type of exercise for my knee osteoarthritis?

Strength training:
Muscles around the knee and hip stabilize the knee and help maintain normal postural alignment during walking and other activities. Muscle weakness is common in knee osteoarthritis. Some muscles become so disused they fail to fire altogether. Strengthening exercises help to build up weak muscles around the hip and knee to protect the knee from forces that load and stress the cartilage.

Strengthening exercises need not require a gym or fancy equipment; some exercises can be performed using your bodyweight alone. You may even prefer to complete your strengthening program in the pool (hydrotherapy or aquatic physiotherapy). The effects of an intensive strengthening program may be felt for up to 6 months, but an ongoing strength maintenance program is recommended for lasting effects.

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Neuromuscular control:
Neuromuscular control is a form strengthening exercise based around everyday movement. People with knee osteoarthritis often adapt their movement patterns to compensate for their knee symptoms. These abnormal movement patterns can cause further weakening of key muscles leading to pain and disability. Exercises that improve the control of the knee during movement also strengthen the muscles around the knee joint and thus help to reduce symptoms of knee osteoarthritis. These exercises are particularly important for those people with osteoarthritis behind the knee-cap.

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Flexibility training:
Often osteoarthritic knees feel stiff. However the loss of movement in the knee is not caused by the joint alone but also often involves the muscles. Stretching exercises aim to improve the flexibility of the body by stretching out tight muscles, joints and other tissues. This may lead to improvements in pain. Stretching can be incorporated into any exercise program, or you may want to take a class that focusses on flexibility such as yoga.

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Fitness training:
We all know that aerobic exercise is good for our heart health; research shows that it is also good for our knees and mental well-being! Aerobic exercise may also help us to shift unwanted kilos that make the pain from knee osteoarthritis a whole lot worse. Low impact activities such as walking, swimming, cycling, aerobic exercise classes and aquafitness are good choices. Aim to include at least 30 minutes of physical activity (at the level of a brisk walk) every day.

There seem to be so many types of exercise I can do- which is the best choice?
Current research suggests that a combination of strength, fitness and flexibility training is the most effective way to reduced pain and improve your ability to move around (and do the things you enjoy!). You may want to mix up the type of training that you do so that it doesn’t become a chore. The best choices of exercise type are the ones that you enjoy, and if you exercise with a friend or two it may double up as a social activity- anyone for coffee after?

How do I start exercising for my knee osteoarthritis?
It is important to seek advice from a health professional before you start an exercise program. Ask your physiotherapist or GP to help get you started with an exercise program that is right for you!

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