It’s normal to limit movement in the face of musculoskeletal pain. Unfortunately, doing so will weaken the affected area’s muscles and joints which can prolong discomfort and increase the likelihood of potential injury. Knee-arthritis patients often fall into this pit. So, in the presence of knee osteoarthritis, what sort of exercises are best for enhancing knee strength?
First, let’s describe two muscle activity types that can occur during exercise: eccentric and concentrated. In a bench press the muscles in the chest shorten in a coordinated motion as you move the barbell upwards. When you lower the bar downwards, lengthen the pectoral muscles, which is an eccentric motion.
A 2019 study involving 54 seniors with knee osteoarthritis studied which of the two phases develops greater strength for the knee – the concentration / muscle shortening process or the process of muscle lengthening. Participants were divided into three groups: CNC RT (concentric resistance), ECC RT (eccentric resistance), or CON (exercise / wait-list group control group). The two exercise groups provided four months of supervised exercise training using conventional weight machines with correct configurations and guidance that stressed the focused or eccentric phase of the exercise.
Participants completed questionnaires each week to assess knee pain and disability. The researchers also reported the maximum weight that could be lifted by each subject with respect to knee flexion, knee extension and leg push.
The findings showed that the strength increases encountered by both exercise groups as opposed to the control group, with the eccentric resistance group making greater improvements in the exercises of leg pressing and knee flexion, but not for knee extension. Both classes of exercise have reported less pain and handicap than the control group. The authors concluded that both modes of resistance training effectively improved leg strength, pain, and function and suggested that the style preferred by an individual should be focused on personal preference, priorities, tolerance, and availability of equipment.
All exercise groups have indicated less pain and impairment than control. This research is a perfect example of the many advantages that exercise can offer to an elderly population with osteoarthritis in the knees. In addition to offering manual therapies, modalities, orthotics (knee braces and foot orthotics), as well as dietary and nutritional advice for stress reduction and pain control purposes, Osteopaths also recommend exercises for patients with knee pain. You owe it to yourself to look for less intrusive treatment methods first before throwing in the towel and rushing to a complete knee arthroplasty (replacement).