Weight Training With Osteoarthritis

Weight training, which involves using weights while you exercise, can help a person strengthen their muscles, including the ones surrounding the joints. Strong muscles help in stabilizing the joints. While that makes sense and sounds like something we all should be doing, you may wonder whether weight training is appropriate for people with osteoarthritis.

Before we answer that question, let's sort out some terms that are often used interchangeably: strength training, weight training, and resistance exercise. Strength training is the broader term that encompasses the other two.

Strength training refers to any exercise that uses some form of resistance to strengthen the muscles. The resistance forces the skeletal muscles to contract. The resistance can be created by using weight machines, hand-held weights, resistance bands (e.g., Therabands), and resistance balls. Resistance can be created using your own body, too.

People with osteoarthritis, as well as the other types of arthritis, have long been encouraged to keep moving and to participate in regular physical activity or exercise. Primarily, low-impact exercise and range-of-motion exercise is recommended for people with arthritis. That's exactly the source of confusion. If weight resistance is added to an exercise regimen, does it hurt more than help someone with osteoarthritis?

Weight training can be helpful, as stronger muscles can take some of the load off your joints. But you have to be careful. You could make arthritis worse if you injure the joint. If your workout causes pain in the affected joints, you may need to scale back the weights or choose other exercises.

Research on Weight Training and Osteoarthritis

A systematic review and meta-analysis published in 2020 analyzed the effects of strength training on muscle mass gain in older adults with osteoarthritis. Focusing on older people is significant because they are commonly affected by muscle weakness as well as osteoarthritis. The results showed that strength training was beneficial in increasing the lean muscle mass and muscle size in older adults with osteoarthritis.

Peak muscle strength normally occurs in your mid-20s and is maintained into your 60s. However, strength declines. By the time you are 80 years old, your strength is about half that of a normal young adult. The loss of muscle mass and strength that occurs with age is called sarcopenia.

Muscle weakness is also common with osteoarthritis, especially of the knee extensors. Muscle weakness occurring with osteoarthritis is linked to an increased risk of functional limitations and disability. Muscle strength, especially knee extensor strength, has been found to be protective against developing functional limitations in those with osteoarthritis.

Appropriate Level of Weight Training

It must be remembered that strength training, if overdone, can stress joints affected by osteoarthritis, possibly increasing pain and decreasing function. Before starting a weight training program, if you have osteoarthritis, you should:

• Discuss weight training with your healthcare provider to become more aware of potential benefits and risks.
• Consult with a physical therapist about weight training with osteoarthritis. Get a physical therapy referral from your healthcare provider. The therapist can then evaluate you and make recommendations that are customized for you.
• Seek out a supervised weight training program at a gym with a personal trainer or at a physical therapy clinic with a therapist. A supervised setting is better than a home-based program, especially in the beginning. There seems to be greater commitment and adherence to a supervised setting.
• Be mindful of the potential effects of your medications. If you take analgesic medication, for example, it may mask your pain and you may unknowingly push beyond your limits, risking injury or causing your osteoarthritis symptoms to worsen.

As you prepare to engage in a weight training program, you should:

• Warm up as you begin! Do light stretching exercises as well.
• Utilize light weights, especially at first, as you become familiar with the proper technique. Increase the weight in small increments when you feel that the current level has become too easy.
• Maintain proper body alignment during weight training—yet another reason that supports having supervision. Proper alignment helps to lessen the strain on joints.
• Work opposing muscle groups to achieve balance. When there is a balance between muscle groups, joint stability is enhanced.
• Consider wearing orthopedic braces or supports on affected joints. However, weightlifting belts are not recommended for people with osteoarthritis.
• Consider using a hot pack on affected joints and muscles before starting your routine to reduce pain and increase circulation. Cold packs may be used following exercise to decrease inflammation.
• Wear appropriate, comfortable footwear. If you wear an orthotic, try to keep it in place to ensure the best support and alignment.
• Alternate between weight-bearing and non-weight-bearing exercise, to lessen stress and strain on your joints.
• Cool down after your routine.

Possible Dangers of Exercise

There's no evidence to suggest that older adults with osteoarthritis who exercise face a greater risk of adverse events (e.g., worsening pain) or that they are unable to effectively strengthen their muscles compared to younger adults. In fact, some level of exercise is possible no matter one's age or the severity of osteoarthritis.

Reasonably, we can assume that increased age or increased severity of osteoarthritis may necessitate using less weight in weight training. However, it can still be done—just at the level that is appropriate.

Be smart. Stop exercising and notify your medical team if you experience:

• Increased pain or swelling in muscles or joints
• Popping, locking, or buckling of an affected joint
• Pain in muscles or joints that was not previously present
• Abdominal pain
• Chest pain
• Groin pain
• Shortness of breath