Resistance Training for Arthritis

November 10th, 2021

Today we will talk a bit about the benefits of resistance training for arthritis. The conventional wisdom when it came to managing arthritis used to be that less was more. It was predicated on the idea that arthritis is a condition caused by “wear and tear” of the joints due to activities that overstressed them. 

It should then seem odd to you that while we are currently facing the largest global sedentarism and inactivity crisis in history, that the rates of arthritis are actually increasing! It’s hard to believe, but when compared to medical records and x-rays from around the 1950’s and bone studies from the agricultural and industrial ages this appears to be the case. 

Other studies around this issue have found that the general guidance to avoid things like high impact activity and resistance training may have been misguided. It appears that there is actually moderate evidence of benefit to strength, function, and pain for folks–older ones in particular–who suffer from arthrits of the knees when they adopt a continual resistance training progam that is focused on progressive overload.

While that may sound complicated, all it really means is doing exercises like squats, lunges, dead lifts, etc and increasing intensity over time. That intensity can come in the form of increased weight (my preference), increased reps, sets, or length of holds. The only real hang up here is finding the appropriate dose for each idividual. 

Worry not though! Even if you do over do it from time to time, the data seems to indicate that there is very little risk of worsening arthritis when adhering to these principles. 

There are some considerations about this information to keep in mnd though. One is that this applies only to the more common version of arthritis known as osteoarthritis. It is still recommended to minimize impact on joints for people who suffer from more severe inflammatory versions of joint disease like rheumatiod, psoriatic, or gouty forms of arthritis–particularly during flare ups. 

It is also challenging to apply these concepts to all joints in the body, as the bulk of the studies that have been done and analyzed have mainly focused on arithrits of the knee. That being said, it seems likely that with continued research the same results would be found elsewhere based on our understanding of biomechanics and the body’s response to resistance training. 

One meta study I found sums up the issue quite well, and I will leave with that:

“The positive message from this review that should be clearly communicated to older people with OA is that no matter how old they are, they will probably benefit in clinically important ways from participating in a strength training program, as long as it provides some consistent overload to their muscles as they exercise. The biggest challenge with any exercise program is to maintain long-term adherence, because the benefits of exercise will diminish if people stop exercising. There is currently no evidence that one type of strength training program is superior to another as long as the program provides progressive overload, so older people should exercise at the intensity, location and using the equipment that they most prefer. Although not the focus of this review, aerobic training programs have been found to have a similar benefit to strength training in an RCT that had one of the largest sample sizes and longest follow-up of any trials in this area.24 If people prefer aerobic exercise, this mode of exercise should also be utilized by older people with OA.”

Lift heavy things. Move Well. Live Well.

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