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Shed some pounds
A good first line of defense, health experts say, is shedding some pounds. "You can get some long-lasting effects," FitzGerald says. Even a little makes a huge difference, because walking and running can put extra force -- equivalent to several times one's body weight -- on the knees with every step. "Even with 5 to 10 pounds, which is a reasonable goal, people can expect a fairly significant improvement in knee pain," he says.
The recommendation comes with a snag, however: When knees hurt, the motivation to exercise goes south.
"Unfortunately, you can't wait for the knee to get better to start exercising," FitzGerald says. "Start exercising, and then the knee will get better."
Laura Bennett, a physical therapist who works with osteoarthritis patients at L.A.'s Good Samaritan Hospital, has a use-it-or-lose-it philosophy when it comes to battling osteoarthritis.
"If we don't use it, we lose strength in our muscles and range of motion," she says. "We can compensate for a while, but if we become stagnant in our movements, then our joints don't get the fluid they need, which means they don't get the nutrition they need, then arthritis sets in, and it hurts to move, so we don't want to move."
Walking, swimming and water workouts are great for some with arthritic knees, Bennett says. "Being in the water takes a certain amount of body weight off the knees and hips. Joints have an easier time moving and the water gives muscles some resistance." Walking time and intensity should progress gradually, she says. Many physical therapists will examine patients' muscle strength and flexibility from their feet to their hips and back, plus assess alignment and gait, possibly prescribing exercises and stretches to correct disparities and weaknesses.
"A lot of times with osteoarthritis," Bennett says, "it could be a muscle imbalance that's causing it, where one side might be weaker and one side is tighter, and people are not working at a biomechanical advantage." It's also not just the knees that are worthy of attention -- other joints that support them, such as the hips and ankles, are important to shore up as well.
