Just how much should you walk – or not walk – if you have knee osteoarthritis? Should you save walking for only essential needs? What about fitness walking?
“Dr. Bergin, is a lot of walking bad for someone who has osteoarthritis in their knees?”
Well…I think so…but what do I know? I’m only an orthopedic surgeon.
If you already have known…or symptomatic osteoarthritis, then walking is likely painful.
And even if it’s not painful, walking IS wearing out your knee.
Now, we all know that walking is good for us. It’s good for our bodies and it’s good for our souls.
We also can assume that some people must walk all day to keep their jobs.
So, I put walking in two categories: the walking we want to do and the walking we must do.
If you have arthritis in your knee, you should diminish the walking you want to do in order to maintain the walking you must do.
I advise my patients to diminish exercise walking, and to absolutely quit the power walking.
They should stick to walking at a leisurely pace, and give up trying to maintain an elevated heart rate, which is almost impossible to do while walking, unless you power walk up hills [or, depending on fitness level, walk briskly on a level course].
The human body quickly conditions itself to any form of walking, and one has to escalate the intensity in order to maintain an elevated heart rate.
But never mind that heart. Let’s get back to the knees. If you have arthritis and you are driven to walk:
1) Keep a leisurely pace.
2) Walk on a flat surface.
3) Avoid hills and uneven surfaces.
4) Use hiking sticks.
5) Wear knee sleeves.
6) Wear supportive shoes.
7) Avoid walking with competitive, fast-walking people.
8) Choose necessary walking over unnecessary walking. Get groceries delivered. Use disabled parking (if you have a permit). Take shortcuts. Drive.
All this in order to do the necessary walking you must do for normal daily living and working.
9) Walk every other day.
10) Choose other low-impact exercises, like swimming, water aerobics and cycling.
So, there’s no question that if you already have arthritis in your knee, walking will contribute to wearing it out.
And that’s fine if you’re ready for total knee arthroplasty. But remember, total knee arthroplasty has about a 20% incidence of dissatisfaction, and they only last about 20 years. That’s an average.
That means some people’s knees last for 25 years, and some last only 15.
If you have a total knee replacement when you’re 55, there’s a very good chance you’ll need a revision by the time you’re 75.
And younger patients (like 55-year-olds) are more likely to wear out their total knees earlier than older folks [since the younger group is more likely to golf, hike, walk a lot on the job, etc.].
What do I have against revisions?
They’re more complicated. The results are not as predictable as virgin knee replacements, and they’re more likely to get infected or have other complications.
You should get only one total knee replacement per knee. Patients don’t seem to care that much about this. They want their knee replacements so they can walk!
Every time I write an article about walking and arthritis, I get all sorts of naysayers who tell me their arthritic knees feel grrreat when they walk. And that’s a beautiful thing.
I feel great when I’m eating ice cream. Does that mean it’s good for me?
Yes…walking is THE BEST exercise humans can do. It’s what we’re put together to do.
But remember, once we’re diseased, it’s not the same. Once I have diabetes, eating ice cream is not good for me, no matter how good it makes me feel.
I often tell my patients that they’re doing this exercise for their health…but if it puts them under the knife and anesthesia…how healthy is that…especially when we’re old?
Dr. Bergin is a general orthopedist, surgically and conservatively treating all manner of bone and joint conditions. She enjoys educating patients so they can emerge stronger than they were before their orthopedic injury or surgery.