Preparing Your Hips & Knees for Post-Quarantine Life

Harlan B. Levine, M.D. May 21st, 2020

Spring is in the air, quarantine restrictions are being lifted, and we are all excited about getting outside, exercising, and seeing family and friends once again. However, with an increase in activity comes the risk of injury or aggravation of already compromised areas of our body.  Therefore, we should all be mindful of sensible ways of returning to our routines and incorporating exercise into our lives.

The benefits of exercise for our minds and bodies cannot be overstated. The positive effects of exercise on the body are well known including strengthening muscles and bones; stronger bones help lessen the risk of fractures and stronger muscles help reduce the risk of falls. Regular exercise helps to maintain joint health and has been shown to be useful even for arthritic joints. Along with a sensible diet, exercise is a cornerstone of weight management. Exercise is essential for healthy hearts, it can help manage diabetes, and may reduce the risk of certain cancers. Physical activity is also essential to maintain a healthy brain. Exercise improves our memory, our mood, and may help reduce the risk of dementia.

While the benefits of exercise are well known, we must be cautious about a rapid increase in frequency, duration, and intensity of exercise. Too much too soon can lead to overuse injuries, aggravation of old injuries, or over stimulation of arthritic joints. During this time of year, it is not infrequent for a patient to come to the office with a painful hip or knee. When asked what they have been doing for the previous few weeks, the patient often recounts a single intense episode of activity or a sudden ramp up of exercise. One overly long walk or a week’s worth of bike riding can be enough to cause a new injury or aggravate a pre-existing injury or overwhelm an already compromised joint. To prevent overuse injuries, I recommend a slow and gradual progression in both frequency and duration of exercise until a comfortable routine is achieved. I also recommend that people incorporate a variety of exercises to lessen the chance of developing a chronic, repetitive injury, or of further aggravating an old injury or arthritic joint. Variety also helps to prevent activity and exercise from becoming stale. Rather than doing the same exercise six days a week, I encourage patients to pick three or four activities or exercises that they enjoy and rotate through them every time they exercise. For example, for someone who enjoys bike riding, it would be preferable to bike ride two to three times per week while engaging in other types of exercise the rest of the week.

Exercise itself can be broken down into four broad and distinct categories that all of us should try to incorporate into our routines to develop a complete and beneficial program.

  1. Strength training-- Strength training helps to build muscle mass which is important for all of us as we age. It helps keep us strong so that we can do essential tasks like picking up heavy objects, getting up from a chair, and going up and down the stairs.  It also aides with posture and helps to reduce stress and strains on bones and joints. Strength training does not necessarily require specialized equipment and can be done in the home using your own body weight for resistance. If you are unfamiliar with strength training, contact your Rothman physician for recommendations on physical therapists who can help you begin a regime safely.
  2. Endurance  -- Aerobic activity is well known to have positive health benefits and, along with strength training, is often a staple within an exercise routine. Common aerobic activities include walking, running, bicycling, and swimming, although any activity that speeds up your heart rate and breathing rate counts. You should work up to at least 30 minutes of aerobic activity three times a week.      
  3. Range of motion and flexibility-- As we age our muscles and tendons begin to lose compliance, or flexibility. This makes us more prone to stresses and strains, as well as, pain. A loss of flexibility and motion in our joints makes basic activities, such as bending over to put on shoes and socks, more challenging. A stretching program should be performed at least three or four times a week. As with strength training, if you’re unsure of where to begin, contact your Rothman physician for personalized recommendations.
  4. Balance and gait-- Aging, injury and illness can affect our balance and gait which can make walking more challenging and can also lead to falls. Activities such as Tai chi and yoga are particularly balance focused, and classes can be found at many senior citizen centers as well as gyms. There are also videos available on the internet.  It is important to start with a gentle beginner class if you are new to these activities. Physical therapists can also work with you to determine your balance needs and to develop a program to address weaknesses in your balance and gait.

In addition to the tips above, the American Association of Hip & Knee Surgeons has a fantastic resource for joint replacement candidates and post-surgical patients during this challenging time—click to learn more. As always, if you have any questions regarding these topics, please reach out to your Rothman physician via the Patient Portal (click here) or if you’re a new patient, schedule a virtual visit to discuss your specific situation from the comfort of your own home.

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