Should You Squat When You Have Knee Arthritis?
Osteoarthritis is one of the most common causes of musculoskeletal pain and disability in your knees. Exercise is commonly prescribed and has been shown to be an effective treatment for knee OA, but what is the best type of exercise?
To squat or not to squat…that is the question!!
The loss of quadriceps strength has been one of the most commonly cited impairments associated with knee arthritis. Studies have shown quadriceps strength deficits that range between 11-56% compared to healthy controls. Eccentric control has been shown to be even worse at deficits of 76%. Eccentric contractions are lengthening contractions of your quadriceps that occur as your lower yourself to a chair, the toilet or down a step.
Several papers have been published that demonstrate that patients with knee arthritis also have a:
- 4-38% reduction in hamstring strength
- 16% reduction in gluteal strength
- 26-40% reduction in hip flexion strength
- 27-40% reduction in external rotation strength
- 20-43% reduction in internal rotation strength
- 22-24% reduction in abduction strength
- 26% reduction in adduction strength
This essentially means that people with knee OA have weakness in EVERY plane of motion in the lower extremity!
To make matters worse, it has also been shown that the unaffected knee develops strength deficits of 16-26% compared to healthy norms. That means that you need to double time your exercises or choose exercises that can provide bilateral quad activation as well as encourage a return of dynamic stability during functional activity.
Here are some main points from “The MOVE Consensus” review in the Rheumatology Journal regarding exercise guidelines for knee QA:
- Both strengthening and aerobic exercise can reduce pain and improve function in patients with knee and hip osteoarthritis, with few contraindications, and are essential in the management of osteoarthritis.
- Improvements in strength and proprioception gained from exercise may reduce the progression of osteoarthritis, although adherence is the principle predictor of long-term outcome from exercise.
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So then, what is the correct way to squat when you have knee OA in order to get the positive effects but NOT the negative effects?
Watch the videos below I will show you the way!