Therapeutic exercise for troubled knees and hips

Exercise is an important component of staying healthy. If you have knee or hip problems, exercise plays an important role in getting healthy. With any knee or hip problem the largest antigravity muscles — the quadriceps and gluteals — often lose strength. An exercise plan that focuses on these muscles can offer many benefits.

Strengthening the muscles around a damaged knee or hip can support the joint. For example, when your quadriceps, gluteals, hamstrings, and abdominal muscles are strong, the load on your hips is lightened. A strong quadriceps muscle can assume much of the shock-absorbing role usually played by the meniscus or cartilage in the knee.

Strength is important, but so is the proper balance of strength in the muscles surrounding a joint. Muscles work in pairs — one contracts while the opposing one relaxes. Imbalances in the function of paired muscles can cause joint problems and invite injury. Well balanced strength in muscle pairs can help keep joints in the most functional and least painful position. Flexibility exercises (to stretch and relax specific muscles) are also important to improving joint function.

If you have knee or hip trouble, you may need to avoid certain activities — at least for a while. For example, you probably should avoid running and fast walking on sidewalks or pavement. If you love these activities, try them on a track or treadmill and wear well-cushioned shoes to lessen impact. Better still, consider swimming or cycling, which are easier on your joints. And do leg resistance exercises two to three times per week to strengthen supportive muscles around the knees.

Physical therapy is often part of treatment for arthritis and other joint problems. Physical therapists create individual exercise programs to help restore or maintain physical functioning, and to help achieve treatment goals set by orthopedists and other clinicians.

A physical therapy session may involve pain-relieving treatments using ice, heat, massage, or other approaches. The physical therapist supervises you doing specific exercises — she or he may have you work in a pool, or use a variety of equipment — and also teaches you exercises you can do at home.

Knee and hip problems often cause pain, restrict joint movement, and weaken muscles. As a result, the mechanics of normal walking get out of whack. A physical therapist can help with this as well. Gait retraining helps you learn to walk more normally. Initially, the proper gait may feel odd and it may take practice before a normal gait becomes comfortable.

To learn what therapeutic exercise can do to relieve your hip and knee pain, buy Knees and Hips, a Special Health Report from Harvard Medical School.