“I wonder why my knees feel so much better when I finish a bike ride than when I run?”
“Do you have arthritis?”
“Dunno – but my knees get stiff. I don’t really have pain, but I sure can feel creaky, especially when I stop running and sit for a while. I walk like an old lady when I first get up. Is that arthritis?”
What is arthritis and how do you manage it?
Osteoarthritis (OA) is a common form of arthritis characterized by the breakdown of the joint’s cartilage. Cartilage is the part of the joint that cushions the ends of the bones and allows easy movement of joints.
A recent study of folks with mild to moderate knee arthritis showed that just 12 weeks of cycling resulted in a huge decrease in knee pain, much more comfort walking, but only a little more strength.
What? If we think about joint pain, we imagine that getting stronger protects our joints. So what is happening when strength has not changed as much as function? Well, better coordination of leg muscles can account for better function. Nerves attached to muscle cells start accepting and sending signals between the muscles and brain more quickly. You use your leg better.
But there’s something else: Low load/ high duration movement of injured joints lubricates the cartilage and gradually allows it to accept more weight. Cartilage can actually get stronger (tolerate more weight) when the load is gradually increased. Yes, with the right exercise, you are actually strengthening cartilage.
People who exercise have thicker cartilage than sedentary people, and thicker cartilage can tolerate more weight. So if you load and unload cartilage – like you would during a 30-minute bike ride, fluid and nutrients flow into the cartilage from the underlying bone. Since cartilage does not have a blood supply, this is how you feed it; this is how it gets stronger.
One famous study done years ago showed that articular cartilage deteriorated more when there was no compression through the joint than when there was a lot. So how much is a lot? How much is too much? And does joint compression vary with different activities such as running and cycling? And what if you already have arthritis?
It is probably safe to say that running falls into the “lots of compression” category. Recreational running for people without knee arthritis doesn’t cause arthritis and may even decrease risk. (Bear in mind that running an ultra- marathon is not the same as recreational running.)
But, if you have some arthritis, continuing to put massive compressive forces through the joint is a bad idea. Instead, an activity like cycling can achieve some joint compression, without being too much. You can decrease the compression by the using higher gears. It shouldn’t damage your cartilage and may even strengthen the cartilage you have left. So, if you have arthritis, it’s time to dust off your bike, and start to ride. First make sure your bike is set up for optimum comfort (get a bike fit if necessary) and make sure you ramp up your time and distance gradually.
The B-360 is fast approaching. Join your friends in a ride around town in June. If you need to get your exercise program dialed in, schedule an appointment at ALTA to enhance your active lifestyle this summer!