Interestingly, running has not been shown convincingly to be a risk factor for knee arthritis. Some studies have suggested an association but an equal number of studies have not. One of the best studies to date has shown that if you keep your mileage under 30 miles a week, the risk of osteoarthritis of the knee is pretty low.
That being said, once arthritis does develop in the knees, then other types of exercise should be considered. Now the purpose of this article is to discuss only the aerobic component of an exercise program. Patients with arthritis need to include aerobic, strengthening, as well as stretching in a comprehensive program.
One option is an elliptical trainer. While these are most often found in fitness clubs, they are available for home purchase and use. An elliptical trainer provides a movement that is midway between a bike and a stairclimber. The feet stay on the pedals and the movement is a smooth elliptical (oval) motion so there is no impact. Some models have attachments for a back and forth arm movement so that there is a total body workout. The angle of pedals as well as the resistance to pedaling can be adjusted. This provides an excellent cardiovascular, low-impact workout. The elliptical trainer is my personal favorite.
Another option is swimming. Swimming provides the best cardiovascular workout and is completely non-impact. The primary concern with swimming is that patients with shoulder problems may have more pain and aggravation of their shoulder symptoms with certain strokes. In addition, patients with low back arthritis may also notice their symptoms worsening with certain maneuvers. If your problems are only knee related, swimming is a great choice.
A stationary bike is another good form of aerobic conditioning. It is a no-impact workout. People with knee problems should use a very low tension and start out slowly. Otherwise worsening of knee symptoms can occur. Quad strengthening and hamstring stretching should also be performed if a stationary bike is used.
Cross-country ski machines are not quite as popular as they once were. And that's too bad because this is a wonderful piece of equipment. This device provides a workout for both the upper as well as the lower body. The feet move in a back and forth gliding motion (make sure you get a good quality machine that moves smoothly rather than in a jerky fashion). No pounding or other impact accompanies this type of exercise. The attachments for the arms provide a brisk workout for the upper body also. Resistance can be changed for both the legs as wells as the arms.
One note of caution... people with low back problems should exercise caution since back symptoms can get worse.
Treadmills are also an alternative. For people with knee problems though, these may not be a good choice. There is impact. Very high end treadmills have a softer more forgiving deck. If you notice that the treadmill makes your knee pain worse, you're probably better off using something else.
Stairclimbers are probably not a great idea. The reason is that the motion of bending and straightening the knee with loading from the rest of the body often times will hurt. This is particularly true for people who have significant arthritis between the patella (kneecap) and the femur (upper leg bone).
With all exercise equipment, it is critical to get clearance from your physician before embarking on a vigorous program. Also it is a good idea to use a heart monitor to make sure your heart rate stays within the range appropriate fro your age group. Obviously, a lot depends on the condition you're in before you start.
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