We know physical activity is beneficial for the body and mind. Walking, running, and recreational sports can all benefit nearly every system of the body. Exercise can also lead to injury and breakdown if the level of stress and strain exceeds the capacity of the body and various tissues. That capacity diminishes in the presence of pathology, such as osteoarthritis.
However, physical activity and exercise is often the best treatment for various pathologies, such as impact activity for osteoporosis and strength training for cardiovascular disease.
Unfortuantely, osteoarthritis is often treated differently.
Our patients with osteoarthritis are often told to avoid strenuous exercise, especially those involving impact or high loads. This review analyzed the current evidence to see if walking, running, and recreational sports are beneficial or harmful for patients with knee osteoarthritis. They found consistent evidence that these common forms of physical activity do not increase the risk of structural progression of knee osteoarthritis. Furthermore, people with osteoarthritis will likely benefit from these activities as they will address other health risk factors such as obesity, sarcopenia, and poor bone mineral density.
It is important for us to look at the big picture, weigh all of the potential costs and benefits, and understand the dose-response. Remember, the dose makes the poison. Load is not inherently bad. We need to consider each individual and determine what dose (exercise, nutrition, sleep, stress, etc.) is beneficial, has no effect, and is harmful.