How often should I walk with Stage 2 OA in both knees?

NeilM

I currently walk a 90 minute circular route three times per week. Much of this route is on grass with slight hills.

I’ve read that walking is good for knee arthritis but I have no clue if the amount I’m doing is too little or too much.

Any advice would be much appreciated.

jamieA

Hi @NeilM

I was told two years ago I needed to consider a knee replacement and last month was told it needs done. I've always been told to keep exercising as much as possible to ensure the muscles, tendons and ligaments are kept as healthy as possible. I walk my dog 50-60kms a week mainly on flat paths and told my consultants that. I was urged to keep it up for as long as possible before I eventually get a replacement knee.

NeilM

Hi, thank you for your reply. It’s good to hear that consultants are advising as much walking as that - makes me feel that I’m not doing too much and could probably get away with doing more.

Will you be going ahead with the knee replacement? From things I’ve read online and on this forum it is a big decision as there can be complications. My wife has had both knees partially replaced and has lost all feeling in them etc.

I’m hoping that with enough exercise I might be able to prevent surgery for as long as possible.

jamieA

https://community.versusarthritis.org/discussion/comment/717272#Comment_717272

Hi @NeilM

I received a letter a couple of weeks ago stating I had been put on the waiting list but the average wait is 107 weeks so it's not something that's going to happen soon. I had a football injury in my early 30's and the meniscus was removed then so I've had issues with my knee for 35 years however my knee has deteriorated more quickly in the last 3 years since my PsA diagnosis. I now walk with a pronounced limp and have been told that issues with my right ankle, foot and hip are being caused by my left knee. So I will take the replacement but I am concerned - I know a fellow walker who has had major health issues after his knee replacement.

My NHS board offer what's called nhsanywhere online whereby you get 12 weeks rheumatology physio face to face via a zoom type call. I've had two 12 week sessions as well as a Nuffield Health Joint Pain course which is free. My NHS online physio was great and she posted a number of youtube videos of the exercises we did and I refer to them regularly. All of the physios I've seen have stressed the need to keep moving and to exercise to ensure the muscles, tendons and ligaments don't wither. Back in 1988 when I had my meniscus removed I was mis-diagnosed for a considerable period of time and left on crutches for 3 months. I remember sitting on a treatment table when they removed the massive Jones bandage they had me in from hip to ankle. My left thigh was 40mm less in diameter than my right and my left calf was 30mm less. It looked like two different peoples legs. I ended up with a couple of years of physio to build it back up but was eventually able to go back to football, squash, cycling and walking the hills with my dog.

If you are concerned could you try to get an appointment with a physio? They would be able to recommend exercises to do - including how much walking.

Best of luck.

jonr

Hi @NeilM

To answer your question, the more mobile you are the better when it comes to Arthritis. This is for the following reasons:

1: It helps joint lubrication which eases stiffness and keeps joints supple

2: It helps develop muscle and tendon strength surrounding arthritic joints which means they can cope more easily with the extra strain they come under which not only eases pain but aids stability

3: Any exercise is healthy for the body as well as the mind and outdoors is an added boost for good measure, particularly if it's a varied route with a few hills and so on.

Sure, you're going to overdo it on occasion and you'll still get flare-ups from time to time so listen to your body but ultimately keeping active is about the best thing any of us can do.

Hope this helps,

Jon

NeilM

https://community.versusarthritis.org/discussion/comment/717286#Comment_717286

Thank you for the lengthy reply @jamieA

It sounds like you have a long history of issues with your knee, very sorry to hear that. My own journey only began in September 2022. Like you, my left knee is my worst. 

My local health partnership does indeed offer physiotherapy sessions, although I am reluctant to initiate their services as I have tried numerous exercises based on YouTube videos I have viewed and overall, they have tended to aggravate my knee rather than alleviate. I have found that the thing that calms my symptoms the most is walking, a pursuit I have enjoyed for decades and am comfortable doing. If my symptoms worsen then I probably will have no option other than to try physiotherapy.

Have you tried any of the injection-type treatments in your knee over the years? I am hoping to get a consultation with a specialist in the near future and will be inquiring about the possibility of such a thing.

NeilM

https://community.versusarthritis.org/discussion/comment/717294#Comment_717294

Hi @jonr

Thank you for your reply. All these replies are giving me the confidence to keep walking! I had nagging doubts at the back of my mind telling me that all this walking might be doing more harm than good but the general mood music seems to be that this is not the case and that I should keep doing what I’m doing.

I love being outdoors, breathing in good clean air, watching the birds in the sky and the squirrels in the trees. It grounds me and momentarily helps me to forget my aches and pains. I would recommend a good long walk to anyone and everyone. Forget your gyms with their fake piped-in air; open fields and big blue skies, being at one with nature, it’s a tonic, makes you feel alive and simply cannot be beaten in my opinion!

jamieA

https://community.versusarthritis.org/discussion/comment/717425#Comment_717425

Hi @NeilM

Although my knee gave me a bit of trouble over the years it wasn't anything that needed medical intervention. I was able play football into my 40's, squash to my 50's and cycling to my early 60's with my knee letting me know when I'd done enough. I was also a keen hill walker and amateur photographer - taking my labrador with me.

I have psoriatic arthritis - it's inflammatory and caused by my immune system attacking my joints. I've had a number of steroid injections directly into my fingers, shoulder and knee during the time my PsA wasn't controlled and they generally gave 4-6 weeks of respite.

I agree with what you say about walking - I'm lucky I have a river and canal walk a few hundred metres from my front door. I would say though that the physio courses I've had have been a real benefit.

NeilM

https://community.versusarthritis.org/discussion/comment/717433#Comment_717433

Hello again. It’s good to hear that the steroid injections give respite but I was kinda hoping it would last longer than 4-6 weeks! I’ve never been a fan of needles; how bad were the knee injections? If they hurt like a [swearword] and only last six weeks I might just give them a miss!!

jamieA

https://community.versusarthritis.org/discussion/comment/717481#Comment_717481

Hi @NeilM

The knee and shoulder injections weren't painful - more uncomfortable. The first knee injections were given after the excess sinovial fluid was drained from the joint and that was probably the most uncomfortable part. They left the needle in while they changed the extraction syringe out for one with the steroid in it. On one occasion the professor had to stop to go get another extraction syringe as he'd filled the first. He said he'd never had to do that before. If I remember correctly the steroid injections into my joints were combined with a local anesthetic. The general steroid injections are into the rump so no local anesthetic there but I don't find them painful at all. My last two steroid injections into my rump have given a longer period of remission probably because the DMARDs and biologic are working to dampen my PsA whereas initially my PsA was not under control when they were injecting steroids into my joints.

NeilM

https://community.versusarthritis.org/discussion/comment/717544#Comment_717544

Wow, reading your reply really magnifies how little I know on the subject of arthritis and associated treatment. I wasn’t aware that local AND general steroid injections were offered, although I recognise that may be specific to your type of arthritis and possibly not mine. I guess I will know more after I speak to my GP on the 30th and then however long it takes from there to see a specialist - if I’m lucky enough to be able to even see a specialist!

I reckon there might be the possibility of me also needing to have fluid drained as there seems to be an excess around both knees. I believe it is this fluid that thickens and causes the pain I experience whenever the temperature drops, or when it rains. I’ve begun to “sense” when it’s raining by the pain in my knees! I spent my entire life wandering around the house in shorts but no longer; long trousers or jogging bottoms is all I can get away with now. The moment my knees get exposed to cold air they begin to throb and ache so I try to keep them covered as much as possible and avoid the cold as much as I can.

Many thanks for all your replies, you are a goldmine of information 😀.