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Indian Journal of Orthopaedics: Osteoarthritis Management Requires Much More than Walking

Daily walks aid joints, but strength training and therapy are vital for effective osteoarthritis relief.

Osteoarthritis (OA), a degenerative joint disease eroding cartilage and bone, afflicts 22–39% of Indians over 40, per a 2025 Indian Journal of Orthopaedics meta-analysis of 50+ studies (n=25,000+). Women face 1.5–2x higher rates due to hormonal shifts post-menopause, while urban dwellers suffer from sedentary lifestyles and pollution-induced inflammation (ICMR 2024). Commonly advised "keep walking," offers cardiovascular perks but falls short for OA, as a RMD Open review (13,000+ participants, 30 RCTs) found minimal pain reduction (effect size 0.2–0.4) that wanes beyond 12 weeks. Here's why—and evidence-based alternatives.

Why Walking Hits a Wall in OA Management

Walking provides low-impact loading (1–1.5x body weight), aiding synovial fluid circulation and muscle endurance. Yet, it lacks progressive resistance for quadriceps atrophy—hallmark in 80% knee OA cases (Arthritis & Rheumatology, 2023). ICMR geriatric cohorts show step counts >7,000/day correlate weakly (r=0.15) with WOMAC pain scores; benefits plateau without overload. Analogy: like light jogging for marathon training—endurance builds, but power doesn't.

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Strength Training: The Game-Changer for Joints

Meta-analyses (British Journal of Sports Medicine, 2024; 45 trials, n=5,000) confirm resistance training reduces knee OA pain 30–50% (SMD -0.6) and slows progression via muscle hypertrophy, proprioception gains, and anti-inflammatory cytokines (IL-10 upregulation). Quads absorb 40–60% knee load; strengthening cuts peak forces 20–30% (Journal of Orthopaedic Research). Home protocols (2–3x/week, 8–12 reps, 60–70% 1RM):

  • Straight-Leg Raises: Lie supine, lift leg 30cm, hold 5s (3 sets x 10).

  • Wall Sits: Back to wall, knees 90°, hold 20–45s (3 sets).

  • Mini Squats: Feet shoulder-width, descend 45°, rise (3 sets x 12).

Progress via bands/weights; gains in 4–6 weeks.

Holistic OA Strategy: Beyond Exercise

Integrate per American College of Rheumatology/OARSI guidelines, adapted for India:

  • Flexibility: Yoga (e.g., Trikonasana) improves ROM 15–20% (Complementary Therapies in Medicine).

  • Weight Control: 5–10% loss halves pain (Annals of Internal Medicine); ICMR diet: millets, omega-3s.

  • Activity Tweaks: Use knee sleeves, avoid stairs.

  • Pain Aids: Topical NSAIDs, TENS (40% relief).

  • Education: Apps like "OA Tracker" boost adherence 25%.

Physical Therapists: Your Precision Guide

PTs customize via gait analysis, reducing injury risk 50% (Physical Therapy, 2023). They address imbalances (e.g., VMO lag), progress safely, and monitor via VAS/WOMAC scales. In India, AIIMS/ICMR programs show PT-led rehab cuts surgery needs 35% in urban OA clinics.

Daily walks start the journey; strength-focused rehab completes it. For 15 crore Indians with OA (projected by 2030), this tailored path restores function—consult a PT today.

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