High-Intensity Strength Training Did Not Improve Knee Pain from Osteoarthritis

We know that exercise is helpful for osteoarthritis of the knees. A walking program has been shown to improve pain scores by 1.4 points (on a 0 to 10 scale),1 and a program including diet AND exercise was better than exercise alone.2 But we aren’t sure how much exercise is best—is more better?

It makes sense that improving muscle strength would decrease the amount of stress on the knee and slow down cartilage wear-and-tear. But a recent study examined this question in people with mild to moderate osteoarthritis and found that high-intensity strength training is NOT better than low-intensity strength training.3

The high-intensity group took part in a supervised program of exercises at 75-90% of their maximum testing, while the low-intensity group worked at 30-40% of their maximum. The people in the low-intensity strength training group appeared to do the best. They had less pain, needed fewer pain medications, and had fewer injuries compared with the high-intensity group.

Another interesting finding was that knee pain in a third (control) group improved by 33%, which is much higher than expected. The people in this group didn’t do any strength training, but they didn’t exactly get placebo. They took part in education sessions with “social cognitive strategies,” which may be another potential “treatment” for osteoarthritis!

  1. Kovar PA. Ann Intern Med. 1992.
  2. Messier SP. JAMA. 2013.

Messier SP. JAMA. 2021.