How to improve age-related knee and hip stiffness when bending?

From the Guidelines

To improve age-related knee and hip stiffness when bending, incorporating daily gentle stretching and low-impact exercises, such as those recommended by the 2023 EULAR update 1, is crucial. This approach should include a combination of strengthening exercises, aerobic activity, and range of movement/stretching exercises, tailored to the individual's preferences and capabilities. Starting with 5-10 minutes of warm-up activities like walking or gentle cycling before performing specific exercises such as hamstring stretches, gentle knee bends, hip rotations, and quad stretches, holding each stretch for 20-30 seconds and repeating 2-3 times, can be beneficial. Water exercises are particularly beneficial as they reduce joint stress while improving mobility, as noted in the 2020 American College of Rheumatology guideline 1. Maintaining a healthy weight, as emphasized in the 2021 VA/DoD clinical practice guideline 1, reduces pressure on joints, and proper footwear with good arch support and cushioning helps with alignment. Heat therapy before exercise and cold therapy after can reduce stiffness and inflammation, improving overall mobility and function. These approaches work by increasing blood flow to stiff joints, strengthening supporting muscles, improving joint lubrication, and reducing inflammation that contributes to stiffness. Key considerations include:

• Individualized management plans that incorporate core non-pharmacological approaches, such as education, exercise, and weight management 1.
• The use of assistive devices, like canes, for patients with significant impact on ambulation, joint stability, or pain, as recommended in the 2019 American College of Rheumatology guideline 1.
• Encouraging patients to participate in some form of exercise, considering their preferences, access, and affordability, as highlighted in the 2020 guideline 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Improving Age-Related Knee and Hip Stiffness

To improve age-related knee and hip stiffness when bending, several exercises and activities can be beneficial. The following points summarize the key findings from relevant studies:

• Exercise Types: Aerobic exercise, mind-body exercise, strengthening, and flexibility/skill exercises can improve pain, function, performance, and quality of life in individuals with knee and hip osteoarthritis 2.
• Hip and Leg Strengthening: Both hip and leg strengthening exercises can improve knee pain, function, and quality of life in patients with knee osteoarthritis, with no significant difference between the two types of exercises 3.
• T'ai Chi Training: T'ai Chi training can enhance arthritis self-efficacy, quality of life, and functional mobility among older adults with osteoarthritis, making it a safe and effective complementary therapy 4.
• Joint Loading Activities: Joint loading activities, such as walking, hopping, cycling, and weightbearing knee bends, can have immediate and delayed effects on knee and hip cartilage, with some activities resulting in minimal cartilage thickness and volume reductions 5.
• Age-Related Range of Motion: Normal hip and knee active range of motion values differ by age, with older adults generally having lower range of motion values than younger adults, but any substantial loss of joint mobility should be viewed as abnormal and treated accordingly 6.

Key Takeaways

• A combination of aerobic, mind-body, strengthening, and flexibility/skill exercises can help improve age-related knee and hip stiffness.
• Hip and leg strengthening exercises can be beneficial for knee pain and function.
• T'ai Chi training can be a useful complementary therapy for older adults with osteoarthritis.
• Joint loading activities should be approached with caution, as they can have both positive and negative effects on cartilage.
• Age-related range of motion values should be considered when evaluating and treating joint mobility issues.