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Exercising While "Bone on Bone"

September 18, 2020

Many people who are diagnosed with “bone on bone” changes ignore exercise treatment due to the belief it will damage their joints further, which is NOT TRUE.  Patients should not live with years of knee pain managing only with medication use while waiting to get their joint replaced.  They need help to manage it with movement, mobility, and strength!

Cartilage Health

Of our major freely movable joints, the knee and hip are most affected by osteoarthritis (OA). Although the exact cause of OA is unknown and probably varies somewhat from person to person, factors such as advanced age and mechanical injury to a joint are associated with the development of OA.

As the condition progresses, articular cartilage begins to soften and demonstrate a less smooth surface, while the underlying bone may increase in size due to having to accommodate extra stress as the cartilage matrix becomes disrupted.

What can you do to help maintain cartilage health? 
  1. First and foremost, excessive stress (increased weight/height ratio, excessive exercise without sufficient rest, etc) have been associated with early cartilage breakdown.

  2. On the flip side, inadequate loading of cartilage (sedentary lifestyle) and not using a joint through its full range of motion may impair nutrient delivery.

Cartilage, unlike many other tissues, does not have a pump to deliver nutrients, so it relies on a special type of diffusion, which you can think of it as a sponge and in order for water, synovial fluid, and nutrients to move in and out, the sponge must be squished (loaded) and then unloaded so that absorption can occur.

This is why loading a joint appropriately throughout the day (this might mean losing a little weight or modifying your exercise program) and using our joints through a full range of motion are so important for maintaining cartilage health long-term.

CONCLUSION…  Get moving, stay active!


Bunzli, Samantha, Penny O’Brien BHealthSci, Darshini Ayton, Michelle Dowsey, Jane Gunn, Peter Choong, and Jo-Anne Manski-Nankervis. "Misconceptions and the acceptance of evidence-based nonsurgical interventions for knee osteoarthritis. A qualitative study." Clinical Orthopaedics and Related Research® 477, no. 9 (2019): 1975-1983.

Roos EM, et al. Positive effects of moderate exercise on glycosaminoglycan content in knee cartilage: a four-month, randomized, controlled trial in patients at risk of osteoarthritis. Arthritis Rheum. 2005.

Bricca A, et al. Impact of a daily exercise dose on knee joint cartilage - a systematic review and meta-analysis of randomized controlled trials in healthy animals. Osteoarthritis Cartilage. 2017.

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