Fitness: Yoga pays hOMage to your knees
Maybe it's the age group I hang with, but sore knees are a constant complaint. For some the ache is persistent. Others find going up or down stairs the most challenging. And we all agree aging knees make getting down and off the floor more challenging then it used to be. But perhaps the worst thing about sore, stiff knees is it affects the enjoyment of day-to-day life, including keeping you from doing the things you love.
How do you get some life back in your knees? Physical activity if often touted as a good option, but there's little consensus on what type of exercise is best. Strength training is a popular choice mainly because of its ability to strengthen the supporting structures around the joint. Added stability puts less stress on the knee, which usually translates into less pain. Also important is stretching, which can improve range of motion and reduce stiffness, making it easier to perform the movements of everyday life.
But how do stretching and strength training compare when it comes to improvements in knee pain, function and stiffness? Should you spend more time in the weight room or on a yoga mat?
An article published in the JAMA (Journal of the American Medical Association) Network Open reported on a study gauging the efficacy of both interventions in a group of 117 Australians (32 men, 85 women) with knee osteoarthritis.
'Multiple international clinical practice guidelines recommend strengthening exercise for the management of knee and hip osteoarthritis, however, to our knowledge, no studies have directly compared yoga with an evidence-based strengthening exercise program,' said lead author, Benny Antony.
The study subjects were randomly placed in either a yoga or strength-training program, both of which lasted 24 weeks. The first half of the study featured two group-based instructor-led sessions per week and one home-based session. The last 12-weeks included three home-based sessions per week without the resources of a trained instructor.
The strength training protocol focused primarily on lower body exercises delivered by physiotherapists in a circuit format. The yoga was led by trained professionals who put the study subjects through a series of poses, breathing, meditation and relaxation exercises. Check-ins were performed at the end of 12 and 24 weeks.
Halfway through the study, both the yoga and strength training groups reported less pain and improved function with no significant difference between the two groups. At the end of 24 weeks, yoga proved slightly more effective than strength training at reducing pain and joint stiffness and improving function and quality of life. It also offered an added benefit not usually associated with strength training.
'The observed reduction in depression in the yoga group over 12 weeks shows the potential mental health benefits of yoga compared with strengthening exercise, as depression is a common comorbidity in knee osteoarthritis and yoga may be well-suited for patients with both conditions,' Antony said.
That's great news for anyone who finds strength training too challenging to be done solo or has limited access to strength-training equipment and or the space it requires. Yoga needs little equipment beyond a mat and is easily performed in small spaces. There are plenty of on-line yoga classes, many of which can be accessed for free or for a nominal fee, making it both affordable and accessible. In fact, adherence to the home-based program offered in the last 12-weeks of the study was better among the yoga group than the strength-training group, which the study suggests could be partly responsible for the superior results among the yogis.
Affordability, accessibility and autonomy are three important elements when it comes to long-term adherence. Yoga is often seen as less challenging than strength training, both in intensity and technical elements. But the most important finding of this study isn't that one form of exercise outperformed the other, but that both options offered similar positive results.
That means anyone who prefers the weight room over a yoga mat can be assured their efforts will result in healthier knees that function with less pain. The same goes for yoga lovers, who would rather perform a series of sun salutations than multiple sets of lunges or squats.
And then there's the mind-body connection that clearly made a difference among knee pain sufferers. The meditative aspect of yoga offers an often under-appreciated benefit to quality of life that, in this study at least, had a positive effect.
But again, it would be unduly limiting to view these results as an either-or equation. It could be that the best results come from combining yoga and strength training as complementary not competing options. There's value in mixing things up, especially when it comes to knees that have endured years of wear and tear.
'Overall, these findings suggest that integrating yoga as an alternative or complementary exercise option in clinical practice may help in managing knee pain,' Antony said.
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Maybe it's the age group I hang with, but sore knees are a constant complaint. For some the ache is persistent. Others find going up or down stairs the most challenging. And we all agree aging knees make getting down and off the floor more challenging then it used to be. But perhaps the worst thing about sore, stiff knees is it affects the enjoyment of day-to-day life, including keeping you from doing the things you love. How do you get some life back in your knees? Physical activity if often touted as a good option, but there's little consensus on what type of exercise is best. Strength training is a popular choice mainly because of its ability to strengthen the supporting structures around the joint. Added stability puts less stress on the knee, which usually translates into less pain. Also important is stretching, which can improve range of motion and reduce stiffness, making it easier to perform the movements of everyday life. 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It could be that the best results come from combining yoga and strength training as complementary not competing options. There's value in mixing things up, especially when it comes to knees that have endured years of wear and tear. 'Overall, these findings suggest that integrating yoga as an alternative or complementary exercise option in clinical practice may help in managing knee pain,' Antony said.
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