The question of walking in cases of knee osteoarthritis is a concern for many people suffering from joint pain. Is it a good idea to continue walking, or could it worsen the situation? Contrary to popular belief, physical activity, and particularly walking, plays a crucial role in the health of our joints, provided that certain rules of dosage and adaptation are followed. Cartilage and the essential role of movement
To understand the impact of walking, one must first look at the anatomy of the knee. Patellofemoral osteoarthritis, for example, affects the
cartilage located between the kneecap and the femur. This cartilage acts as a true shock absorber, distributing pressure on the joint surfaces during our movements.
In adulthood, cartilage has little to no blood supply, meaning it doesn’t receive nutrients from the normal bloodstream. It is nourished almost exclusively by synovial fluid. This fluid lubricates the joint and nourishes the cartilage, but it is only activated by movement. Without activity, the synovial fluid doesn’t circulate properly. One can Compare it to the oil in a car engine: if the vehicle remains stationary, the parts are not lubricated. Therefore, it’s not walking itself that damages the knee, but rather prolonged inactivity, poorly managed exertion, or improperly treated injuries. When should walking be modified?
Although walking is generally beneficial, there are specific situations where it should be modified or temporarily avoided:
Very advanced osteoarthritis: If the cartilage is completely worn down and the bones are in direct contact, walking can cause
Severe inflammation and swelling. This is often the case for people awaiting knee replacement surgery. In this context, walking without protection is not recommended. A state of extreme fragility (sarcopenia): In a deconditioned person who has lost a significant portion of their muscle mass, the muscles no longer properly support the joint. This lack of stability increases the stress on the knee and worsens the pain associated with osteoarthritis.
In these situations, it’s important not to give up completely. It’s possible to use support strategies such as…
elastic knee brace (with an opening for the kneecap), walking sticks, or starting active rehabilitation to progressively strengthen the muscles.
