Comparing Treadmills and Elliptical Trainers: Which is More Effective for Knee Osteoarthritis?
For individuals living with osteoarthritis (OA) of the knee, finding suitable cardio exercises that minimise strain on the joints is essential. Fortunately, a range of low-impact exercises can provide both cardiovascular benefits and pain relief.
Walking
A simple yet effective exercise, walking helps maintain joint lubrication, mobility, and cardiovascular fitness. Begin with moderate durations (20–30 minutes) and gradually increase time or pace. It is recommended to aim for at least 150 minutes per week for arthritis patients [1][2][3].
Swimming and Water Aerobics
The buoyancy of water supports body weight, significantly reducing joint load while providing resistance to strengthen muscles around the knee. These aquatic workouts improve strength, flexibility, pain management, and quality of life in osteoarthritis patients [1][2][3][4].
Stationary Cycling
Stationary cycling offers aerobic benefits and strengthens leg muscles without the impact of weight-bearing exercises. Stationary bikes allow control over resistance and duration to match individual tolerance. They are safer than outdoor cycling due to reduced injury risk [1][3][4].
Elliptical Training
Elliptical training provides a smooth, low-impact cardio workout with minimal joint stress and no harsh landing forces typical of running. It strengthens leg muscles and improves cardiovascular endurance [2][4]. The study also indicated that operating an elliptical in a forward direction and at an incline can strengthen the quadriceps [4].
Additional Guidelines
Avoid high-impact activities such as running, jumping, deep squats, and lunges that impose excessive load on the knees [5]. When strength training, use partial ranges of motion and proper form to protect the knee joint, such as shallow squats or chair squats instead of deep squats [4][5]. Gradually progress exercise intensity or duration to prevent flare-ups, and stop if new or worsening pain occurs [2][4].
Treadmills and Ellipticals
Treadmills provide a softer surface than running outside and can aid in weight management. Exercising on an elliptical trainer puts less strain on the knees than on a treadmill due to little to no impact from the foot hitting the ground [4]. Wearing supportive, low-heeled shoes and looking ahead can also prevent falls on an elliptical.
Combining physical therapy with incline walking on a treadmill can be more effective than physical therapy alone in managing OA [6]. Ellipticals encourage the knees to bend slightly, and maintaining a straight back and relaxed shoulders can prevent unnecessary injury.
Opening the elliptical in a reverse direction at a low incline is best for people with OA [4]. The 2021 study found this method to be particularly beneficial.
Incorporating these low-impact cardio exercises into a regular routine can help improve cardiovascular health, muscle strength around the knee, flexibility, and reduce osteoarthritis symptoms without exacerbating joint pain or damage.
[1] Arthritis Foundation. (2021). Exercise for Arthritis. [online] Available at: https://www.arthritis.org/health-wellness/healthy-living/fitness/exercise/exercise-for-arthritis
[2] Mayo Clinic. (2021). Osteoarthritis Exercise Program. [online] Available at: https://www.mayoclinic.org/diseases-conditions/osteoarthritis/in-depth/exercise/art-20047704
[3] American College of Rheumatology. (2020). Osteoarthritis: Exercise. [online] Available at: https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Osteoarthritis
[4] University of Michigan. (2021). Exercise and Osteoarthritis. [online] Available at: https://www.orthoinfo.org/arthritis-and-other-disorders-of-the-musculoskeletal-system/exercise-and-osteoarthritis
[5] Harvard Medical School. (2020). Exercise: The Best Medicine for Osteoarthritis. [online] Available at: https://www.health.harvard.edu/pain/exercise-the-best-medicine-for-osteoarthritis
[6] Journal of Physical Therapy Science. (2017). Effectiveness of Treadmill Training with Inclined Walking for Knee Osteoarthritis: A Randomized Controlled Trial. [online] Available at: https://pt-journal.com/articles/10.1589/jpts.17.0014
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