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Are Isometrics Best for Joint Pain?
If you experience joint pain, reducing repeated movements during exercise makes intuitive sense, but what does the science say about isometrics and it’s potential contribution to recovery?
Joint pain vs. exercise
If you’re dealing with joint pain, this can put you off exercise altogether – for fear of inflamming more discomfort. That was certainly my belief.
Fear of making the pain worse – and possible further ‘damage’ to the joint – stopped me exercising regularly for 4.5 years prior to starting my largely isometric workout. And, minimising repetitive movement was central to my logic for building the workout around isometrics. In fact, I believed it as the only way I could restart regular exercise in my fifties, my pain was so bad previously.
Anecdotal evidence
I know I’m not alone in the dealing with these issues. In my Instagram DMs, knee and shoulder pain are frequently mentioned, when you ask me whether the workout is suitable for you. My own experience has been that it is, because my shoulder pain especially has diminished and my knees are certainly no worse. But, this week I thought I’d look to see if science had a more definite answer!
What does the science say?
Knee pain and, particularly Osteoarthritis-related knee pain, are better studied than other joints and causes. This combination seems to be a popular research topic – perhaps due to the number of sufferers. But, even if your specific joint and cause differs, strong evidence in this area surely points to isometric training’s suitability more generally?
Here’s what I’ve discovered…
Isometrics for Osteoarthritis: Solid Evidence
In a randomised control trial[1], isometric strengthening exercises significantly reduced pain and disability in patients with knee osteoarthritis (OA). After just six weeks, participants who performed quadriceps isometric exercises experienced a substantial decrease in pain and a marked improvement in their range of motion (ROM) and functional ability. Not only were their pain levels lowered, but functional tasks like walking and stair-climbing became easier.
Another study comparing isometric and dynamic resistance training[2] showed similar improvements. Participants in the isometric group saw a 16-23% improvement in functional tasks like ascending stairs and getting up from the floor, with knee pain dropping by 28-58%. The results were comparable to those of dynamic resistance training, demonstrating that isometric exercises are just as effective in reducing pain and improving function.
A third study[3] compared the effects of isometric exercises and acupressure on knee OA. While both interventions reduced pain, isometric exercises had a greater impact on stiffness and functional ability.
This study suggests that isometric exercises offer a more holistic improvement in knee pain and function. It recommends combining both for maximum benefit, but isometric exercise is the most readily available to us all.
Long-Term Benefits for Strength and Motion
Isometric strengthening exercises also offer long-term benefits. In a case study[4] spanning 16 months, a woman with knee OA demonstrated progressive strength gains across a wide range of knee angles, despite training only in the midrange position. This suggests that isometrics don’t just improve strength at specific angles but can enhance overall knee function, making them a valuable tool for long-term rehabilitation.
Beyond Osteoarthritis
Isometrics aren’t just for beneficial for osteoarthritis suffers. Patellofemoral pain syndrome is pain at the front of the knee, around the kneecap. It’s sometimes called runner’s knee. A study of runners suffering from patellofemoral pain syndrome (PFPS)[5], found a combination of isometric exercises and somatosensory training led to significant improvements in pain, balance, and proprioception (awareness of joint position).
The isometeric training included air squatting, posterior lunge, side stepping, lateral lunge, standing on one leg, standing on one leg with heel raised, and a lateral step-up. The somatosensory training was used to improve proprioception and balance. Examples of these kind of exercises might be: standing on one leg with your eyes closed; balancing on pliable or mobile surfaces; or climbing.
The study highlighted how isometrics can benefit a younger, more active population as well. For those dealing with anterior knee pain during running or athletic activities, isometrics provide a simple yet effective solution.
While a 2024 study of elite freestyle swimmers[6] with elbow pain, highlighted the potential role of isometric training for perserving muscle strength (Maximum Voluntary Contraction/ MVC) during rehabilitation. Sixty swimmers followed one of two treatment protocols or none (the control group): the classic Rest, Ice, Compression and Elevation (RICE) method or isometric training. Swimmers in the isometric training group showed a positive trend, with an approximately 2% increase in MVC. Conversely, MVC of subjects in the RICE treatment group and control group decreased by approximately 4% and 5%, respectively.
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So, Are Isometrics the Best for Joint Pain?
The research strongly suggests that isometric exercises are highly effective for reducing joint pain, improving range of motion, and enhancing functional ability. Whether you’re dealing with osteoarthritis, recovering from an injury, or looking to manage running-related knee pain, isometrics appear to offer a versatile, low-impact solution.
By prioritising isometric training over dynamic, there’s evidence to suggest my workout is helpful for sufferers of joint pain. And, importantly, that it is preferential to rest as a protocol for recovery.
Steve — MiniWorkoutDad
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References
1 Effects of Isometric Strengthening Exercises on Pain and Disability Among Patients With Knee Osteoarthritis, Chinelo N Onwunzo, Sylvester E Igwe, Joseph O Umunnah, Chigozie I Uchenwoke, Uchechukwu A Ezugwu, Cureus October 2021.
2 The effect of dynamic versus isometric resistance training on pain and functioning among adults with osteoarthritis of the knee, Robert Topp RN, Sandra Woolley, Joseph Hornyak III, Sadik Khuder, Bashar Kahaleh, Archives of Physical Medicine and Rehabilitation, Sept 2002
3 Effectiveness of acupressure versus isometric exercise on pain, stiffness, and physical function in knee osteoarthritis female patients, Amany S.Sorour, Amany S. Ayoub, Eman M. Abd El Aziz, Journal of Advanced Research March 2014
4 The Effects of 16 Months of Angle-Specific Isometric Strengthening Exercises in Midrange on Torque of the knee-extensor Muscles in Osteoarthritis of the Knee, Ray Marks, MScPT, BScPT, BSc, Journal of Orthopaedic & Sports Physical Therapy 1994
5 Efficacy of Isometric Exercises and Somatosensory Training for Pain, Proprioception, and Balance in Runners with Patellofemoral Pain Syndrome, Shraddha S Kochar, Tejaswini Fating, and Shubhangi Patil, Cureus March 2024
6 Effects of isometric training and R.I.C.E. treatment on the arm muscle performance of swimmers with elbow pain, Weihan Li, Maryam Hadizadeh, Ashril Yusof & Mohamed Nashrudin Naharudin, Nature – Scientific Reports 27 February 2024.