Exercise training while wearing a weighted vest is undergoing somewhat of a renaissance. Social media posts and trainers are promoting them as a potential strategy for improving fitness and health.

Exercising with additional weight attached to the body is nothing new. This idea has been used with soldiers for many centuries if not millennia – think long hikes with a heavy pack.

The modern weighted vest comes in a range of designs that are more comfortable and can be adjusted in terms of the weight added. But could one be helpful for you?

What the research says

One of the earliest research studies, reported in 1993, followed 36 older people wearing weighted vests during a weekly exercise class and at home over a 20-week period. Wear was associated with improvements in bone health, pain and physical function.

Since then, dozens of papers have evaluated the exercise effects of wearing a weighted vest, reporting a range of benefits.

Not surprisingly, exercise with a weighted vest increases physiological stress – or how hard the body has to work – as shown by increased oxygen uptake, heart rate, carbohydrate utilisation and energy expenditure.

Adding weight equal to 10% of body weight is effective. But it doesn’t appear the body works significantly harder when wearing 5% extra weight compared to body weight alone.

Does more load mean greater injury risk?

A small 2021 study suggested additional weights don’t alter the biomechanics of walking or running. These are important considerations for lower-limb injury risk.

The safety considerations of exercising with weighted vests have also been reported in a biomechanical study of treadmill running with added weight of 1% to 10% of body weight.

While physiological demand (indicated by heart rate) was higher with additional weight and the muscular forces greater, running motion was not negatively affected.

To date no research studies have reported increased injuries due to wearing weighted vests for recreational exercise. However a 2018 clinical study on weight loss in people with obesity found back pain in 25% of those wearing such vests. Whether this can be translated to recreational use in people who don’t have obesity is difficult to say. As always, if pain or discomfort is experienced then you should reduce the weight or stop vest training.

Better for weight loss or bone health?

While wearing a weighted vest increases the energy expenditure of aerobic and resistance exercise, research to show it leads to greater fat loss or retaining muscle mass is somewhat inconclusive.

One older study investigated treadmill walking for 30 minutes, three times a week in postmenopausal women with osteoporosis. The researchers found greater fat loss and muscle gain in the participants who wore a weighted vest (at 4–8% body weight). But subsequent research in obese older adults could not show greater fat loss in participants who wore weighted vests for an average of 6.7 hours per day.

There has been considerable interest in the use of weighted vests to improve bone health in older people. One 2003 study reported significant improvements in bone density in a group of older women over 32 weeks of weighted vest walking and strength training compared to a sedentary control group.

But a 2012 study found no difference in bone metabolism between groups of postmenopausal women with osteoporosis walking on a treadmill with or without a weighted vest.

Making progress

As with any exercise, there is a risk of injury if it is not done correctly. But the risk of weighted vest training appears low and can be managed with appropriate exercise progression and technique.

If you are new to training, then the priority should be to simply start exercising and not complicate it with wearing a weighted vest. The use of body weight alone will be sufficient to get you on the path to considerable gains in fitness.

Once you have a good foundation of strength, aerobic fitness and resilience for muscles, joints and bones, using a weighted vest could provide greater loading intensity as well as variation.

It is important to start with a lighter weight (such as 5% bodyweight) and build to no more than 10% body weight for ground impact exercises such as running, jogging or walking.

For resistance training such as squats, push-ups or chin-ups, progression can be achieved by increasing loads and adjusting the number of repetitions for each set to around 10 to 15. So, heavier loads but fewer repetitions, then building up to increase the load over time.

While weighted vests can be used for resistance training, it is probably easier and more convenient to use barbells, dumbbells, kettle bells or weighted bags.

The bottom line

Weighted vest training is just one tool in an absolute plethora of equipment, techniques and systems. Yes, walking or jogging with around 10% extra body weight increases energy expenditure and intensity. But training for a little bit longer or at a higher intensity can achieve similar results.

There may be benefits for bone health in wearing a weighted vest during ground-based exercise such as walking or jogging. But similar or greater stimulus to bone growth can be achieved by resistance training or even the introduction of impact training such as hopping, skipping or bounding.

Exercising with a weighted vest likely won’t increase your injury risk. But it must be approached intelligently considering fitness level, existing and previous injuries, and appropriate progression for intensity and repetition.

Rob Newton, Professor of Exercise Medicine, Edith Cowan University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to updated treatment guidelines from the Australian Commission on Safety and Quality in Health Care.

So what is knee osteoarthritis and what are the best ways to manage it?

More than 2 million Australians have osteoarthritis

Osteoarthritis is the most common joint disease, affecting 2.1 million Australians. It costs the economy A$4.3 billion each year.

Osteoarthritis commonly affects the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles.

Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs.

Is it caused by ‘wear and tear’?

Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is not caused by “wear and tear”.

Research shows the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are not required to diagnose knee osteoarthritis or guide treatment decisions.

Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have shown this in people with osteoarthritis, and other common pain conditions such as back and shoulder pain.

This has led to a global call for a change in the way we think and communicate about osteoarthritis.

What’s the best way to manage osteoarthritis?

Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These include education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines.

Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms.

Health professionals who use positive and reassuring language can improve people’s knowledge and beliefs about osteoarthritis and its management.

Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as paracetamol and anti-inflammatories and can prevent or delay the need for joint replacement surgery in the future.

Many types of exercise are effective for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you.

Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time.

Weight management is important for those who are overweight or obese. Weight loss can reduce knee pain and disability, particularly when combined with exercise. Losing as little as 5–10% of your body weight can be beneficial.

Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. Recommended medicines include paracetamol and non-steroidal anti-inflammatory drugs.

Opioids are not recommended. The risk of harm outweighs any potential benefits.

What about surgery?

People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement.

Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain.

However, high-quality research has shown arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis.

Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, 53,500 Australians had a knee replacement for their osteoarthritis.

Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management.

The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments.

I have knee osteoarthritis. What should I do?

The care standard links to free evidence-based resources to support people with osteoarthritis. These include:

• education, such as a decision aid and four-week online course
• self-directed online exercise and yoga programs
• weight management support
• pain management strategies, such as MyJointPain and painTRAINER.

If you have osteoarthritis, you can use the care standard to inform discussions with your health-care provider, and to make informed decisions about your care.

Belinda Lawford, Postdoctoral research fellow in physiotherapy, The University of Melbourne; Giovanni E. Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney; Joshua Zadro, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, University of Sydney, and Rana Hinman, Professor in Physiotherapy, The University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.