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Osteoarthritis & Exercise

Osteoarthritis and You

Arthritis is one of the most common conditions many individuals have in the western world and there are many different types.

Osteoarthritis is the most common type and mostly affects older adults. It is a degenerative joint disease that is caused by a loss of cartilage (by wear and tear on the joint or injury) or osteophyte formation (extra bone growth) within a joint in your body.

Pathophysiology of Osteoarthritis

Osteoarthritis is traditionally thought of as the ‘wear and tear’ disease. The development of osteoarthritis involves a degradation of you cartilage and remodelling of the bone due to an active response of chondrocytes, which are cells found in healthy cartilage. This process occurs in the articular cartilage and the inflammatory cells in the surrounding tissues. The release of enzymes from these cell break down collagen, which as a result, destroys the articular cartilage.

There are many stages of osteoarthritis development, which involve:

  1. Minimum disruption, with perhaps already 10% cartilage loss
  2. Joint space begins to narrow, cartilage begins to break down and there is an occurence of osteophytes in the joint
  3. Gradually, there is a moderate joint-space reduction. The gaps in the cartilage can expand until they reach the bone
  4. Joint-space is greatly reduced. Approximately 60% of the cartilage is already lost and there is occurrence of large osteophytes.

The most common joints in which Osteoarthritis can affect are the hips, knees, hands and spine. Osteoarthritis is associated with a number of factors including genetic, mechanical, hormonal and inflammatory. Several risk factors for Osteoarthritis include:

  • BMI over 25
  • Family history of osteoarthritis
  • Having an injury or trauma to a joint
  • Increasing age
  • Repetitive movements associated with an occupation

Symptoms of Osteoarthritis

The symptoms of osteoarthritis can vary from one person to the next and change for the same person over a period of time. Some common symptoms include:

  • Stiffness
  • Pain associated with movement
  • Muscle weakness
  • Joint instability
  • Reduced range of movement
  • Sounds within the joints
  • Feelings of low mood

Management of Osteoarthritis

If you have been diagnosed with osteoarthritis, then it is important that your condition is monitored by a health professional, and that you have an osteoarthritis management plan created and in place. It is also important that you have an understanding of osteoarthritis and how to manage it appropriately. This involves being informed about:

  • Your condition
  • Living with and managing osteoarthritis
  • Managing pain
  • Pain relieving medication
  • How to adopt a healthy lifestyle (it is important to maintain good general fitness levels, to reduce sedentary lifestyle habits and eat well)
  • The importance of managing your weight
  • Exercises of physical activity that will be of specific and appropriate help to you.

Is there a cure?

There is currently no cure for osteoarthritis, however, there are a number of treatment options available to aid in its management including:

  • Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) which can be prescribed by your GP
  • Weight loss can be used to decrease the extra pressure that is placed on the joints and therefore reduce the pain experienced in the joint.
  • Ice/Heat treatment. For most people heat works best, however, ice may be more beneficial during a flare up when inflammation is increased.
  • Surgery which can be used to ‘clean out’ the joint and repair or replace the joint. This is generally the option that is used after other options have been tried.

Exercise should also be used as a treatment option due to the numerous benefits it has, including:

  • Increasing the strength of the muscles around the joints which increases the level of support to the joint
  • Decreased pain levels
  • Decreased stiffness of joints and increased mobility
  • Increasing the joint nourishment by increasing the flow of synovial fluid in and out of your joint. This will also work to increase the nutrient supply and decrease the amount of waste products that remain in the joint.
  • Improved physical functioning
  • Synovial fluid also works to decrease the friction between surfaces in the joint which will decrease the amount of wear and tear in the joint and contribute to decreased pain levels
  • If you exercise, this also facilitates weight loss which means there will be less stress placed on the joints, decreasing the wear and tear the joints may experience
  • Exercising in warm water (hydrotherapy) is particularly helpful for those with arthritis as it allows you to increase movement and muscular support around the joint while not incurring the pain of weight bearing

If you are interested in resistance training, we have developed a guide which can be found by clicking here.

Exercise Precautions

  • You should use correct technique so that no extra stress is placed on your joints. For example if you are completing a sit to stand – make sure you square up your body, have your feet shoulder-width apart, toes pointing forwards, so that when you get up, your knees aren’t bending inwards.
  • Make sure that you try to complete your exercises at times of the day when you are in the least amount of pain. For example, if you feel the most pain in the morning, try to complete your exercises in the evening.
  • Do exercises that don’t aggravate your pain! If climbing the stairs aggravates your arthritis, you should try walking (on a flat surface) or cycling instead.

When to stop exercise

It is important to know when to cease exercise. If any of the following occurs, you stop exercising:

  • You experience a flare up – if your joints are red, sorer then usual or swollen, it is a sign that you should give exercise a rest for the day or decrease the time or intensity of the exercise.
  • You experience an increased, persistent or sharp pain during or after exercise. There is a normal amount of pain that you may experience when exercising with arthritis, but if you start to feel sharp or increased levels of pain during the exercise, stop the exercise and consult a health professional before commencing that exercise again.

In Conclusion

If you feel increased, new or persistent pain after exercising, it may be a sign that you have worked too hard during the exercises or that those particular exercises are aggravating your arthritis. You may need to decrease the duration, difficulty or intensity of your exercise and/or consult a health professional for advice.

To contact one of our health professionals, please click the Make an Appointment button at the top of this web page.

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