Exercise and Osteoarthritis- does it increase the risk?
Exercise and Osteoarthritis
Does it increase the risk?
What is Osteoarthritis?
Osteoarthritis (OA) is the most common form of arthritis and is most prevalent in people over the age of 45. It can occur in younger people, particularly those with a previous joint injury.
Symptoms vary with each individual and X-rays don't always correlate to the level of pain experienced. For example, someone who has been diagnosed with a mild knee arthritis on X-ray may have high levels of pain on weight bearing compared to someone else diagnosed with severe knee arthritis who is still managing to carry out their normal activities with low pain levels.
In OA the cartilage and other tissues within a joint break down and cause narrowing of the joint space. Bony spurs can also develop resulting in joint deformity. These changes are not caused by normal "wear and tear" of a joint. This structural breakdown is thought to occur due to the release of enzymes within the tissues. This causes a chemical reaction resulting in breakdown of the tissues. These changes occur more commonly with age. Researchers are currently working to find out more about why these changes happen (Versus Arthritis).
OA can cause pain, stiffness, clicking/cracking, and swelling. Surrounding muscles commonly lose strength due to reduced movement. This can aggravate symptoms further, causing increased difficulty with normal activity and movements.
Most joints can be affected by OA although it most commonly affects knees, hips, spine and hands.
If osteoarthritis is due to “wear and tear,” will I damage my joint further by using it?
OA is often thought of as "wear and tear" to the joint. While OA is a degenerative condition, this definition is misleading as many people think that they must avoid walking, or weight bearing on painful joints, or avoid activities which cause discomfort. People with knee OA for example, often report to physiotherapists that they have been avoiding exercise or activity due to concern that they will wear the joint away more and cause more damage.
Exercise has NOT been shown to increase the risk of developing OA in normal joints and is now thought to lower the risk of developing osteoarthritis (Kong et al, 2022).
Studies have demonstrated various exercises such as resistance training, aerobics, pilates and aqua therapy have all been effective in reducing symptoms of knee OA including pain, stiffness, function and quality of life (Mo et al, 2023).
There is astounding evidence available demonstrating the benefits of exercise in arthritic joints. As well as improving muscle and joint strength, exercise can reduce pain, reduce stiffness, improve quality of life and independence.
Exercise can help manage and reduce symptoms in people with already established OA. Lack of exercise and sedentary lifestyles are thought to contribute to the risk of developing OA. Weight bearing exercise can help to nourish the cartilage and joints and remove inflammatory waste products (arthritis foundation), thus improving the health of the arthritic joint. Furthermore, aerobic exercise helps to improve heart and lung health and helps to control weight (arthritis foundation).
Risk factors
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Usually starts late 40's which could be due to the changes that come with ageing such as delayed healing times, reduced muscle strength, weight gain (versus arthritis).
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OA is more common in women and often more severe.
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Being overweight, increases stresses through the joint and fat cells promote inflammation (arthritis foundation).
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Family history of OA can increase the risk of developing arthritis.
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Previous joint injury can increase the risk of developing OA later in life.
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There is some evidence that heavy physical work and repetitive loads such as kneeling and squatting over long periods of time can increase the risk of developing knee OA (McMillan et all, 2005). Conversely, other studies have found having good muscle strength around the knee helps to protect the joint against high impact and reduces stresses through the knee cartilage showing no harm or changes to normal joints under high loads (Sandmeier, 2000).
How you can help?
Maintain a healthy weight.
Avoid a sedentary lifestyle and keep active.
Good sleep hygiene- sleep promotes healing, aids pain management, manages fatigue levels and improves mental health.
Supportive footwear.
EXERCISE- improves muscle strength, reduces pain levels, aids joint flexibility and reduces stiffness, maintains mobility and function, improves balance and overall health and well-being.
How physiotherapy can help
Your physiotherapist will provide a full assessment, reviewing your medical history as well as providing a comprehensive assessment of your joints and how you are moving. They will look at your walking, balance, strength and function and identify areas of concern. They will discuss with you your main issues and devise a tailored treatment plan to suit you.
This may include-
- Advise on how you can manage your symptoms at home.
- Stretches to maintain joint flexibility and reduce stiffness.
- Tailored exercises to improve muscle strength and bone health. These may include exercises to improve your walking or balance as required.
-"Hands on therapy" such as massage or assisted movements.
-Pain management or pacing advice.
- Advice and techniques on how to improve day to day activities.
-Walking aid advice.
- Falls management if identified.
-Onward referral if your physiotherapist feels you would benefit from an orthopaedic opinion.
If you're struggling with osteoarthritis or have concerns you may have developed arthritis and are unsure where to start contact us for advice or to book an initial assessment.
Call: 07384 590177
References
J Anat. 2009 Feb; 214(2): 197–207. doi: 10.1111/j.1469-7580.2008.01013.x Exercise and osteoarthritis. David J Hunter1,2 and Felix Eckstein3,4
McMillan G, Nichols L, McMillan G, Nichols L. Osteoarthritis and meniscus disorders of the knee as occupational diseases of miners. Occupat Environ Med. 2005;62:567–575
Orthop J Sports Med. 2023 May; 11(5): 23259671231172773. Published online 2023 Jun 5. doi: 10.1177/23259671231172773
Exercise Therapy for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis
Ling Mo, MD,* Banghua Jiang, MD,* Tao Mei, PhD,corresponding author*† and Daihua Zhou, MD‡
Robert H Sandmeier, MD. Perm J. 2000 Fall; 4(4): 26–28. PMCID: PMC6220608
Osteoarthritis and Exercise: Does Increased Activity Wear Out Joints?
Exercise for Osteoarthritis: A Literature Review of Pathology and Mechanism
Hui Kong, 1 Xue-Qiang Wang,corresponding author 2 , 3 , * and Xin-An Zh. Front Aging Neurosci. 2022; 14: 854026. Published online 2022 May 3. doi: 10.3389/fnagi.2022.854026
PMCID: PMC9110817PMID: 35592699
Arthritis foundation. Make Running With Arthritis Safe With Tips and Modifications. Available at: https://www.arthritis.org/health-wellness/healthy-living/physical-activity/other-activities/tips-for-running-safely-with-arthritis. Accessed 25/08/24.
Arthritis foundation. Osteoarthritis. Available at: https://www.arthritis.org/diseases/osteoarthritis. Accessed 24/08/24
