Thursday, January 24, 2008

Exercise and Osteoarthritis

According to the Arthritis Foundation, there are over 100 different types of arthritis, with osteoarthritis being the most common. Arthritis, as most of us know, is inflammation of the joints. For those of you who have arthritis you can attest to the pain and discomfort that accompanies this disease.

Osteoarthritis (from here out referred to as OA) is a type of arthritis that causes cartilage to become soft and break down, cartilage that covers bone to reduce friction and absorb shock. When this wears away it leaves a joint unprotected, causing a “bone on bone” situation. The effects of OA can be pain when the joint is first engaged or post exercise, with the joint feeling stiff or tender. Any joint can be affected with the most common being the hips, knees, spine and certain joints of the hands and feet.

According to the Arthritis Foundation, OA affects an estimated 20.7 million Americans, mostly after age 45, with women being more commonly affected than men. The causes of OA are not clearly defined but it seems that heredity/genetics is a key component while unstable ligaments, atypical joint movement; injury and obesity can be contributing factors in the development of OA.

When an individual has OA, especially in the knee or hip region, pain and discomfort can reduce a person’s desire to be mobile, which causes the joint to stiffen and become less pliable. This of course makes the person suffering from OA less likely to want to move about, producing a decrease in muscular strength that can be up to 75% of normal levels. Obviously this situation can be a vicious cycle, leaving an individual in a situation where their gate may change to help compensate for the pain which in turn can lead to new problems if not properly addressed.

Some known treatments for OA are the use of analgesics and heat, reduced strain on the inferior joint by reducing body weight and active exercise to strengthen the surrounding muscles and improve ROM (range of motion) around the joint.

For individuals with mild to moderate degrees of OA, recommendations have been made to follow moderate intensity levels of resistance training and cardiovascular exercise to help alleviate the discomfort of OA. Careful selection of resistance exercise(s) and the inclusion of non-impact cardiovascular work such as swimming or cycling do not put excessive force on the troubled joint. Water based exercises in particular are very beneficial because it reduces the effects of gravity on the joints, thereby allowing the person to exercise with mild resistance and to stretch while the warm water helps soothe the sore joint.

Studies have shown that proper resistance and cardiovascular exercise has beneficial effects on pain for those with OA. The goal of course for those individuals is to perform exercise with little or no pain, with the hopes of even increasing their exercise selection and intensity. No, exercise hasn’t been yet established that it can’t make OA go away or even postpone or prevent OA from occurring, but the Arthritis Foundation and many physicians promote exercise as therapy because people with this disease generally feel better, function better and experience less debilitating pain when they are regularly active.

Fred Fornicola