Osteoarthritis and Exercise
Have you been told before that you have “Osteoarthritis”, “degenerative joints” or “wear and tear”?
Did you know that Osteoarthritis is the most common form of arthritis? Estimates suggest that up to 8.5 million people in the UK are affected by joint pain that may be attributed to osteoarthritis (1).
Have you had the cycle of “I’ve got pain so I can’t exercise” into “when I exercise, I have pain”?
If yes, this blog may be for you.
What is osteoarthritis?
Osteoarthritis is a normal age-related or trauma-related change that can occur in the joints of the body – particularly the knees, hips and hands. However, Osteoarthritis is not an inevitable part of getting older.
In a non-Osteoarthritic joint, cartilage covers the surface of the bones and helps the bones to move freely and smoothly against each other.
When a joint develops Osteoarthritis, part of the cartilage thins, and the surface becomes rougher. This means the joint doesn’t move as smoothly as it should. As the body tries to repair this cartilage, the process may change the structure of the joint, but will often allow the joint to work normally and without pain and stiffness (2).
It’s a complex disorder involving many risk factors – genetics play a role, biomechanical factors such as employment, recreational hobbies, muscle strength and joint flexibility, and personal factors e.g. age, gender, obesity.
What does it mean to have Osteoarthritis?
As you can see from the figures above, Osteoarthritis is a common presentation in the general public. However, the exact numbers of people with osteoarthritis is difficult to determine because joint pain and stiffness does not always correlate with changes seen on scans (1). For example, this could mean that moderate Osteoarthritic changes are seen on a scan but may not result in joint pain or stiffness.
How about if we change the narrative that Osteoarthritis is “causing your pain”, and instead suggest it “may contribute to your pain experience”? This can lead us to a viewing the diagnosis differently and to enable a productive, efficient and targeted management plan to be made.
The key to managing your Osteoarthritis is working out a plan that is tailored to you with the help of a medical professional such as your Osteopath, Physiotherapist or GP. This may include advice about weight management, nutrition, exercise, and the use of aids at home e.g. jar openers or shoehorns.
“How can I exercise when I am in pain? Aren’t I doing damage?”
One statement I say frequently when in the clinic is that “pain does not equal damage” i.e. if you have significant pain, this does not always mean that an x-ray or MRI will show a significant level of damage to the joint.
However, it is important to emphasise it is not a case of “no pain, no gain”. If your body is telling you “pain” it is important to modify what you are doing to be tolerable and productive. With support from your Osteopath or Physiotherapist, they should be able to create exercise plans with you in mind to support strengthening of the muscles that act on the joint(s) and to encourage mobility of your joint(s) as well as your own personal goals.
When considering exercise, it is important to find a form that you enjoy and can stick to.
Some people with Osteoarthritis can find that lower-impact forms of exercise can be useful such as Yoga or Pilates. However, it is important to consider both cardiovascular and strength/resistance training for diversity and your overall health.
You shouldn’t have to “always deal with the pain” – your healthcare professional should work with you to help figure out the best way to manage your Osteoarthritis and pain.
Having Osteoarthritis doesn’t necessarily mean ‘doom and gloom’ as there are many different methods of managing the symptoms and exercise is just one of these methods.
Conclusion
Ultimately, it is best to consult your Osteopath, Physiotherapist and/or GP about your own situation. Every person is an individual - your symptoms of Osteoarthritis and the way in which it impacts you will be just as unique as you are.
References:
NICE (2007) Osteoarthritis National clinical guideline for the care and management of osteoarthritis in adults. Available at: https://www.nice.org.uk/guidance/CG59/documents/osteoarthritis-full-version-draft-guidance-for-consultation2 [Date accessed: 22.04.20]
2. Versus Arthritis (2018) What is Osteoarthritis? Available at: https://www.versusarthritis.org/about-arthritis/conditions/osteoarthritis/ [Date accessed: 21.04.20]
