Arthritis Pain

PREVENTING OSTEOARTHRITIS IN THE KNEE

WHAT IS IT?

Osteoarthritis is the medical term for the more common "arthritis" and refers to the general deterioration of cartilage that leads to damage on articulating surfaces of joints. 

Osteoarthritis can occur in any joint, some as small as the bones in the hand/fingers, and as large as the hip and knee joints. 

Preventing osteoarthritis in the knee, or delaying onset, is a lifetime practice, as many of the causes that lead to deterioration of bone articulating cartilage are due to overuse during youth, adolescence, and early adulthood. Other increased risks come from lifestyles, and habits that are typically formed at a younger age. 

INCREASED LIFESTYLE RISK FACTORS INCLUDE, BUT ARE NOT LIMITED TO: 

  • Extremely active lifestyle, where the joints take a beating
    • Participating in physical activity that heavily load the joint, such as running, put large loads onto the body that continuously put stress on the cartilage and articulations of joints, running the articulation cartilage thin.
  • Extremely sedentary lifestyle, where the joints receive very little to no load
    • Sedentary lifestyles tend to lead to a decrease in bone density, and a decrease in bone density leads to an increase risk of osteoarthritis
  • Ligament, tendon, or cartilage tears
    • Tearing your ACL, MCL, and PCL all show an increase risk for early onset osteoarthritis, as the joint lacks stability, and therefore overloads cartilage 
  • Misalignments
    • Having leg length discrepancies, wearing shoes that lack arch/medial support, etc. lead to increased pressure on one side of the body compared to the contralateral side, and results in deterioration of cartilage
  • Musculoskeletal discrepancies
    • Having weak muscles on one aspect of the leg compared to the other leads to decreased stabilization in the knee, which leads to increased load on one aspect of the joint. 
    • This is the highest, non-impact cause that is correlated with an increased risk of developing osteoarthritis in both adults and children

WHAT CAN YOU DO? 

Prevention is key. Having musculoskeletal evaluations, leg length, joint alignment measured by a physical therapist prior to your child starting physical activity is key to identifying potential problems early. Children are resilient, physically, but those same joints may not be so quick to heal at age 40, and like wearing sunscreen, it's extremely necessary to attempt prevention at a young age. 

Preventative physical therapists, including us here at CHAMPION, can take your children, or even you through preventative programs to help decrease risk, delay onset, or even delay surgical repair. 

MANAGING ARTHRITIC PAIN WITH EXERCISE

According to the National Center for Health Statistics, more than 50 million adults have some form of arthritis. The most common type is osteoarthritis — also known as "wear and tear" arthritis — which most often affects the weight-bearing joints in the knees, hips, neck, and lower back.

In osteoarthritis, the smooth cartilage that cushions our joints begins to wear away. Cartilage does not heal or grow back, and over time it can become rough and frayed. Without healthy cartilage, our bones can no longer smoothly glide across one another, and movement begins to cause pain and stiffness.

When it is very severe and there is no remaining cartilage cushion, the joint becomes bone-on-bone.

How Exercise Helps Arthritis Pain

It is not uncommon for arthritis pain to limit activity and slow most down - the body's natural reaction is to avoid movements that increase pain. Not exercising, however, can result in more problems. Recent research shows that not only do the compensations naturally adapted to limit pain during required daily movements (limping while walking, shuffling as opposed to stride walking), but also that over time inactivity actually worsens osteoarthritis pain, and puts adults at greater risk for eventual total loss of mobility.

Because exercise is painful for so many adults with arthritis, it may be hard to understand how exercise helps to actually relieve pain. First, exercise increases blood flow to cartilage, bringing it the nutrients it needs to stay healthy.

In addition, specific exercises will strengthen the muscles that surround your joints. The stronger your muscles are, the more weight they can handle without pain. As a result, the bones in your joints carry less weight, and your damaged cartilage is better protected.

Having strong muscles to support your joints is even more important if you are overweight. And exercise, of course, can help you with weight loss. Losing just a few pounds can make a big difference in the amount of stress you place on your weight-bearing joints, such as hips and knees.

Studies have also found that people who exercise are less likely to be depressed or feel anxious. Plus, exercise can help you manage stress and improve your sleep patterns. Getting a full night's sleep is especially important because arthritis symptoms often worsen when you are tired. With hip and knee arthritis, it can be helpful to sleep with a pillow under your knees or between your legs for comfort. 

Starting an Exercise Program

Of course, understanding how exercise can help is just the beginning. Starting an exercise program is the next step and often the toughest. Be sure to talk to your doctor first, especially if activity is painful for you or you have been sedentary for a long period of time.

Your doctor will talk to you about the types of exercises that would be best for you, depending on the severity of your arthritis - and they'll likely recommend you to physical therapy so you have medical oversight while adjusting to the exercise programs and increasing skeletomuscular strength - this is where we at Champion Performance and Physical Therapy come into play. Our staff maintains the perfect mix between experience, studying under some of Kansas City's longest-practicing physical therapists, and practicing based off of the most up-to-date research and developments. 

The program we would create would likely include three types of exercise:

  • Range-of-motion exercises to improve your flexibility and reduce stiffness in your joints
  • Strengthening exercises to help build muscle mass and protect your joints
  • Some aerobic exercise to strengthen your heart and lungs, and improve your overall fitness. Aerobic exercise is key to controlling your weight, as well.

Even if pain does not prevent you from exercising, it is a good idea to talk to your doctor about your fitness program.

Moderate Exercise

Typically, doctors recommend a moderate, balanced fitness program. If you regularly do high-impact aerobic exercises, such as running or competitive sports, your doctor may recommend that you switch to low-impact activities that place less stress on your weight-bearing joints. Walking, swimming, and cycling are good alternatives. A stationary exercise bike, even a recumbent one, can provide aerobic exercise for those who cannot walk well or have balance problems. 

To help with balance, strength, and flexibility, your doctor or therapist may suggest you try yoga or tai chi, a program of exercises, breathing, and movements based on ancient Chinese practices.

Start Slowly

If it has been awhile since you have exercised, slow and steady is the safest and most effective way to begin a fitness program. Your goal is 20 to 30 minutes of aerobic activity, 3 to 4 times a week. If this is challenging for you, you can break it up into shorter segments, such as a 10-minute walk in the morning and a 10-minute walk in the evening.  We will likely focus on the first two of the three key exercises focuses - then when your pain dissipates enough to add aerobic activity back into your lifestyle, we'll provide the keys to upkeep on your own.

Strength exercises can be done every other day, and you can work on your range of motion every day. Always begin with a warm up to prepare your body for all types of exercise.

As you get stronger, gradually increase the duration of your aerobic exercise and the number of strength exercise repetitions. Be sure not to overdo it. You should not feel serious pain after exercise. It is typical to feel some muscle soreness the day after you exercise, but if you feel so sore that it is difficult to move, then you have overdone your exercise. You can reduce muscle soreness with a heating pad or a warm bath or shower. 

Talk to you doctor or therapist if you have any pain or are unsure about your fitness program. Your therapist may recommend assistive devices, such as braces or shoe inserts, to help reduce stress on your joints.

Living with osteoarthritis can be very challenging. Remember that there are many things you can do to lessen the impact arthritis has on your life. Regular, moderate exercise can help.

Call us at Champion Performance and Physical Therapy at 913-291-2290 with any questions.

Source: National Center for Health Statistics (NCHS), National Health Interview Survey 2010.