Osteoarthritis is very common. In fact, nearly all of us will experience some level of arthritis, or joint inflammation in our lifetimes. Arthritis may sound like a scary word, but in truth its poorly understood by the general population, and poorly explained by healthcare professionals. In the past, it has been standard advice to immediately halt all physical activity if someone has ‘arthritic knees’, out of fear that this will progress the condition and the rate of degradation will be catastrophic, we now know this is wrong.
What is Osetoarthritis?
Osteoarthritis, is a condition characterised by a slow, gradual change within a joint, to the articular cartilage and bone surfaces. Most joints int he human body are lined with hyaline cartilage, this helps to improve congruency at joints to keep you moving smoothly and to protect the joint. These joints are lubricated by synovial fluid, which is produced by the synovial membrane, which encases most joints. This damage is often referred to as wear and tear of the joint. There are of course different stages of arthritis, from early to late stage. The earlier stages are in fact REVERSABLE.
As you can imagine, the early stages are where minimal damage has occurred, and minimal pain would be experienced. However, as the condition progresses joints suffering from osteoarthritis can become very stiff, swollen and painful. These symptoms are somewhat attributable to breakdown of the cartilage, and bone abnormalities called osteophytes which are small lumpy buts of bone that grow in this toxic environment in the joint.
What can I do about my knee pain?
Firstly you need to understand how the cartilage works. Very simplistically, you can imagine cartilage as a more rigid sponge. It’s a porous tissue that does not have a blood or nerve supply. Cartilage relies on water being squeezed in and pulled out of it for its nutrition and for the removal of waste products. This is known as the ‘sweep and squeeze’, and this is where the analogy ends but you can imagine if you have a wet sponge and you squeeze it, the water comes out, and if you have a dry sponge in water it soaks it up.
Now we know that the cartilage relies on the squeezing and relaxing like the sponge soaking up water we can apply that knowledge to your exercise. The key to protecting the joints are as follows:
Resistance training
Axial loading
Appropriate doses of impact and loading
Resistance training for osteoarthritis
Strengthening the muscles that have an impact on how the joint works. take the knee for example, strengthening all the muscles in and around the hip, knee and ankle will help to protect the joint. Don’t just work on the muscles immediately in contact with the joint as other muscles with influence biomechanics. The caveat here is appropriate loading which is where the guidance of a professional will help *Link to book*
E.g Squats, lunges, wall sits, calf raises, hips thrusts and bridges are all good exercises for arthritic knees
Axial Loading for osteoarthritis
This is the process of how bones strengthen and means loading something along its axis. For example, axial loading of the thigh bone (the femur) would include walking, standing, squatting etc. this will also help the sweep and squeeze of the cartilage and promote healing.
Appropriate dosage of load and impact
We know the cartilage and bone both respond to loading and in fact will help the healing process to reverse early stage damage but the key word here is appropriate. This is very much down to each individual, their pain, their exercise tolerance, and their joint condition. Taking complete rest will in fact slow down or even prevent these structures from getting the attention they need. The caveat here is appropriate loading which is where the guidance of a professional will help *Link to book*
E.g. walking, hopping, skipping, running, jumping are all good impact exercises as long as they are applied at the right dosage, and progressed in a safe and gradual manner
Take home message
Osteoarthritis is not the end of your active lifestyle. It is in fact the beginning of your new approach to exercise. One that’s is focused on resistance training and impact-based exercises. It must be tailored to your needs, and your goals. For any help with this book in with your physio today.