The Management and Prevention of Osteoarthritis
Osteoarthritis (OA), which causes pain and stiffness in the affected joint/s, as a result of inflammation and changes within the joint/s, is often thought of as an inevitable part of aging, however, there are many steps that one can take to prevent it.
Positive lifestyle changes can make a huge difference in minimizing the impact of OA on one’s quality of life: slowing disease progression, increasing mobility, improving mood, reducing pain and fatigue and eliminating, or delaying the need for hip-, knee- or shoulder replacement surgery.
- Reduce the load on your joints
Carrying too much weight can lead to joint instability and muscle weakness, increasing the load on bones and joints. Excess weight can also contribute to “metabolic syndrome” of obesity, which increases OA risk. Every extra 10lbs you weigh puts another 40lbs of loading on your knees. Losing even 5kg/11lbs of extra weight can reduce the risk of knee replacement by 50 percent.
- Practice a regular exercise activity you enjoy and can be consistent with
Mind-body activities eg Tai Chi or Yoga are highly recommended because you get the combined benefits of physical movement and increased flexibility, along with proven stress – , depression- and pain relief. This results in more function. Low impact workouts like swimming, cycling, walking or Tai Chi are well suited to those with OA, versus the “pounding” exercises like high intensity aerobics or running. A lot of OA clients enjoy a rehab OA aquatic class. If the activity causes pain or stiffness, adjust the frequency or intensity, or consult your physiotherapist about whether or not you need to modify the movements. Always start any new exercise program gradually to minimize injury.
- Strengthen the muscles that support the joint/s
Strengthening the muscles around the joint/s provides greater stability and support for the joint/s, lessening the risk of OA developing and progressing.
- Limit saturated fats and sugars
Having an anti-inflammatory diet and maintaining a healthy weight is key– eat plenty of fresh fruits and vegetables, nuts and wholegrain foods. Limit saturated fats, foods and drinks with added sugars, refined carbs like bread and pasta, and processed meats. Maintain adequate Vit D levels and stay hydrated.
- Avoid injuries and do proper rehab
Doing proper rehab exercises after an injury can mitigate the risk of developing OA.
If one needs a joint replacement, doing prehab exercises (therapy based on exercises to avoid further injury and prepare for surgery) will lead to a better outcome and quicker recovery, as well as completing post- op rehab.
- Adapt to hormonal changes and reduce OA risk
The incidence of OA of the knees or hips is at a 1:1 ratio for men and women up until women go through menopause. The ratio then jumps to 2:1 for women to men. It appears the loss of protective estrogen seems to leave joints more vulnerable in certain women, also making it easier to gain weight, and this combination increases the risk of developing OA.
- Try Neuromuscular training
The GLA:D (Good Life with OA in Denmark) neuromuscular exercise program has proven in studies and practice to be very effective in improving physical function and activity, relieving pain and reducing the number of OA clients using analgesics and on sick leave. This program includes strengthening the muscles and using them correctly, such that the affected joint/s move in a safe, aligned manner so that the pressure and stress of activities of daily living are exerted at the correct points in the body. The GLA:D Canada Program is widely accessible.
- Wear appropriate footwear
Wear comfortable, supportive walking shoes with a lot of shock absorbency and good arch support. Some clients will benefit from custom orthotics. Proper footwear helps stabilize your frame while weight- bearing and it cushions the impact of the ground reaction forces on your body.
I have helped numerous clients over the years to manage their osteoarthritis, thus reducing the need for a lot of medication or the need for joint replacement surgery. In those clients that did need surgery, prehab and post- op rehabilitation has always served to hasten a favorable outcome and expedite recovery.
All of us will develop some OA at some point in our lives, so I think prevention is key, particularly in our adult lives.
If you are uncertain about what type of exercise program you should be undertaking, book a consultation , and we will develop an individualized routine together.
References: Dr. Lauren King (Rheumatologist, Sunny Brook Health Sciences Centre, Toronto); Dr. David Hart (Professor Dept. of Surgery and Faculty of Kinesiology, University of Calgary & Scientific Director for the Alberta Health Services Bone and Joint Health Strategic Clinical Network), Women’s College Network Hospital in Toronto
Photo: Thorsten Bareuther