Have you heard the word osteoarthritis (OA)?
More than likely you have – and probably from an older person. If you are middle-aged do not fool yourself, you could have OA as well. OA has been stereotyped as a disease that only affects an aging population, however; it also affects those over 35. Approximately five per cent of people between the ages of 35 and 54 and 30% of people between ages 50 and 70 have OA. It is more common than high blood pressure and diabetes.
Research has demonstrated one of the most important factors in preventing and managing OA is to increase muscle strength around the joints, manage weight and increase physical activity. All of this can be done with exercise.
OA is a progressive disease that occurs when there is an imbalance between the break down and rebuilding of cartilage. As cartilage breaks down, the bones rub together causing joint dysfunction.
OA can affect any joint that has cartilage around the end of the bones, it leads to pain, and it most commonly affects the hip, knee and hand joints. In the past, X-rays have been the most commonly used tool to diagnose OA, but it can take 10 to 15 years for OA to show on an X-ray. Recent research indicates clinical findings, symptoms and risk factors are just as effective and more economically friendly in diagnosing OA.
Symptoms of OA can come and go initially and gradually get more consistent as the disease progresses. They can fluctuate throughout the day and differ between people. Someone with severe OA may have very few symptoms or very severe symptoms. The most common symptoms of OA are pain, stiffness lasting more than 30 minutes in the morning, aching, reduced range of motion in the joint and swelling.
Many people also feel that the joint may “give out,” hear cracking or feel grinding within the joint. Non-modifiable risk factors of OA are age, heredity and gender – and these cannot be changed. However, a person can make lifestyle changes to reduce modifiable risk factors: previous joint injury, physical inactivity, overuse, muscle weakness/imbalances in the legs and excess weight.
The majority of people with OA are physically inactive because they perceive being active leads to an increase in pain. When exercising, there are two important rules with regard to pain while exercising. Pain levels after exercises should return to regular levels 24 to 48 hours after exercise and pain should stay within an acceptable range; four to six on a scale of zero to 10.
The fact is, in order for cartilage to have a balance of break down and rebuilding it needs the appropriate amount of load, which can be achieved through exercise. Exercise helps by loading and unloading the joint, helping move the synovial fluid around the joint providing nutrients to the cartilage.
However, the proper amount of loading and unloading and the proper technique are just as important as moving the joint in order to reduce pain. When doing strength training the joints have to be in proper alignment in order to load the joint correctly. You want to ensure your ankles, knees and hips are aligned, knees do not go past your toes, and the back stays in a neutral position. After exercising with proper alignment pain levels can decrease.
The modifiable risk factors already discussed can also be reduced with exercise. Exercise helps to increase muscle strength and helps manage weight. The effects of exercise on OA has been proven in research. It has also been demonstrated exercise has a positive effect on other chronic health conditions like high blood pressure, diabetes, depression and others.
Good Life with Osteoarthritis (GLA:D) is a program to help manage symptoms of OA in the hips and knees. This program is based on research and best practice guidelines: exercise, education and weight management. To find a GLA:D program near you, visit gladcanada.ca for more information
Remember, Canada’s exercises guidelines are 150 minutes of moderate to vigorous aerobic physical activity per week, in bouts of 10 minutes or more; muscle and bone strengthening exercises at least two times per week. If you feel you are not achieving these guidelines contact your local family health team and speak with the health promoter/kinesiologist.
For more information about any of the free services offered by the Minto-Mapleton Family Health Team, visit www.mmfht.ca or call the Drayton/Palmerston office at 519-638-2110 or Clifford office at 519-327-4777. Like the FHT on Facebook (Minto-Mapleton Family Health Team) and follow on Twitter (@MintoMapleton) for healthy living tips and information on upcoming programs and events in the area.
Theresa Russwurm is a kinesiologist with the Minto-Mapleton FHT.
