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Osteoarthritis: Keep moving!

Updated: Oct 31, 2020

Approximately 45% of Canadians over the age of 65 live with Osteoarthritis. More than 10% of Canadian adults have been diagnosed with Osteoarthritis, costing the Canadian economy an estimated $33 billion a year in cost of treatment and lost productivity (Arthritis Society, Canada) .

This is real so what are we going to do about it?

Arthro = joint, itis = inflammation. Together they create Arthritis, inflammation of the joint space. There are many different forms of arthritis, but this post will focus on the most common type... Osteoarthritis (OA). Both the hip and knee joints will be in the spotlight because this is where OA is most commonly found.

Visualize the knee joint as the meeting spot for the end of two bones. In a healthy knee joint, the end of the each bone has its own padding i.e. cartilage. As the knee bends and straightens there is enough cushioning so the joint can glide smoothly. When there is thinning of the cartilage and less cushioning, there is more rubbing of the bones and ultimately more inflammation of the joint space. This process gets labelled as Osteoarthritis.

OA is a chronic, progressive condition that largely occurs when healthy cartilage is exposed to heavy work loads over a long period of time and becomes damaged (just like the more you wear your shoes, the more the souls get worn down). As we age, it is normal to have thinning of the cartilage, but whether we have pain and/ or disability associated with these changes, is frequently up to us.

How do you know if you have OA? Well... diagnosis is mainly based on he following symptoms: Morning stiffness, stiff/ tight after long periods of rest, difficulty/ pain with specific daily activities (ex. going down stairs is common) and clicking/ creaking of the joints.

You do not need an x-ray to tell you that you have OA and this is an important fact! X-ray's do not play a huge role in the diagnosis of OA because X-ray reports rarely correlate to a patients severity of symptoms. Essentially this means: Patient A: x-ray shows significant cartilage loss, but reports very minor symptoms. Patient B: x-ray shows minimal cartilage loss, but presents with significant symptoms and decreased mobility. There are other factors involved. Don't wait for x-ray results, because there is plenty you can do for yourself without the radiography... it starts with education, exercise and weight control! This is the first line of treatment for OA (see pyramid below taken from GLAD Canada Website)

The issue is this: for most people when they begin to have pain somewhere in their body, they stop moving it because they are worried about making it worse or causing further injury. Then they wait, and wait. They realize its not getting better and discover more stiffness and more pain in other areas of the body. Then they skip to the second or even third line of treatment which is costly and not as effective, spending most of their time with functional limitations. This is a sneak peak of the common downward cycle...

It is not all or nothing, we need to keep moving and this is critical, especially for people with OA. Not moving at all is only going to make it worse (a good portion of the time). I am not saying no pain, no gain... I'm saying use pain as a guide. Every exercise can be modified. You may need professional assistance to guide you in the right direction, but please, please, do not stop moving.

Taken from the American College of Sports Medicine, for individuals with arthritis, the following is recommended:

Aerobic Exercise 3-5 days (at least 150 minutes)/ week: Low joint stress activities like walking (or Nordic pole walking is great!), swimming, cycling etc

Resistance Exercise 2-3 days / week: Strength training of major muscle groups

Flexibility and Range of Motion exercises are essential and should be performed daily if possible.

This is a simplified summary in keeping of the theme of my blog. There are special considerations that should be taken into consideration on a case by case basis (for example, dealing with acute flare ups or periods of intense pain etc). Contact your local physiotherapist that treats with an active-based approach for more details on what your program can look like specifically. If you are in my area, please feel free to message me.

Bottom line, exercise is an essential tool for managing symptoms of OA, so let's #getafterit

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