Monday Medical: Keep your joints moving


If you have reached middle age, you may be experiencing some pain and stiffness caused by osteoarthritis. This is a common joint disorder in which cartilage - the cushioning between the bone joints - wears away.

"Osteoarthritis is a process that occurs over a long period of time," said Scott Blair, physical therapist and assistant director of SportsMed in Steamboat Springs. "When you are younger, you can absorb injury better. As you age, repetitive injury or general wear and tear adds up to pain and stiffness, especially in knees and hips."

Inactivity is a major risk factor for osteoarthritis. Muscles atrophy quickly from disuse and become unable to provide structure and support that joints need. To be nourished and healthy, the cartilage in the knee requires the movement of muscle over bone to get a sufficient blood supply.

Persons already suffering from arthritis need to know how to protect their joints so they can continue to exercise. Those with healthy joints need to do the right things to keep them that way. First, choose your activities wisely.

"Low-load, high-repetition exercise will help promote lubrication of the joint surface," said Marti Irish, physical therapist at SportsMed in Steamboat Springs. "Stationary biking or spinning is an excellent choice."

Although running and jogging have strong cardiovascular benefits, they usually are classified as high-impact and risky for the joints. The greatest risks come from downhill running, workouts on hard surfaces such as concrete and worn-out or poorly chosen shoes.

Walking often is touted as the ideal low-impact exercise. Be aware, however, that gait irregularities can lead to joint or muscle problems.

"Nordic walking can help take the load off the knees and hips," Irish said. "By using ski poles when walking, you are decreasing the impact across the joint surface."

Stair-stepping is another activity that can have adverse effects. The stair-stepper machine increases force on the knee joint by as much as four times your body weight. To protect your joints, don't use the stair-stepper two days in a row, reduce the speed and pay attention to pain or swelling in your knees.

Don't exceed your limits. Exercise capacity is determined primarily by conditioning. If you try to do too much too fast, your muscles tighten and put extra strain on surrounding joints. Nagging pain during exercise or after you stop is a sign that you are overdoing it. Treat injuries promptly with rest, ice and anti-inflammatory medications.

Some athletes, particularly long-distance runners, develop strong quadriceps muscles but ignore the hamstring muscles in the back of the thigh. This creates the potential for joint injury. Hamstrings can be strengthened through specific exercises and should be 60 to 70 percent as strong as your quadriceps.

Watch your weight. Protect your lower joints by keeping your weight at a healthy level. One study found that losing as little as 11 pounds resulted in a 50 percent reduction in arthritis risk.

Wear the right shoes. Foot problems can radiate up to the knees and hips. Be sure to buy shoes that give you the shock absorption, cushioning and motion control you need. Replace your shoes promptly when they've lost their cushioning or are showing wear on the soles.

Consider orthotic shoe inserts to correct high arch, low arch, inward or outward rotating gait or other imperfections. By supporting the arch and centering the heel, the orthotic balances the body's weight in a proper alignment, taking stress off joints and muscles all the way to the hip. Podiatrists and some physical therapists, including Blair, can provide custom orthotics.

Prolonged standing can take a toll on the feet and joints. If you have aches and pains from standing on your feet all day at work, don't relax on the couch - get up and get moving to lubricate your joints.

Before starting or significantly modifying any exercise program, see a health care provider. If you suspect you have osteoarthritis, discuss it with your doctor. Early diagnosis can lead to successful management of this condition.

Lisa A. Bankard coordinates the Wellness and Community Education department at Yampa Valley Medical Center.



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