Physical activity joint pain and osteoarthritis


It is very well known that physical activity has numerous health benefits. Yet, for many living with osteoarthritis
 (OA), those benefits are often outweighed by the joint pain that is experienced during or after physical activity. The good news is that research is showing that when physical activity and exercises are done correctly, they can actually help reduce pain, facilitate proper joint function, and improve overall health. 


Movement
 equals healthy joints: 

  • As we move, there is increased blood flow to the joints, bringing nutrients to be absorbed by the cartilage and removing waste.
  • Movement requires the use of muscles, and the more we use our muscles, the stronger they get. This can help take some of the stress off of the joint.
  • Movement can aid in weight loss. This can also take significant stress off of the joint. Did you know that 1lb of weight lost can take up to 40lbs of weight off of the knee joint?
  • Movement facilitates flexibility and joint ROM by maintaining the elasticity in the joint. This is very important for proper joint functioning.


All of these benefits can result in less pain and discomfort for an individual living with OA. 
 

So, what can you do to reap the benefits of physical activity and exercise without causing additional pain? 

The first and foremost important thing is to listen to your body. Learn the difference between ‘muscle soreness’ and ‘joint pain’. Muscle soreness, within limits, after exercise is normal, joint pain is not. Muscle soreness will often occur in areas surrounding a joint; for example, in the quadriceps above the knee or calf muscle below the knee. Joint pain will occur right in the joint. If you are experiencing joint pain after an exercise, it is a good indication that the exercise needs to be modified by adjusting the intensity, frequency, or type of exercise that you are participating in.

Before starting an exercise program or physical activity, it may be greatly beneficial to consult with a health care professional such as physiotherapist. They can help you to differentiate between muscle soreness and joint pain, as well as give you direction on how to modify your activities and exercises. Furthermore, they can assess muscle strength and flexibility to determine an appropriate exercise program.

Always warm up before starting any activity or exercise to loosen up the joints and warm up the muscles. A warm up should be about 5 to 15 minutes of low intensity exercise or a slower version of the activity to be performed.

Maintain flexibility or joint range of motion by doing dynamic and/or static stretching. This will help relieve joint stiffness associated with osteoarthritis. When doing stretches, it is important to move the joint in a slow and controlled manner through the full range of pain-free motion. Stretches are best done when the muscles are warm and should be done both before (dynamic stretches) and after (static stretches) an activity.

Do isometric and isotonic strengthening exercises to build strength in the muscles surrounding the joint. Increased strength in the muscles will provide the joint with adequate stability and support, and reduce the amount of stress going through the joint.

  • Isometric strengthening contracts the muscle without having to move the painful joint
  • Isotonic strengthening applies a mild resistance throughout pain-free range of motion

Start strengthening exercises with a weight or resistance that can be completed 10 to 15 times, comfortably. Progress slowly by either increasing the resistance or the number of sets. It is a good idea to see a professional when starting out to ensure that progressions are not going to cause more damage. Stop the exercise if you are experiencing joint pain.

For knee osteoarthritis, pay specific attention to strengthening the quadriceps, hamstrings, gluteus, and core muscles.

 Avoid high-impact sports and activities as they are very hard on the joints. Some examples include running, jumping, and activities that involve movements with sharp stops and turns. This may require finding a ‘new normal‘ or new activity. It may have been ‘normal’ for you to run 10km a day in the past, but now that activity is putting too much stress on the joint.

Osteoarthritis friendly activities: 

  • Walking is a low impact activity with great health effect. It is inexpensive and can be done almost anywhere – outdoors, the mall, a track! All you have to do is make sure you have a good pair ofshoes with adequate support.
  • Water aerobicsis another low impact activity. The buoyancy of the water reduces stress on the joints, while the water provides some resistance. Be aware that treading water or doing ‘whip kick’ involve rotational movements of the knee against resistance and can be painful. Start in shallow water or use a flutter board. As well, water activities may seem easier and therefore, it is more likely that you will overdo it. Be aware and start off slowly.
  • Cycling is great for building strength and endurance. It can be done outdoors or on a stationary bike.  
  • Yoga can help you increase flexibility and balance. Modifications may need to be made to some of the poses.

Use mobility devices if necessary. When first starting out, mobility aids such as a walker or cane, or an orthopedic brace can help reduce the pain enough to start or keep moving.

Remember that physical activity does not always have to be planned. Physical activity involves all activities of daily living. Even if you do not have time every day to do planned exercises, you can incorporate physical activity into your daily life. So, as you start building strength and endurance and the pain decreases, you can try:

  • Parking farther from the entrance
  • Taking the stairs rather than the elevator or escalator
  • Taking frequent breaks at work to walk around
  • Viewing household chores as a chance to be more active.

 

Author:
Meaghan Kadowaki
Orthopedic Bracing Specialist
Arthritis & Injury Care Centre

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