Exercising with Osteoarthritis

With the winter weather now in full swing with cooler days and nights, yourself or someone you may know might start noticing joints feeling more achy and stiff than usual. For individuals with osteoarthritis, colder weather can cause some interruptions with everyday life through increased joint stiffness and pain. However, keeping active and moving can be beneficial in the management of the condition. But before we jump into the deep end, let’s cover the basics of what the disease is.


Understanding Osteoarthritis:

Osteoarthritis (OA) is the most common form of arthritis affecting 1 in 5 Australians over the age of 45 and is the leading cause of inactivity in people over 65. Most commonly affected joints are those in the hands, knees, hips and spine.

So what is Osteoarthritis?  OA is a degenerative joint disease that affects tissues within a joint, most commonly the cartilage. Cartilage is a firm slippery tissue that acts to 1) reduce friction in the joints allowing smooth gliding of bones, 2) absorb shock by providing a cushion and reducing the stress and impact on your bones and 3) supports joint structures to keep their shape while moving. Over time the cartilage can deteriorate increasing the friction between bony structures.


Common symptoms of OA include:

● Pain during or after movement.
● Stiffness, often noticed after being inactive or in the morning.
● Swelling and tenderness to touch.
● Clicking, grating sensation or loss of range in a joint.

A common misconception is that OA is a ‘wear & tear’ disease; however, there is evidence that moderate loads on the cartilage can aid in regeneration and the reduction in symptoms in individuals with osteoarthritis. Before we move onto the use of exercise in management, let’s cover some risk factors for osteoarthritis.


Risk Factors for OA include:

● Age: The risk of OA increases with age.
● Gender: Although unknown why, women are more likely to develop OA
● Obesity/Weight: Carrying extra body weight can increase the risk, as the additional weight adds to the stress on weight-bearing joints such as hips and knees.
● Previous joint injuries: Those that occur from playing sports or accidents, although seemingly healed at the time, can increase OA risk.
● Repeated stress on the joint: Jobs or sports that place repetitive stress on a joint can impact the chance of developing OA.
● Genetics and bone deformities


Osteoarthritis and Exercise:

Physical activity and exercise is important for people with or without arthritis, however, research has found that exercise can improve muscle strength, mobility, flexibility and balance while reducing pain, fatigue and muscle tension in individuals with osteoarthritis.

Improving muscle strength: Provides more support and reduces pressure on joints, improves bone strength and balance.

Improving flexibility: Can maintain or increase the movement of your joints and nearby muscles which keeps your joints moving and reduces joint stiffness.

Increasing mobility and fitness: Helps to improve heart and lung health, endurance
and weight loss.


Australian exercise guidelines recommend for adults under the age of 65, they should perform 2.5 to 5 hours of moderate activity per week, 1.25 to 2.5 hours of vigorous intensity or an equivalent combination of each. In addition to 2 days of strength based training. And for adults over the age of 65 at least 30 minutes of moderate intensity activity on most days, preferably all days. This should incorporate aerobic, strength, flexibility and balance activities.

Generally, an easy way to measure intensity is through something as simple as talking. With moderate intensity activity you should be able to talk in full sentences without pausing for breath, but not be able to sing. When performing vigorous activity you should be able to say a few words at a time but will need to pause for a breath before continuing.

Exercise isn’t a one size fits all approach, however examples of low impact activities can include brisk walking, yoga and pilates, cycling, water-based exercise, strength training and tai chi just to name a few. To expand on water-based exercise it may include swimming, water-based exercise classes or hydrotherapy with a physiotherapist.


Keep in mind:

When starting exercise or physical activity you haven’t performed before, it’s hard to predict
how your body will react. Below are some general suggestions:
● See a health professional before starting a new exercise program
● Start slowly and gradually progress the frequency (how often), intensity and the total time you perform the activity. Note: you should increase one aspect at a time.
● Avoid high impact activities, moving or forcing your joint further than comfortable
● If you’re experiencing prolonged or a ‘new’ pain afterwards, reduce the intensity of your exercise next session.
● Wear suitable clothing and footwear whilst exercising.

As previously mentioned exercise and activity is not a standardised approach and visiting a health professional (such as a Physiotherapist) is recommended before embarking on the journey.


What to expect from a Physiotherapist:

When visiting a Physiotherapist prior to commencing exercise, you can expect an initial assessment in which your joint range, strength and functional movements can be assessed. From there, we can prescribe an exercise program at the appropriate level, observe and correct techniques and provide additional advice or education required. In addition to the exercise program, physiotherapists can also use hands-on techniques including, but not limited to, joint mobilisations or soft tissue massage to reduce pain or improve joint range of motion or joint function.


Take home message:

Osteoarthritis can be a painful and disruptive condition, but with the inclusion of exercise in the management it can lead to improved overall function and reduce pain as a result of the disease. Throughout the journey, physiotherapy can play a vital role in the return to activity and exercise process by providing guidance and tailored programs targeted to individual needs and levels.

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