Prevent osteoarthritis. Get more exercise, right? Well, not always, says the Arthritis Foundation. Certain sports, such as football, rugby, hockey, tennis, martial arts, athletics and long distance running can actually make things worse.
But before you get ready for a long slouch on the couch, remember that the right kind of exercise is highly effective for both managing and preventing osteoarthritis (OA).
With OA, the cartilage covering the ends of bones becomes roughened and thin. The space between the joints narrows and bones eventually scrape against each other, causing stiffness, inflammation and pain.
Professor Jones Cilliers of the Department of Sport, Rehabilitation and Dental Sciences at Tshwane University, cites himself as a prime example of someone with sport-induced OA. He recently had surgery to manage severe OA that had developed in his feet after twenty years of participating in long distance running and competitive judo.
He stresses, however, that he must have had a genetic predisposition towards developing OA in the first place. “Many people play competitive sports and do not develop OA,” he points out. “You must have the genes to make it happen.”
“Another major cause of sport induced OA,” he says, “is multiple injuries in the same joint or playing sport before an injury has fully healed. “
Football and rugby players frequently make this mistake and pay the price for it. According to research carried out at Coventry University, nearly 50 percent of the 284 professional footballers surveyed said they had osteoarthritis. The average age of diagnosis was 40 years old.
Soccer, rugby and OA
OA is a very real problem for many of the world’s most famous players. In 2005, The Independent reported that David Beckham had a mild form of arthritis in his toe. His former teammate, Roy Keane, has OA in his hip and in 2003 he told reporters that he would need a hip replacement operation when he retired from the game.
Formerly a medical committee member for The SA Rugby Football Union, Prof Cilliers says that he often saw rugby players going back onto the field before they were ready to do so. “This is unnecessary,” he says, “because biokineticists can assess the status of the joint by measuring its strength and alignment with specialised equipment. If you look after yourself properly, you can go on playing sport for many years without experiencing any problems.”
In the Biokinetics Unit at Tshwane University, Professor Cilliers says that OA in sportspeople is commonly seen in the knees, ankles, shoulders and back joints.
The right kind of exercise important
Paradoxically, the remedy for sports induced OA is exercise, but the right kind for the injury in question.
“It is important to strengthen the muscles around the affected joints in order to protect them,” says Professor Cilliers. “For example, stronger thigh muscles take some of the stress off weight-bearing joints like the knees and hips. A major preventive strategy for OA of the knee is to strengthen the quadriceps muscle of the knee.
“Mobilisation and stretching exercises are also critical. These help to prevent the stiffness associated with OA and also help to prevent injury.”
How do you know whether you are genetically predisposed towards developing OA? “If you regularly exercise and you start to experience pain in one or more of your joints, have yourself properly assessed by a rheumatologist,” says Professor Cilliers.
Are exercise routines such as Pilates or Callanetics good for the prevention or treatment of OA? “It depends on whether the instructor has some knowledge of physiology,” says Professor Cilliers.
“The best preventative strategy is to have a thorough physical assessment by an experienced physiotherapist or biokineticist. Each individual is different and you need to know what exercises can help – or harm – you in the medium to long term. “
Exercise – getting it right
- Studies have shown that obesity, inactivity and muscle weakness increase a person’s chances of developing OA.
- Many people with OA become less active because of pain and the fear of causing more damage. This can unfortunately lead to muscles becoming weaker and wasted.
- If you have OA, remember that the right kind of exercise will increase your muscle strength and flexibility, and also reduce your pain and stiffness.
- Know your limits. It is usual to feel some pain as your muscles get used to being exercised. However, if an exercise starts to hurt, especially in a joint you are exercising, and for two hours or more after your stop, check if there is a problem with a doctor or physiotherapist before trying it again.
- Do not do strengthening or resistance exercises during a flare up, when your joints are more painful than usual, or when you are very tired.
- Make sure you warm up (5 – 10 minutes) and cool down (5 minutes) to avoid injury.
- Aerobic exercises strengthen your heart and allow your muscles to work more efficiently. In addition to individually tailored exercises, people with arthritis benefit generally from aerobic activities such as walking, cycling, swimming, yoga and pilates.
- How much exercise should you do per week? Rheumatologist, Dr Anne Stanwix recommends 30 minutes per day for five days a week – i.e. 2.5 hours per week. If you have been completely inactive, you need to build up slowly.
- There is usually an improvement after approximately six to eight weeks of regular exercise.
- Go to www.worldarthritis.org to view exercises for osteoarthritis.
- (Information from the Arthritis Foundation)