Every day in my orthopedic practice I coach patients about the power they hold againstthe formidable force of arthritis. Too often, I see patients with enlarged and painfulknees who can no longer get up from a chair without help. Their knee joints no longerbend far enough to tuck their legs and feet under the chair. Once stiffness takeshold, it’s hard to reverse.
I remind these patients that while they may not be able to undo the damage, theyusually can control the effect on the joint and their life.
We often respond to pain by avoiding any movement or activity that causes discomfort.But in the case of arthritis, we need to overcome this instinct. Here’s where tostart.
What is causing your arthritis pain?
In order to overcome your pain, it’s essential to remember exactly what caused itin the first place. Arthritis is the deterioration of the cartilage in the joints.Cartilage is the soft end cap at the end of a bone. This resistant fibrous coveringallows for smooth joint motion. Inflammation or trauma initiates the erosion ofthis protective layer, leaving the bone uncovered.
Bone is sharp and unforgiving when it rubs on another bone, bone-on-bone. So lossof cartilage leads to swelling, pain and stiffness of the joints.
Why you should keep moving
I encourage my patients diagnosed with arthritis of the knee to keep moving theirjoints despite the pain.
The results are clear when they do. Patients who stay active despite arthritic jointsoften delay or eliminate the need for joint replacement surgery. That’s becausemuscles around the joints weaken with disuse. These muscles are key to protecting the joint. Stronger muscles cushion and lessen the strain acrossthe joints.
The key is to find ways to modify workouts and maintain joint motion. True, therewill be some pain. By switching from walking exercises to the recumbent bicycleor swimming will decrease the strain across the weight bearing joint while workingthe muscles and keeping joints flexible.
Avoiding pain and exercise will NOT stop the progression of arthritis. Better tohave a painful knee that moves than a painful knee that no longer moves.
Maintaining joint mobility also improves the outcome of total knee replacement whenand if that becomes inevitable. There is a direct correlation between pre-surgeryto post-surgery range of motion. If your knee only bends to 80 degrees before surgery,you will struggle to reach 90 degrees after surgery. In order to get up easily froma chair, you need 120 degrees. So staying active isn’t just important, it’s essential.
What doesn’t have to happen
I wish I had known about the importance of continued movement 30 years ago in theearly days of my practice. When one of my patients developed arthritis of the hands,the therapist made her a splint to keep the finger immobilized when she felt pain.
I watched the incremental progression of the disease and its effect on her life.The enlarged knuckles of her hands were no longer painful but they were stiff. Shecould no longer hold a paintbrush. The golf club twisted out of her weak grip. Todayshe must even rely on others for help with simple daily chores such as pouring aglass of water.
If she had exercised and bent the fingers despite the pain during the destructionphase, the joints would still be enlarged — but she could have maintained her independenceand continued the activities that gave her most pleasure.
The lesson is to move and keep joint mobility despite some pain!
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