Arthritis is a pain, isn’t it? Being a clinical sports physiotherapist one of the regular findings we see in the clinic is people suffering from osteoarthritis. Unfortunately, most people are clueless as to what it is and how it occurs.
There are no more great wife’s tales out there than ones that surround arthritis. Most of the time it usually involves your great gran who did back breaking work their whole life lifting hay bales, and thus has a degenerated spine. Or your uncle (who you never see) who has a dodgy knee from his years dominating local footy.
These stories are generally powerful in that they are emotive and capture our imagination. But they lead to harmful myths such as ‘bending your back is bad’ or that ‘playing sport will always leads to arthritis’. They create misconceptions that can last multiple generations as the story is passed down from one member to the next. However, science is now confirming they are just misconceptions, not reality.
Now before I go on I can hear you yelling saying ‘well my gran has a does have bad back for that very reason!’ To make my argument more convincing, you must remember all the rest. All the rest who did the same hard labour well in to their later years, and have fabulous health and a strong spine. Or all the rest that played footy into their forties and can still run around the tan with no problems.
The better question to ask is if it were general overuse that causes arthritis, why doesn’t everybody have it?
To answer this, we must first understand what arthritis is. The technical way to explain osteoarthritis is degeneration of the surfaces between the joints, leading to pain and difficulty moving.
The non-technical way to explain it is wear and tear. The cartilage is the tissue that helps the bones roll and slide on top of each other. It allows for a smooth glide, but in arthritic cartilage the joint finds it difficult to bend. This can lead to rubbing, swelling, and pain.
Now I am sure we all know someone, or ARE someone, who suffers from osteoarthritis. It can be debilitating at times – with stiff, sore and puffy joints being the hallmark. It stops people doing the things they love, like going for a run through the park or getting on the floor to play with the grandkids, and reduces your quality of life.
In recent years’ science, has gone leaps and bounds into understanding what is happening, with 2 very important papers being released that must be discussed.
The first was a landmark study by Vanwanseele et al 2002. They showed significant thinning of cartilage in people with spinal cord injury. They found that it is actually parts of the cartilage that are NOT being compressed that start to break down. It is because pressure or load, helps to squeeze nutrients into the cartilage to keep it healthy.
It is the opposite to what most people believe. We need healthy load and movement to keep it strong. It is when people stop moving or the joint is in the wrong alignment that we see cartilage degradation. Now being overweight or doing high impact activities without sufficient strength can add to this, so they must be addressed. But staying active and strong are your best weapons.
The second was as recently as May of this year. In this paper titled The role of metabolism in the pathogenesis of osteoarthritis. Nature Reviews Rheumatology, 2017, the researchers found the biggest single influence on the cartilage was diet and our metabolism.
They found that like everything in our body, the cartilage requires a nutrient dense diet to remain healthy and viable as we age. It stops the cells from breaking down, and as described above they respond positively to loading and stress, which actually keeps it strong and healthy.
Most people are under the impression that arthritis occurs because we have overworked a joint. Therefore, they are under the impression they need to stop moving when they have arthritis. As you can see, this is not the case.
The 3 most important things you can do are if you suffer from arthritis:
- Eat a nutrient dense diet, full of fruits, vegetables and whole grains. This will also help to keep you in a healthy weight range
- Keep moving and gently progressively loading the joint in a minimally painful way. Examples of this are gentle walking, Pilates or swimming
- Maintaining as much muscular strength around the joint as possible, by doing resistance based exercises
Chris Jellis is a physiotherapist and director of Sum Of Us. SUM is a health and wellness studio in Prahran that combines the science of modern physiotherapy and health care, in a nourishing holistic environmentwww.sumofusstudio.com.au