Before running straight into answering the above question, it is important to tackle the issue of what OA is and how it is managed. But, if you’re in this read for the sprint and not the marathon, the answer to the above question is NO!
For those beginning the marathon… read on.
If you’re suffering from OA and are looking for the most effective ways to self-manage, understanding your condition is the first step to regaining functional freedom, knowledge is power! Described below are the key knowledge points for obtaining your power against OA.
What is Osteoarthritis (OA)?
OA is a disorder of synovial joints, most commonly the knees, hips and small joints of the hands, which occurs when damage triggers the body’s repair processes leading to structural changes within the joint. This joint damage may occur through repeated excessive loading of a joint over time or by a previous injury to the joint.
It is the most common joint disease worldwide. As OA can affect many joints within the body, its prevalence varies depending on the joint affected. About 18% of the UK population aged over 45 years have sought treatment for OA of the knee and about 8% for OA of the hip.
What are the risk factors?
The exact causes of OA are not fully known, but we understand that it is a multifactorial condition involving genetic, biological and biomechanical components. One of the strongest risk factors for developing OA is increasing age. Gender can also influence our risk of developing OA; females are almost twice as likely to have hip OA than men. Obesity is also a risk factor for developing OA (as well as most all other diseases), the added bodyweight increases the load on weightbearing joints, accelerates the disease progression and increases the risk of developing knee OA more than threefold.
What is the prognosis?
OA is not always a progressive condition that inevitably leads to debilitating pain and joint replacement surgery. Similarly to the risk factors, the prognosis also varies depending on the joint in question. Hip OA tends to have a poor prognosis, with a significant proportion of people requiring a hip replacement within 5 years of diagnosis. Knee OA has a more variable prognosis, with some people improving spontaneously, some people’s symptoms remain stable and of course some peoples gradually worsen.
When should you suspect a diagnosis of OA?
An accumulation of the below features could possibly lead to a diagnosis of OA:
- Aged 45 years or older
- Activity related joint pain (worse with excessive activity or inactivity)
- Morning joint stiffness lasting no longer than 30 minutes
If you have got OA and you’re still reading this, stand up, walk around for 5 minutes, then do 10 squats. It is known that excessive inactivity such as sitting can lead to joint stiffness and aggravate your pain and Physiotherapists know whether you’ve been completing your home exercise programme or not!
We’re about halfway through our OA marathon, the next section will be discussing the treatment and management of OA. There are some interesting points in this next section, so feel free to grab a pen & paper, you aren’t expected to be able to remember all of this. For those readers who just want to know why running isn’t bad for your joints, don’t worry we will get onto it, I did warn you this blog was a marathon!
What is the treatment for OA?
As we discussed in the risk factors section, we currently do not know the exact causes for OA. Unfortunately, this therefore means that there is no current cure for OA. But fear not, there is light at the end of the marathon. As we discussed, we know that OA cannot be cured, therefore I prefer to use the term self-management when discussing treatment options for people suffering from OA. When physiotherapists create an individualised management plan, the below points are at the forefront of our plan to battle OA:
- Weight loss
- Aerobic fitness training
- Muscle strengthening
- Pain medication
So, no magic medication? No magic manual therapy technique? No phone number to book my joint replacement ASAP? While the above points are no magic cure, they may well be the information you’ve needed all this time to equip you along your OA journey. Not convinced? Have a read of this:
Weight loss – a scientific research study found that overweight individuals who suffered from OA who took part in a health program consisting of diet and exercise achieved a 50% reduction in their OA knee pain from 10% weight loss. Looking at this simply, this makes sense, right? Less bodyweight leads to less load going through the joint which leads to less aggravation of symptoms. If you’re now hooked on what the science says, get this, for every 1kg of weight loss, the peak knee load was reduced by 2.2kg at walking speed!
Aerobic fitness training – this term refers to any exercise which gets you moving and increases your heart rate, such as jogging, cycling or playing racket sports. Alongside a balanced nutritious diet, aerobic exercise is perfect for achieving that pain reducing weight loss described above. Alongside this, exercise can improve mood, decrease pain, increase flexibility, strengthen the heart and improve blood flow. If exercise could be prescribed in tablet form, it would be the most effective (and expensive) tablet in the world.
Muscle strengthening – this form of exercise is vitally important for joints and its surrounding structures. We strengthen and increase the size of our muscles by lifting heavy weights. By doing so, not only do our muscles become stronger, but also our tendons and ligaments, this leads to a more stable and protected joint. You may be surprised at how effective muscle strengthening can be at reducing your symptoms.
Pain medication – this is commonly the most important and emphasised complaint when clients describe their symptoms, not just for OA, but for any injury or disease. Pain isn’t just that unpleasant sensation, it can also be debilitating and stop us from doing the things we love. Initially, we advise paracetamol or a type of drug called nonsteroidal anti-inflammatory drugs such as ibuprofen, these drugs can really help with managing your pain. But there is trick with how to use them, which in my experience not many people know, so here it is. When taking pain medication to manage pain associated with OA, the trick is to take the medication regularly and religiously, instead of when needed. For example, when we have a headache, we take paracetamol and then it stops. With OA, we should take pain medication even on the days we are not suffering from pain to build our bodies capability to reduce the pain, similarly to taking hayfever medication. Although, please seek medical advice from your GP prior to starting new medication to ensure you are suitable to take it.
Is running bad for my joints if I’ve got osteoarthritis?
Right then, you’ve had your crash course in all things OA. Now, onto the question in hand, ‘Is running bad for my joints if I’ve got osteoarthritis?’. As you’ll remember from the start of this blog, the answer to this question is, no. But why? Well, linking in the science again; whilst running, the cartilage in joints such as the hip and knee are squashed, cells living within this cartilage detect this squash and subsequently block the action of inflammatory molecules within the joints, which are associated with OA. Scientific evidence also shows that a low level of physical activity (not running) is associated with a tendency towards a greater thinning of cartilage within the knee joint and that moderate running activity does not worsen the structural progression of OA, but is associated over 2 years with a higher probability of an improvement in joint pain and function.
This is interesting. However, you may be thinking that this cannot be a one size fits all… and you’re right. The level of running activity interspersed with your other daily activities and exercise, general health, muscle strength, BMI and OA stage & severity needs to be carefully assessed and gradually progressed under the supervision of a Physiotherapist to get the safest and most effective results.
If you’re suffering from OA and are interested in developing your individualised management plan or are keen to get started with your OA preventative strategy, we are here to help, so please get in touch today to book your free physiotherapy consultation.
To help you get your running shoes on, it doesn’t matter whether you’re new to running, experienced or never ran before, get started, give it a go! Get underway with the ‘Couch to 5K’ or get involved with local fun or charity runs. A brilliant smartphone app called ‘Map My Run’ by Under Armour is amazing for routes, tracking your times and sharing your runs with friends.
Ready, set, go!