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  • Dori Nissenson

Are your joints talking to you?

Do you ever hear your joints go snap, crackle, pop???

Do you wonder why there is a crunching sound coming from your joints with movement??

If you answer yes to either of these questions, then you may have a degree of osteoarthritis or OA in your joints. Osteoarthritis is the most common form of arthritis and is usually caused by the deterioration of a joint over time and is mainly due to AGING but also due to past injuries and/or overuse. Typically the weight-bearing joints are affected by osteoarthritis, with the hip and knee being the most common.

So, to all of my aging lifelong over-achieving athletes and exercise junkies, NOW is the time to start protecting your joints because they may be at risk for developing osteoarthritis.

Read on to understand how to minimize the effects of this condition and prevent worsening of your symptoms.

Read on to understand how to minimize the effects of this condition and prevent worsening of your symptoms.

What Is Osteoarthritis???

Your bones are connected to each other at your joints. The ends of the bones that make up your joints are covered with a rubbery substance called cartilage. In addition, your joints are bathed in an oily substance called synovial fluid. Both cartilage and synovial fluid help to reduce friction when you move and ease movement.

When these protective coverings breakdown, the bones begin to rub together during movement. This can cause pain and the process itself can lead to more damage in the remaining cartilage and the bones themselves.

This pain will cause decreased movement at the joint, causing a reduction in the synovial fluid produced. This, in turn, will cause more stiffness and lead to more degeneration at the joint level.

This vicious cycle results in osteoarthritis and if not treated this cycle will continue until the joint is completely deteriorated.

What Are The Causes of Osteoarthritis??

The main cause of OA is unknown but current research points to AGING as the main cause.

Factors that may increase your risk of OA include:

1. Age: As you age, your cartilage and synovial fluiddegenerate and increase your risk of developing OA.

2. Genetics: Research indicates that some of our bodies have difficulty forming cartilage and this can be genetically linked.

3. Past injury: Individuals with a past injury, with or without surgical intervention, especially in a weight-bearing joint (the hip or knee joint) are at increased risk for developing OA.

4. Occupation: Jobs that require repetitive motion that is stressful on the spine, hips, knees, and ankles are risk factors for developing OA.

5. Sports: Athletes who repetitively use a specific joint or individuals who participate in intense exercise involving jumping, high impact activity, and/or squatting may increase their risk of developing OA.

6. Obesity: Individuals who are overweight may be at increased risk of developing OA due to the increased stress on their weight-bearing joints.

What Are The Symptoms of OA?

The Symptoms of OA can include the following:

1. Stiffness in a joint, especially in the morning 2. Stiffness in a joint after sitting or lying down for an extended period of time 3. Pain during an activity that is relieved by rest 4. Cracking, creaking, crunching or other types of joint noise 5. Pain when you press on the joint 6. An enlarged joint representing increased bone growth around the joint which you may be able to feel 7. Swelling around the joint may be a sign of OA but is most likely a sign of something else

OA is usually diagnosed using an X-ray but an experienced PT can diagnose OA using the American Academy of Rheumatology criteria.

A positive diagnosis of OA lists the presence of pain, plus at least of 3 of the following 5 criteria:

1. Age > 50 2. Stiffness < 30 minutes 3. Joint grinding, crunching sound with movement 4. Bone tenderness 5. Bony enlargement

How Can A Physical Therapist Help?

Physical therapy has proven to be effective in BOTH the treatment and prevention of OA and may help you in avoiding surgery and using prescription painkillers.

Your PT will perform a detailed evaluation of the affected joint or joints and he or she will observe what activities are difficult for you.

Your PT will then put together a comprehensive individualized treatment program to help relieve your symptoms and slow the progression of the condition.

This program will include:

  1. Administration of skilled hands-on techniques to relieve joint pain and improve joint motion and soft tissue mobility

  2. Stretching of tight musculature

  3. Strengthening exercises targeting the muscles surrounding the affected joint(s) as well as muscles up and down the kinetic chain that will help to support the affected joint(s)

  4. Balance training to prevent falls that may cause joint injury

  5. Recommendation and fabrication of braces and/or orthotics to externally support the affected joint(s)

  6. Instruction in a home program of stretching and strengthening exercises

  7. Evaluation and modification of your workstation or car to lessen the strain on your joints

  8. Instruction in joint protection techniques to prevent worsening of the OA

  9. Instruction in modifying your sport or exercise regimen to lessen the strain on your joints

  10. Education in appropriate footwear to provide cushion for your lower extremities during weight-bearing activity in order to prevent pain and worsening of the OA

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