Osteoarthritis 101

What do Jack Nicklaus, Shaquille O’Neal, and Dorothy Hamill have in common? Aside from being legends in their respective sports, they are all individuals who managed osteoarthritis while competinging in professional sports.

Modern medicine has deemed osteoarthritis (OA) as a “wear and tear” injury.Though it corresponds with previous injury and age, there are steps you can take to minimize your risk of getting OA, minimize the impact of OA, and maximize your mobility, if you have it.

The Facts

There are more than 100 forms of arthritis that affect our joints, but the most common kind is osteoarthritis. Here are the facts:

Nearly 10% of the US population experiences OA – that’s over 30 million people.

60% of cases are women.

OA costs the US over 130 billion annually.

Over 30% of people with OA experience depression and anxiety.

Often labeled the “wear and tear” disease, osteoarthritis leads to degradation of the cartilage and surrounding structures – bone, ligaments, and fatty tissue of the joint. The changes caused by osteoarthritis can deform the shape of the affected bones leading to inflammation, stiffness, reduced mobility, aches, and pain.

Typically, cartilage is a tough connective tissue that absorbs force and facilitates smooth movements between two bones. With osteoarthritis, this cartilage breaks down leading to rougher movement between two bones, and possible bone-on-bone contact.

OA is most often felt as stiffness in the morning, with pain further aggravated with activity. People with OA will experience movement restriction with daily activities such as walking, sit-to-stand, and going up/down stairs. The extent of damage is typically determined by a physical assessment, mobility screen, and X-ray.

Who Gets Osteoarthritis?

Osteoarthritis can happen at any joint. It typically occurs at the knees, hips, low back, hands, and neck. Note that these regions typically experience significant weight-bearing and movement.

Those most at risk for developing osteoarthritis are over 50 years old. If you’ve had a previous injury at a joint (e.g. meniscal tear or an anterior cruciate ligament (ACL) tear), your risk of developing osteoarthritis increases. Moreover, if you are overweight or inactive, your risk for OA also increases.

What Causes Osteoarthritis?

There are several factors that may contribute to developing OA:

Age: risk increases if you are over 50 years old.

Previous injury: if you have injured a joint before via bone fracture, cartilage damage, tendon tear, or ligament tear.

Obesity: excessive weight leads to stress of the joints.

Overuse: repetitive stress to a joint may lead to OA.

Gender: women are much more likely to develop OA compared to men.

Musculoskeletal dysfunction: if you have misaligned joints, muscle weakness, or a tendinopathy, you may be at risk for OA.

Environment: at the end of the day, modifiable risk factors may contribute to your OA such as occupation, physical activity levels, hormones, movement patterns, and bone density.

What Can You Do About It?

The most severe cases of osteoarthritis restrict specific patterns of movement, and limit daily mobility. Depending on the extent of damage and activity limitation, some cases require surgical intervention e.g. total knee replace, total hip replacement, and joint fusions to name a few.

Thankfully, there are several interventions you can do with your physical therapist to reduce the impact of osteoarthritis:

Lose weight: did you know that for every 1lb in the body, 3-4 lbs of weight are placed on the knee when you walk and go up/down stairs? Losing any weight can reduce stress to the joints affected by OA.

Stretch: OA typically leads to muscle tension at the corresponding joints. For example, knee OA may lead to quadriceps, hamstring, hip flexors, and glute tightness. Having a stretch routine dedicated to improving range of motion and mobility can protect against OA, even if you already have it.

Strength train: OA can lead to muscle weakness, further contributing to muscle tightness, immobility, and pain. Having a strength routine under the guidance of your physical therapist can improve mobility and reduce pain. This may include full-body workout such as swimming, cycling, and compound movements performed safely e.g. weight-lifting.

Manual therapy: joint mobilizations can be performed to maximize available movement at a joint. Treatment of the muscles contributing to movement restriction and pain may involve massage techniques, myofascial techniques, cupping therapy, acupuncture, and dry needling.

Medication and alternative therapies: your physician can help determine other forms of treatment to manage pain while you maintain mobility such as over-the-counter medications or prescription drugs.