Osteoarthritis [OA], also known as degenerative joint disease, can occur at any joint of the body. It is the most common joint disease, and can cause pain, loss of function, disability and financial burden (Coaccioli et al., 2022).
OA occurs when the cartilage between bones starts to disappear, which would cause our joint to lose some of its range of motion (ROM). OA is diagnosed using scans and imaging, as the joint condition can then be assessed (Corti and Rigon, 2003).
The main symptoms for OA are pain, stiffness of the joint, and swelling. A quick overview of the symptoms would conclude that pain is felt due to the loss of cartilage which causes the joint to move with less ease affecting structures within the joint. The stiffness, is created either due to osteophytes (bone growths) that block the ROM in the joint, or the pain restricting the ROM over time. Since the body would try to fix the joint, an inflammatory process would start at the joint causing swelling.
Before starting physical treatment through training, it is important to understand the specific joint affected by OA, for example, if we look at the shoulder, is it the Acromioclavicular joint of the Glenohumeral joint. And another aspect we would need to check is the ROM that is troublesome.
After we’ve understood the exact joint that is affected by OA, we need to investigate that joint from an Anatomical-Muscular view, examine the muscles relating to the joint, and once those are memorized, connect them to the issued ROM (which we’ve inspected before as part of step two) to understand how to work through the range.
Don’t
Since pain can be somewhat alarming, let us begin with things you should not do, and the first thing is to be afraid. Pain is indeed unpleasant and it is one of the body’s mechanisms to avoid damage, but bare in mind that the client is suffering from daily pain and they know how much they can handle or whether or not that pain is right for them or exceeding their normal range. If you are not familiar with pain training, either consult someone who is, or refer the client to another professional. The client’s health is first priority, and there is no shame in admitting you are not qualified to work with them.
Another aspect that is occurring with OA training, is the cracking / clicking / creaking noises that the joint may produce. As long as those are not painful, they are a part of the pathology, and may reduce over time with training and therapy. So DON’T be afraid of those.
Do
Make sure you understand the condition as best as you can.
Prior to every exercise perform the motion with no resistance to inspect problematic areas of the ROM.
Should you find alarming areas at the ‘dry run’ of the exercise, consider warming up some more, or skipping those areas when using high resistance.
Build up the motion, start from basics. Build a good movement pattern with the client! If they control the basics, and are gradually introduced to training, they will benefit greatly from the exercise.
A well prescribed exercise routine can help conservatively manage OA and offer relief (Hunter and Eckstein, 2009).
We can help with OA symptoms with training. Every case is unique and requires different considerations for the program to work. If you have any questions, or wish to consult us, reach out to us, and we’d do our best to supply you with the most relevant data we can. Stay Safe!
Reference
Coaccioli, S., Sarzi-Puttini, P., Zis, P., Rinonapoli, G. and Varrassi, G. (2022). Osteoarthritis: New insight on its pathophysiology. Journal of Clinical Medicine, 11(20), p.6013. doi:https://doi.org/10.3390/jcm11206013.
Corti, M.C. and Rigon, C. (2003). Epidemiology of osteoarthritis: Prevalence, risk factors and functional impact. Aging Clinical and Experimental Research, 15(5), pp.359–363. doi:https://doi.org/10.1007/bf03327356.
Hunter, D.J. and Eckstein, F. (2009). Exercise and osteoarthritis. Journal of Anatomy, 214(2), pp.197–207. doi:https://doi.org/10.1111/j.1469-7580.2008.01013.x.