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 The Need-To-Knows about Exercising with Osteoarthritis  

It's important to initially establish just what the physical activity guidelines are for everyday people, and for those people suffering from osteoarthritis as well. It is recommended that we complete 150 minutes of moderate aerobic exercise per week, which can be walking, running, cycling, swimming, or whatever type of aerobic exercise you prefer. It is also recommended that we partake in 2-3 resistance or strength-based sessions per week and this can also be accompanied by a flexibility or mobility type program.  

Exercising with osteoarthritis is safe!

So it goes without saying that yes, there are some considerations about how to exercise safely when you have osteoarthritis and there are some considerations about how to safely partake in those three modalities of exercise mentioned before. Let’s first focus on the general relationship between osteoarthritis and exercise, go through some of the common beliefs and investigate what we now know about how to exercise safely and long term for people suffering from osteoarthritis. When we ask those with osteoarthritis about what they actually think it is, perhaps the most common term or phrase that we hear is that it is a wear and tear type condition. Typically, they also believe that partaking in exercise is only going to lead to their bones rubbing together more, exacerbating their symptoms of pain, swelling, and reduced range of motion at that given joint as well. Justifiably it can be quite hard to educate and also motivate these clients that partaking in an exercise program is actually going to be a really important part of managing their osteoarthritis long term, but also just managing their overall health as well. We want to give you all a bit of an insight into some of the newer research around osteoarthritis and why it's safe to participate in exercise, but also some of the effects that exercise can have on not only our pain but the way we perceive our osteoarthritis in general.

How “wear and tear” becomes “wear and repair”

Let’s address the common phrase of “wear and tear”. What we're seeing through the newest research is that “wear and repair” may be a more apt way of discussing the principles that occur within osteoarthritis. The reasoning behind this is because cartilage is avascular, meaning that it doesn't have a blood supply. Some of the more important ways of how we maintain our cartilage and maintain cartilage homeostasis are actually mechanical load and stress. What this means is that it can actually be a positive thing for people with osteoarthritis to load and compress their joints. Obviously, this needs to be done within reason and in the supervision of a health professional. 

Changing your perceptions

Another issue that we tend to come across when working with people with osteoarthritis and introducing them to exercise is pain. In a previous blog, we have discussed the direct relationship between osteoarthritis and how it affects our pain systems and how we perceive pain. It's critically important to appreciate that when exercising with osteoarthritis, pain isn't always a direct correlation of our joint or tissue health. We do acknowledge that those people suffering from osteoarthritis will have systemic increase in inflammation that will heighten their perception of pain, and so it's really important that we consider breaking down that safety barrier that people will have around exercise to keep them exercising and living their life in general. However, it's also important to appreciate that exercise can actually have a physiological response to some of that systemic inflammation associated with osteoarthritis. Research has shown that even just 20 minutes of moderate-intensity aerobic exercise can stimulate an immune system response, reducing systemic inflammation within the body. This shows that through exercise, (in this example aerobic exercise) we can physiologically start to reduce that systemic inflammation and downregulate our pain systems and our perception of pain. At the same time this will also be working on breaking down some of those psychological barriers that we may have established around exercise, whether it be negative connotations or even fear due to our osteoarthritis. Ultimately, it's really important that those suffering from osteoarthritis partake in regular physical activity. Exercise interventions have been shown to reduce all those symptoms related to osteoarthritis, whether it be pain, swelling, or even reduced range of motion. It can also improve your function and your quality of life as well. Even with osteoarthritis, we still need to be meeting those physical activity guidelines each week to maintain our overall well-being and our fitness as well.

If you want help with treating osteoarthritis and with setting up a tailored exercise program, get in touch with an exercise physiologist at Health in Balance. 

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