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January 2014

Many fitness enthusiasts would say that fitness is their drug. They are actually not that far off from the truth. Exercise has been found to provide benefits to many different medical conditions such as heart disease and high blood pressure. In osteoarthritis, exercise provides moderate benefits to pain levels. While this may not seem like much, it is actually about the same relief you can get from simple pain relief medications like Paracetamol (Panadol) and oral anti-inflammatories (NSAIDS) like Ibuprofen which are the first line drug treatments for many sufferers of OA.

With this knowledge it’s clear that exercise will be good for you but what kind is best when your joints are already vulnerable? There are many types of exercises that are prescribed including cardiovascular exercising (like cycling or walking), balance training and muscle strengthening. These exercises work by strengthening the muscles that control and stabilise your knee, reducing joint load by weight loss and by improving your general health!

There are many recommended exercises but here are a few tips to get started:

• Try low impact activities to reduce the force going through your joints. This includes things like walking, swimming (the heated pool will feel great!) or Tai Chi.
• Aim to exercise for about 30 minutes a day. This could even be in blocks of 10 minutes.
• Plan your exercise for when you experience the least pain or stiffness in the day or even when your medications are most effective.

Muscle strengthening is also really important for lower limb OA and here are a few simple exercises you can try:

1)Standing Calf Raises

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Starting position
Stand on two feet near a wall or table. Hold on gently to maintain balance.

Activity
Keeping the knee straight, rise up on the toes and hold for 3 to 5 seconds then lower slowly.
Try to do 2 to 3 sets of 10 repetitions

Hint: The exercise can be made more difficult by doing it on one leg

2)Partial wall squats

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Starting position
Stand with feet approximately one foot (30cm) away from the wall and feet apart. Slightly turn your feet outwards (if you get pain in the front of your knees with this exercise related to kneecap arthritis we would not encourage this exercise).

Lean your trunk and buttocks against a wall and keep your back straight.

Activity
Slowly slide down the wall (as if to sit) keeping your body in contact with the wall as you do.
Keep your knees moving over your toes.
Stop when your knees are bent to about 60 degrees (or less if it is painful).
Hold the position for 5 seconds.
Slowly slide back up keeping your body in contact with the wall as you do.

Try doing 2 to 3 sets of 10 repetitions

A physiotherapist can help recommend more exercise suited to your needs and ability.

For more information on physical activity and OA check out the physical activity fact sheet on MyJointPain.org.au.

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Christmas time is probably one of the most difficult times to watch your weight. With everyone giving you chocolates, mince pies and many treats along with the Christmas Eve/Christmas day/post-Christmas feasting, it’s quite likely to have put on a little bit of weight by the start of the New Year.

But when you have osteoarthritis and are overweight, putting on more weight is probably not a great thing. A lot of emphasis is put on weight loss by doctors in regards to reducing OA pain the knee, hip and back. There are actually a few good reasons for that! Firstly, obesity (Body Mass Index > 30) increases the risk of OA in women by four folds and men by almost 5 times [1]. A weight loss of just 5kg reduces the risk of developing OA by half[2]. Secondly, research has found that a 10% body weight reduction results in up to a 50% reduction in pain. In fact, the same study showed that 38% of participants reported little or no pain after their weight loss![3]

The big question really is about how weight affects OA. While not everyone who has osteoarthritis is overweight and vice versa, obesity is considered a great risk factor to develop OA. Excess weight can affect the joint in a number of ways including an increase in the amount of force on you joints. The knee, hip and back are called load bearing joints because, well, they bear load. The extra body weight creates an abnormal load for this joint causing them to essentially wear out faster. Furthermore, cartilage (which is found in the joint) responds to the increased loads by triggering mechanisms that result in the production of harmful material that can lead to the destruction of the joint[4].

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Another thing that researchers have noticed is that obesity is still a risk for OA in joints that do not hold up any weight like your thumb. This is because the fat cells release molecules that result in inflammation in your whole body which can affect the health of the joints. These molecules have been found to increase the loss of cartilage and affect the severity of arthritis[5].

There are many more details to how obesity affects osteoarthritis but the bottom line is that obesity is bad news for joints. The good news is you can still make positive changes and losing weight can make an enormous difference not only to the health of your joints but also your general health.

If you would like some tips on weight loss check out this amazing fact sheet about weight loss and how you might achieve this on MyJointPain.org.au

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