Is it a case of ‘USE it or LOSE it’ (Move = Good) or
‘WEAR and TEAR (movement wears out your joints)?
Navigating the conflicting advice around causes of and
best management for Osteoarthritis (OA)
OA is a leading cause of pain and disability in Australia. 22% of Australians over the age of 45 have been diagnosed with OA. Whilst not directly life threatening it results in reduced activity levels, reduced participation in recreational activities and the workforce, which can in turn increase the risk of other chronic diseases such as diabetes, osteoporosis and dementia.
The term WEAR and TEAR is often used when talking about OA. This leads to the belief that using your joints wears them out, when actually the reverse is true. Joints are designed for movement. They require movement to circulate the synovial fluid that brings nutrition to and waste products away from the tissues in the joint. This includes the articular cartilage and bone.
Rest is sometimes required for very short term settling of an OA flare up. Rest might be reducing down higher impact activity for a few days for a flared up hip or knee, such as getting on a bike or in the pool instead. Then as the joint settles you can re-introduce a graduated return to your desired activities.
Clinical guidelines recommend land based strength exercise as a first line treatment for hip and knee OA (RACGP, 2018 ). The strength exercise does not have to be pain free to be effective. In fact research shows that exercise within an acceptable pain level, leads to improvement in strength and function and a reduction in symptoms (Ageberg et al 2010).
What is an acceptable pain level? 4/10 or lower that settles within a 24 hour period would generally be considered acceptable.
So how do I get started?
The GLA:D programme is an 8 week programme of education and exercise specifically to treat OA of the hip and or knee. It is a supervised, small group programme that is tailored to your level.
*Private Health Rebates apply
For more information visit www.gladaustralia.com.au, speak to your Physio or Exercise Physiologist or download brochure here.
References
Ageberg et al, (2010). Feasibility of Neuromuscular Training in Patients with Severe Hip or Knee OA: The Individualised Goal Based NEMEX-TJR Training Programme. BMC Musculoskeletal Disorders
Bannuru,R.R et al ( 2019). OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis
https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/knee-and-hip-osteoarthritis
