Understanding Osteoarthritis (OA)
Osteoarthritis (OA) is a chronic and progressive joint condition characterised by the breakdown of cartilage, which serves as a cushion between the bones in joints. As cartilage deteriorates, bones can rub against each other, leading to pain, stiffness, and reduced mobility. OA predominantly affects the hands, spine, hips, knees, and ankles. It is the most common form of arthritis, affecting approximately 2.1 million Australians, or 9% of the population, and is the leading cause of knee and hip replacement surgeries in Australia. OA affects people of all ages but is more prevalent in individuals aged 45 and older, with 21% of Australians over 45 and 35% of those aged 80 and above reporting the condition.
Causes and Risk Factors of Osteoarthritis
While the precise reasons for the breakdown in the repair process leading to osteoarthritis are not fully understood, several factors contribute to its development:
Age: The risk of OA increases with age due to the cumulative wear and tear on joints.
Gender: Women are more likely to develop OA, especially after menopause, possibly due to hormonal changes.
Obesity: Excess weight adds extra stress on weight-bearing joints, particularly the knees and hips.
Joint Injuries: Previous injuries, even those that occurred years ago and seemingly healed, can lead to OA.
Genetics: A family history of OA can increase the likelihood of developing the condition.
Joint Overuse: Repetitive stress on a joint due to certain occupations, sports, or activities can increase the risk of OA.
Local mechanical issues can also contribute to OA, particularly in the knee:
Adduction Moment: Increased pressure on the inner part of the knee.
Malalignment of the Kneecap: Improper positioning can lead to uneven stress on the joint.
Meniscal Damage: Tears or injuries to the meniscus, a cartilage in the knee, can lead to OA.
Altered Quadriceps Strength and Lower Limb Mechanics: Imbalances or weaknesses can increase the risk of OA.
Benefits of Exercise for Osteoarthritis
Exercise is considered the most effective non-drug treatment for improving pain and function in individuals with OA. Three types of exercise are particularly beneficial:
Range of Motion (Flexibility) Exercises: These exercises help maintain and improve joint flexibility and mobility, reducing stiffness.
Endurance (Aerobic) Exercises: Activities like walking, cycling, and swimming improve cardiovascular health, enhance stamina, and help with weight control.
Strengthening Exercises: Building muscle strength around the affected joints, especially the quadriceps for knee OA, helps stabilize the joints and reduce pain.
Focus on Resistance Training
Muscle weakness, particularly in the quadriceps, is a significant risk factor for knee OA. Research has shown that quadriceps strength is often 20% weaker in women with radiographic signs of OA. This weakness can precede the onset of OA symptoms, indicating that it may be a risk factor for developing the condition. Strengthening the quadriceps can improve knee stability during activities, reduce pain, and enhance function in those with OA. A recommended regimen often begins with isometric exercises (muscle contractions without movement) and progresses to isotonic exercises (muscle contractions with movement) as tolerated.
Tailoring Exercise Therapy
Exercise therapy for hip or knee OA should be individualised, taking into account the patient’s preferences and ensuring adequate advice and education to promote increased physical activity. Personalized exercise plans can enhance adherence and effectiveness, leading to better outcomes.
For personalized guidance and support, contact Innovate Exercise Physiology at 0419 159 903, visit our Facebook page, or email us at contact@innovatexphys.om.au.
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