Does exercise really make arthritis worse? Here is what a knee replacement surgeon wants you to know

From hindustantimes.com

By Debapriya Bhattacharya

Exercise helps strengthen muscles and maintain joint health, helping people with arthritis stay active, shares Dr Sushil Sharma

For people living with arthritis, exercise can seem counterintuitive. When every step causes knee pain, fingers feel stiff in the morning, or hips ache after a short walk, resting may appear to be the safest option.

However, that does not make exercise bad for arthritis patients, shared joint and knee replacement surgeon Dr Sushil Sharma told HT Lifestyle. He cautioned that prolonged inactivity can weaken the muscles supporting the joints, reduce mobility and make everyday movements increasingly difficult.

“The key is not to avoid exercise, but to understand which activities are appropriate and how they should be performed,” highlighted the doctor.

Arthritis should not be an excuse not to exercise. (Pexel)

What happens to the joints in arthritis?

To understand the effect of exercise on arthritis patients, it is important to know what the condition actually is. “Arthritis is a term for a class of diseases associated with joint discomfort, tightness, swelling, and the inability to move easily,” stated Dr Sharma.

In osteoarthritis, the cartilage, the underlying bone, and other joint tissues are affected, eventually resulting in pain. In the case of inflammatory diseases, like rheumatoid arthritis, the immune system reacts abnormally, leading to synovitis, which is inflammation of the synovial membrane surrounding joints, which can be destructive to the cartilage and bones.

“Although the causes of these diseases are different, the result is the same, which is pain that drives people to minimise their physical activities,” the surgeon pointed out.

Can exercise help arthritis patients?

Dr Sharma noted that exercises prescribed for arthritis patients help strengthen the muscles around the affected joints, enhance flexibility, and maintain mobility. For instance, the quadriceps and hip muscles help maintain knee stability while commuting, climbing stairs, and sitting on a chair.

“Additionally, engaging in regular physical activity helps strengthen cardiovascular fitness and balance,” he shared. “For those suffering from knee and hip osteoarthritis, exercise and dieting may help manage weight and minimise the stress felt on the joints.”

Exercise might be advantageous when it comes to addressing issues such as sleep and mood improvement, the surgeon highlighted. “Nevertheless, it should be noted that exercise does not offer a remedy for damaged cartilage nor improve the treatment of arthritis,” he added.

Exercise helps strengthen the muscles around the joints, shares Dr Sharma. (Pexel)

How to choose the right exercise?

An effective exercise programme generally combines muscle strengthening, aerobic activity and range-of-motion exercises.

“Walking on even surfaces, stationary cycling and swimming are often suitable low-impact options,” stated Dr Sharma. “Aquatic exercises can be particularly helpful because water buoyancy reduces the load on weight-bearing joints while allowing muscles to work against water resistance.

The surgeon pointed out that the intensity should be increased gradually, with exercises adapted to the affected joints and the severity of symptoms. “During an inflammatory flare, strenuous activity may need to be reduced in favour of gentle movement,” he noted.

How to balance movement and rest?

When beginning a new exercise program, Dr Sharma shared that it is normal to experience mild, temporary discomfort. However, noticeable pain, increasing swelling or sustained worsening symptoms must be taken seriously.

“If a discomfort remains high following activity, consideration should be given to adjusting the intensity or the duration of the exercise program,” he noted. “An individualised exercise program can be developed on the basis of joint function, muscle strength and the extent of mobility issues with the help of doctors or physiotherapists.”

He further reminded that people with inflammatory arthritis should remember that exercise should be used alongside prescribed treatment.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

Dr Sushil Sharma is a senior consultant (joint and knee replacement surgeon) at Kailash Hospital, Noida, with over 35 years of experience.

https://www.hindustantimes.com/lifestyle/health/does-exercise-really-make-arthritis-worse-here-is-what-a-knee-replacement-surgeon-wants-you-to-know-101792130450878.html

Arthritis myths vs facts: Surgeon explains common misconceptions about symptoms, causes, treatment

From hindustantimes.com 

By Anukriti Srivastava

From joint cracking to exercise, a surgeon busts common arthritis myths that could mislead you about joint health

Many patients arrive believing that arthritis is an unavoidable part of ageing, that nothing can be done about it, or that surgery should always be the last resort. These myths can sometimes prevent people from seeking timely care. In an interview with HT Lifestyle, Dr Tushar Kohli, gold medallist, arthroscopy and joint replacement surgeon, senior consultant at Hari Ram Kohli Memorial Hospital, Dehradun, debunks common myths about exercise, pain, and joint health.

Myth 1: Arthritis only affects older people.

While the risk of osteoarthritis increases with age, it is not exclusively an age-related condition. Dr Tushar Kohli highlighted that previous injuries, obesity, genetics, repetitive stress and certain medical conditions can contribute to joint damage in younger people too.

Myth 2: Exercise will make arthritis worse.

The opposite can often be true. Appropriate, low-impact physical activity can strengthen the muscles supporting a joint, improve mobility, and help manage pain. The key is choosing exercises suited to the individual's condition, rather than avoiding movement altogether.

Myth 3: Joint pain is something you simply have to live with.

“Persistent pain should not be dismissed as a normal consequence of getting older,” highlighted Dr Kohli. Depending on its cause and severity, arthritis can often be managed through weight management, physiotherapy, medication, lifestyle changes and other non-surgical approaches.

Delaying treatment despite severe pain, stiffness, or declining mobility can affect independence and overall wellbeing. (Unsplash)

Myth 4: Knee or joint replacement means the end of an active lifestyle.

Modern joint replacement procedures have evolved significantly. For patients with advanced arthritis who have not found adequate relief through conservative treatments, knee or joint replacement can help restore mobility and improve quality of life. The goal is not simply to reduce pain, but to help patients return to meaningful everyday activities.

According to Dr Kohli, advances in surgery have also changed how we approach these procedures. Minimally invasive techniques can involve smaller incisions and reduced disruption to surrounding tissues in appropriately selected patients. Robotic-assisted technologies available at selected sites can further support surgeons in complex cases with significant deformities.

Myth 5: Surgery should always be avoided for as long as possible.

There is no universal timeline for surgery. Delaying treatment despite severe pain, stiffness, or declining mobility can affect independence and overall wellbeing. The right approach is an individualised one, based on symptoms, imaging, lifestyle and response to other treatments.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

https://www.hindustantimes.com/lifestyle/health/arthritis-myths-vs-facts-surgeon-explains-common-misconceptions-about-symptoms-causes-treatment-101791617482361.html

Researchers study if diet and exercise can prevent knee osteoarthritis

From health.yahoo.com

Stopping knee pain before it starts

INDIANAPOLIS (WISH) — Osteoarthritis may sound like just another part of getting older. However, for millions of women, it can mean years of knee pain, stiffness and losing the simple ability to get up, get out and keep moving.

The CDC says about 33 million US adults have osteoarthritis. This condition is the leading cause of disability among adults. It's the third most common diagnosis for inpatient hospital stays, and women are more likely than men to develop it, especially after age 50. Now, a research study is asking a different question: what if some of that damage could be stopped before the pain even starts?

Inside the gym, women are pushing, lifting and walking toward better health. However, there's a lot more riding on these reps than just a number on the scale or blood test results.

"Finding out that my cholesterol was high. I had grandchildren coming, so that was huge for me was realizing that, you know, I wanna be around for them, and I want to be able to do things with them," Linda Whitlow said.

"Women are about, almost two times more likely to develop knee osteoarthritis than men are," Shannon Mihalko, PhD, Behavioral Psychologist at Wake Forest University said.

That's why study participants Linda Whitlow and Laura Cauble have made a four-year commitment to finally break the cycle.

"What I need is follow-up, and this is a four-year program, and I thought if they're gonna weigh me once a week for four years, I'm gonna keep it off," Cauble said.

"We're now looking at whether we can use exercise and diet in people who are overweight and obese to try to actually prevent knee OA from developing," Mihalko said.

OA occurs when the tissues in the joint become inflamed, and the loads on the joint are excessive, resulting in degeneration of the cartilage and surrounding tissue. The result is pain, swelling and loss of motion.

The Wake Forest researchers said losing just one pound can take about four pounds of pressure off your knee with every step you take, adding up to thousands of pounds less stress over the course of a day.

"We found that we can have even more profound impact with 10 percent weight loss," Mihalko said.

What's more important is you keep the weight off, according to other experts. They said the hope is to change how we think about osteoarthritis, not just treating the damage after it happens but helping women prevent it in the first place.

Health experts said one thing many people don't realize is that your knees absorb forces equal to three to six times your body weight every time you walk or climb stairs. Researchers said that's why even modest weight loss and regular exercise can make a big difference in protecting joints over time.

https://health.yahoo.com/conditions/musculoskeletal/arthritis/osteoarthritis/articles/researchers-study-diet-exercise-prevent-001554030.html 

Saina Nehwal’s arthritis diagnosis: How years of competitive sport can impact body

From indianexpress.com

The former Olympic medallist recently opened up about retiring because of arthritis. An orthopaedic surgeon explains why elite athletes may develop arthritis early, the warning signs to watch for and how to stay active after diagnosis

Ace shuttler Saina Nehwal recently spoke candidly about how arthritis brought her illustrious badminton career to an end. During an interview with Hauterrfly, when asked, “When you retire because of arthritis, it must be so hard for you,” the former Olympic medallist reflected on life after stepping away from competitive sport.

“It hurts a lot, you know, when you play some sport for 25 years. Every day is like a challenge; you have to fight, you have to just give your best. So it feels like life has become a little easier, and how do I make it even tougher every day? So that becomes a challenge,” she said.

Arthritis is often viewed as a condition that affects older adults. But can years of high-intensity training, repeated impact and sports injuries cause joints to wear out much earlier? Dr Sanjeev Jain, Chief of Orthopaedics (HOD) & Joint Replacement Surgeon, KIMS Hospitals, Thane, explains.

                                                     Saina Nehwal on artritis diagnosis (Photo: Instagram/nehwalsaina)

Can years of competitive sport lead to arthritis at a younger age?

According to Dr Jain, the answer is yes—especially for elite athletes whose joints endure years of repetitive stress. “Certainly, it can. Because of their years of training, competition and vigorous movement, elite athletes subject their joints to repeated stress.”

Sports that involve frequent jumping, sudden changes in direction and repetitive impact can gradually damage the protective cartilage inside joints.

“Sports which include a lot of jumping, frequent changes in direction and heavy impact can slowly deteriorate the cartilage,” he explains.

The risk rises significantly if an athlete has previously sustained serious joint injuries. “The risk is even greater if the athlete has already suffered ligament injuries, meniscus tears or fractures since these conditions can change the way the joint functions and accelerate cartilage damage,” he adds.

However, Dr Jain points out that arthritis is not inevitable. “While not all athletes go on to develop arthritis, a long sporting career together with past injuries can lead to osteoarthritis appearing earlier than would be expected.”

What are the early warning signs athletes shouldn’t ignore?

According to Dr Jain, arthritis often begins subtly. “The first signs are usually mild and can easily be regarded as just normal aches.”

He says athletes and physically active individuals should watch out for:

* Persistent joint pain
* Morning stiffness or stiffness after periods of inactivity
* Swelling around the joint
* Reduced flexibility
* Clicking or grinding sensations
* Pain that returns during activity
* Longer recovery after training sessions

“Some athletes also find that their recovery time after training is longer than it used to be,” he adds.

Ignoring these symptoms can delay treatment. “When joint pain lasts for several weeks, keeps coming back, hampers performance or is accompanied by swelling or instability, it is important to see an orthopaedic specialist. Early diagnosis may help in slowing down the progression and in maintaining joint function,” he explains.

Does arthritis mean you have to stop exercising?

Dr Jain says remaining active is one of the most effective ways to manage arthritis and maintain joint health. “Receiving a diagnosis of arthritis doesn’t mean that one has to stop exercising. On the contrary, remaining active is one of the best methods for keeping your joints in good condition.”

The focus, however, should shift from high-impact activities to joint-friendly exercises. “Instead of concentrating on high-impact activities, you should turn to exercises that are kind to the joints, such as swimming, cycling, walking, yoga and strength training under supervision,” he explains.

Increasing the amount of muscle surrounding the joint in question helps to improve stability and lessens pain. He also recommends combining exercise with other lifestyle measures.

“Weight management, physiotherapy, wearing good footwear and making changes to the way you are active are also important factors. The aim is to stay active while at the same time protecting the joints, not to entirely avoid movement,” he adds.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

https://indianexpress.com/article/lifestyle/health/saina-nehwals-arthritis-diagnosis-how-years-of-competitive-sport-can-impact-body-10816299/ 

The best exercises to ease arthritic hips and knees

From telegraph.co.uk 

By Dr Thomas Naylor

One orthopaedic doctor reveals the movements and stretches shown to both delay progression of the disease and prevent the onset of symptoms

I’ve seen over and over how patients with arthritis become inactive over fear of damaging their joints. I think orthopaedic doctors are in part to blame. We used to refer to osteoarthritis, the most common form of the disease, as “wear and tear”.

That phrase puts the idea in patients’ heads that their joints have worn away because they’ve used them too much. We know that’s not the case – your genes determine whether your cartilage will break down, or a previous injury may have damaged the surface of the joint – and a recent study from Arthritis UK has in fact found that exercise is the most effective way to reduce pain and improve mobility.

This reinforces what doctors have suspected for quite a while but now know: Physical activity is beneficial for – and protective against – all forms of arthritis, rather than causing more damage to arthritic hips and knees.

There are a number of reasons for this. Movement flushes fluid through cartilage – the smooth, slippery surface that coats the end of our bones so they can glide smoothly against each other – keeping them healthy and mobile.

Then there is the increase in strength and range of movement around the joint, as well as the very nature of being active and getting your blood flowing. All of these benefits compound on one another and make getting back into exercise the best thing you can do for painful, arthritic joints.

It can be difficult to get arthritis patients on board with exercise, but I promise it’s worth persevering. I’ve seen patients go from “I can’t go on, I need a hip replacement” to “my symptoms have improved, I don’t need surgery”.

Your new exercise routine

Dr Thomas Naylor demonstrates a standing hip abduction, one of the exercises he recommends to ease arthritis symptoms Credit: Jon Super

I’ve shared seven exercises and three stretches meant to ease arthritic hips and knees, delay its progression and even prevent the onset of arthritic symptoms in those who don’t have them yet.

Expect some discomfort if you haven’t exercised in a while, especially when doing the moves that target your range of movement. A joint that hasn’t been moved much will no longer want to move. It’s important to push through the pain, as the knee and hip will eventually become more supple and the day-to-day pain from your arthritis will reduce dramatically.

Ease yourself into this routine, being conservative with the number of repetitions. While these moves may seem simple, your stabilising muscles will be working quite hard and you may experience delayed onset muscle soreness in the following days.

This routine works best if you do it at least three times a week, and you will really feel the benefit after three months. From that point you can progress back to the activity you enjoy doing, whether that’s walking, swimming, cycling or any other sport.

If your joint pain gets progressively worse after a few weeks of following this routine, however, I would recommend seeing your GP or a musculoskeletal practitioner.

For each exercise, aim for three sets of 10 repetitions. For the stretches, hold for at least 20 seconds. Increase the number of repetitions and the duration of stretch in line with what you feel able to do.

Exercises

Seated knee extension

Arthritis benefit: Improves knee range of movement and strengthens the quadriceps (thigh muscles)

Sit on a chair with your feet resting on the floor. Keep one foot planted flat on the ground and, with your back braced against the back of the chair, straighten the other leg out in front of you. Hold that position for about five seconds, contracting the quadriceps. Relax and lower your foot to the ground. Repeat for one side as many repetitions as able, and then swap sides.

Modification: If you can’t get your leg completely straight, aim for as straight as you can. Your muscles will still be working hard, and your range of motion should increase over time.

Sit to stand

Arthritis benefit: Strengthens quadriceps and glutes and improves hip and knee mobility

Sit in a chair and rest your arms on your lap or by your side. Without pushing up with your hands, stand up. When standing, maintain good posture and push your hips forward.

Modification: Try a supported squat. Stand up with your hands on a sturdy surface, with a seat behind you, in case you lose balance. Bend your knees and lower yourself, as if you are going to sit on the chair, without doing so. Go as low as you can safely go, before standing back up.

Standing hip abduction

Arthritis benefit: Strengthens the glutes and hip abductors to stabilise the hip joint

Stand with your hands on a chair in front of or beside you. Lift one leg sideways, as high as you can, in a straight line from the side of your body, keeping your toes pointing forward. Hold this position for five seconds before lowering your leg to the floor. Repeat for one side as many repetitions as you are able, and then swap sides.

Modification: If you struggle with this exercise, lower your leg. As you get stronger and improve your range of motion, you will be able to raise your leg higher for longer. You can make it more challenging by using ankle weights to increase the load.

Standing knee raise

Arthritis benefit: Works the hip flexors, increasing the range of movement in the hip joint

Stand next to a chair, resting one hand on it for balance. Raise one leg in front of you, bending at the knee, as if you are going to kick out. Aim to have your thigh horizontal with the floor.

Modification: Lift your knee only as high as you feel comfortable.

Lying leg raise

Arthritis benefit: Engages the quadriceps and hip flexors to reduce pressure on the joint and improve hip and knee control

Lie on the floor with your legs straight and arms by your sides. Lift one leg off the floor, keeping it as straight as you can, while your resting leg remains flat and your back is flat on the floor. Hold your leg in the air for five seconds before lowering it.

Modification (displayed above): If this is too difficult, bend the knee of your resting leg so your foot is flat on the floor. This takes some of the weight off the quadriceps, making it easier to raise your leg.

Heel slides

Arthritis benefit: Improves range of movement in the knee and the hip while working the hamstrings (thigh muscles)

Lie flat on the floor. Bend one knee, keeping that foot flat on the ground. Slide your foot as close to your bum as possible and hold it there for five seconds. Slowly slide your foot back to the starting position.

Modification: If you are struggling to bring the hip and knee bent using just your leg muscles, you can use a towel looped around the ankle and help to pull the leg bent with your arms too.

Step-up

Arthritis benefit: Strengthens the quadriceps and glutes and improves movement control

Stand facing your stairs or an aerobic step. Place your foot on the step and push through it to bring your other foot onto the step. Step back down slowly, one foot at a time.

Modification: The smaller the step you use, the easier this will be. Once your confidence and control grow, you can do bigger steps or two steps at a time.

Stretches

Knee extensions

Arthritis benefit: Improves the knee’s range of movement and activates the quadriceps

Sit on the floor with your back against the wall and your legs straight in front of you. Keep one leg bent and with the foot planted flat on the floor. Roll up a towel and place it under your ankles so your straight leg is slightly elevated. Contract your thigh muscles and push the knee down towards the floor. For an even deeper stretch, use your hands to gently push down on your knee.

Hip flexor stretch

Arthritis benefit: Improves flexibility in the ligaments around the hip

Lie flat on the floor. Bend one knee up to your chest and hold the back of your thigh or the front of your knee, pulling the knee as close to your chest as possible. Repeat on the other side.

Lying hip external rotation

Arthritis benefit: Rotating the hip outwards to improve range of motion

Lie on your back and bend your knees, so your feet are together and flat on the floor. Slowly lower your knees out to the sides. Rest your hands on the inside of your knees and gently push down to deepen the stretch.

Dr Thomas Naylor is an orthopaedic surgeon and sports scientist

As told to Emily Craig

https://www.telegraph.co.uk/health-fitness/conditions/bones-joints/orthopaedic-dr-best-exercise-routine-to-treat-arthritis/