Osteoarthritis and GLA:D® Australia
Osteoarthritis (OA) is defined as a degenerative disorder of a joint in the human body; most commonly the knee, hip and hand. Formerly OA was thought to just involve the wearing of cartilage and changes to the underlying bony surface, however more recent research has led to the new definition of OA encompassing the whole joint and considers the interactions between all structures. (Practitioners TRACoG 2018).
OA has also now been recognised to be influenced by a multitude of other factors outside of those physiological degenerative changes. These factors include co-morbidities (e.g. obesity, fatigue), lifestyle (sleep, physical activity level), social factors (stress, isolation, depression), pain-related fear avoidance, muscle weakness, physical loading as well as negative beliefs and poor coping strategies.
In Australia, 1 in 11 people are clinically diagnosed with OA – that equates to 2.1 million people! (ABS 2018). It is also the most common lifestyle disease in people aged 65 years and over – more than both high blood pressure and diabetes!
Most commonly, these individuals visit their doctor when their pain gets too much and they are subsequently referred to an orthopaedic surgeon for consultation before undergoing a joint replacement. Whilst the outcomes of said surgery can be very successful, the economic burden placed both on the health care system (cost of surgery and hospitalisation) and the welfare system (due to time unable to work due to pain associated with OA) makes this option a very expensive one!
Surely there is something else we can be doing?
There is now irrefutable evidence that exercise can not only assist in managing Osteoarthritis in terms of pain reduction, but also delay, and in some cases, remove the need for joint replacement surgery altogether. (Skou ST, Roos EM 2017)
Exercise is important for Osteoarthritis because:
cartilage needs appropriate loading to be healthy,
it improves the range of motion in your joint,
it improves stability and joint function,
it decreases pain,
it helps you move better,
it improves joint confidence.
(GLA:D Australia, 2021)
So what exercises do you need to do to gain this benefit?
The physical activity guidelines in Australia recommend everyone should aim to complete 150 minutes of moderate or 75 minutes of vigorous physical activity per week (ACSM 2018). The benefit is increased if this amount is doubled. This may seem daunting, but can be completed in a number of short bouts of 10 minutes across the day to make it more achievable. This physical activity can be land or water based exercise, but should be in addition to your usual activities of daily living.
For people with Osteoarthritis it is recommended to undertake more specific therapeutic exercise:
Neuromuscular,
functional,
endurance,
strength,