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Week 10

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Reason 10

Exercise Decreases Effects of Arthritis and Reduces the Need for Surgery

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The most common type of arthritis is called osteoarthritis. In severe cases, it can cause chronic pain, physical disability, and reduced quality of life [1, 2]. Unfortunately, there is no cure for the condition; hence medical treatment is based on symptom reduction. The good news is that exercise can both protect the joint and prevent deterioration once arthritis sets in. It can also decrease the pain and effects of arthritis.

A review by Fransen and team investigated the effects of exercise regarding hip osteoarthritis [1]. They identified nine different research studies which showed that exercise reduced pain and improved physical function in patients with hip osteoarthritis [1]. Their research showed that exercise reduced pain by 8 points on a 0 to 100 scale. On a second 0-100 scale, exercise improved physical function by 7 points [1].

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Exercise helps with osteoarthritis of the hip and decreases the need for a total hip replacement

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A second review by Fransen and a different team investigated the effects of exercise on knee osteoarthritis [2]. In this review, the researchers identified 44 trials that had obtained evidence suggesting that exercise reduced pain and improved physical function in patients with knee osteoarthritis [2]. On a scale of 0-100, exercise reduced pain by an average of 12 points. On a second 0-100 scale, exercise improved physical function by 10 points [2]. The researchers also identified 13 trials that showed exercise improved overall quality of life for people with knee osteoarthritis [2].

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Exercise decreases the onset of the severe symptoms of arthritis

Unfortunately, osteoarthritis is also called “wear and tear” arthritis. This implies that using the joint will increase the “wear and tear” and worsen the symptoms of osteoarthritis. This causes patients with osteoarthritis not to use the joint because of the concern that it could make it worse. This is, however, not the case. Earlier in Reason 8, we showed evidence on how running would reduce the incidence of osteoarthritis. Here, we will show you evidence of how even after a person develops osteoarthritis, running can decrease the symptoms of osteoarthritis. A 2018 study by Lo and team evaluated the association between running and the symptoms of osteoarthritis in the knee [3]. This was similar to the 2017 study by the same research team described in Reason 8. However, rather than investigating the effects of running on the occurrence of osteoarthritis symptoms, they focused on the effects running may have on knees already affected by osteoarthritis. The study included 1203 participants over the age of 50 who had osteoarthritis in at least one knee [3]. Participants who were runners were identified [3] and grouped together. The participants were followed for a period of four years. Outcomes including “worsening knee pain”, “new knee pain”, and “improved knee pain” were measured [3]. Interestingly, runners made fewer reports of worsening knee pain than non-runners. They were also found to have developed fewer new cases of knee pain throughout the duration of the study [3]. Additionally, runners also experienced higher rates of resolved knee pain than non-runners [3]. This study has clearly shown that running improves pain and symptoms in patients with already-established osteoarthritis of the knee. Hence running should not be discouraged in people with osteoarthritis of the knee [3].

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Total Hip Replacement

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Exercise helps with osteoarthritis of the knee and decreases the need for a total knee replacement

Exercise reduces the need for surgical treatment and helps patients who are unable to undergo surgery due to other reasons

It is generally accepted that osteoarthritis is a debilitating condition, which can only get progressively worse over time. In patients with end-stage osteoarthritis of the knee, a total knee replacement (TKR) is often performed to reduce symptoms and improve the quality of life. In recent years there has been a rapid increase in the number of total knee replacements year by year [4].

However, approximately 20% of patients who undergo a total knee replacement still experience long-term pain after surgery [4]. Additionally, as is the case with any surgical procedure, a total knee replacement comes with risks of infection and nerve damage.

Furthermore, some people may not be able to undergo surgery, as they may have other health problems like heart failure, diabetes, or some other condition that prevents them from undergoing surgery. Exercise is a suitable and relatively risk-free option for them.

A study by Skou and team investigated and compared the two-year outcomes of Total Knee Replacements versus non-surgical treatment [4]. All the patients included in the trial were patients who had osteoarthritis and were waiting for knee replacement surgery. The non-surgical treatment included the use of exercise, patient education and insoles. After two years of intervention, the researchers found that the non-surgical treatment improved pain and function in patients with osteoarthritis of the knee [4]. In their study, two-thirds of the patients who were eligible and were informed that they needed a total knee replacement delayed their need for surgery by at least two years [4]. This suggests that patients considering a total knee replacement could first attempt non-surgical interventions, as this may delay their need for the procedure. It is important to talk to your doctor or surgeon and seek their advice. The results of the same research study show that patients who are not suitable for surgery due to other health reasons improved with exercise and found relief from the symptoms of knee osteoarthritis even though they have not been able to undergo surgery [4].

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Metaphor 1 – Showers don’t Clean Your Teeth

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What is the Story?

Parry was a bus driver and worked long hours. The job was tiring, and he was usually exhausted at the end of a shift. The work was manual and involved turning a heavy steering wheel. He assumed that the heavy work that he was involved in was giving him enough exercise for his entire body.

One day, he developed severe back and leg pain. He was diagnosed with sciatica.

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So, what went wrong?

Parry wrongly assumed that regular work provided adequate exercise for his whole body. This, unfortunately, is not true. Parry exerted his arms when turning the steering wheel and exerted his legs when operating the foot pedals. There was, however, no exercise for his lower back. Parry’s back was weak, and that caused the back pain and sciatica.

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How can we relate this story to our health?

Assuming that driving a bus for extended periods will exercise every part of the body is like thinking that a shower will also clean the teeth. Showers do not make our teeth clean, and a separate action of brushing the teeth is required. In the same way, it is crucial that even if we are regularly working, we need to specifically focus on the core muscles in the back to keep it strong and healthy. We tend to exercise our arms and legs more than our core. Not exercising our core, like in Parry’s case, can lead to back and spinal problems.

Moral of the story

Don’t neglect your core – wrong assumptions can cause harm.

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Exercise Notes For Week 1

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“Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.”

“At vero eos et accusamus et iusto odio dignissimos ducimus qui blanditiis praesentium voluptatum deleniti atque corrupti quos dolores et quas molestias excepturi sint occaecati cupiditate non provident, similique sunt in culpa qui officia deserunt mollitia animi, id est laborum et dolorum fuga. Et harum quidem rerum facilis est et expedita distinctio. Nam libero tempore, cum soluta nobis est eligendi optio cumque nihil impedit quo minus id quod maxime placeat facere possimus, omnis voluptas assumenda est, omnis dolor repellendus. Temporibus autem quibusdam et aut officiis debitis aut rerum necessitatibus saepe eveniet ut et voluptates repudiandae sint et molestiae non recusandae. Itaque earum rerum hic tenetur a sapiente delectus, ut aut reiciendis voluptatibus maiores alias consequatur aut perferendis doloribus asperiores repellat.”

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Remember the traffic light system should be used when you exercise.
Please do not go through the red light or break the pain barrier!

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Short intro of encouragement to compliment the notes above.

Please now go to the video page and begin you exercise plan for the week.

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Head and Neck

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Lower Back

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Otago

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References

Fransen M, McConnell S, Hernandez-Molina G, Reichenbach S. Exercise for osteoarthritis of the hip. Cochrane Database Syst Rev. 2009;(3). :CD007912. Published 2009 Jul 8.
Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee: a Cochrane systematic review. Br J Sports Med. 2015;49(24):1554-1557.
Lo GH, Musa SM, Driban JB, et al. Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative. Clin Rheumatol. 2018;37(9):2497-2504.
Skou ST, Roos EM, Laursen MB, Rathleff MS, Arendt-Nielsen L, Rasmussen S, Simonsen O. Total knee replacement and non-surgical treatment of knee osteoarthritis: 2-year outcome from two parallel randomized controlled trials. Osteoarthritis Cartilage. 2018 Sep;26(9):1170-1180.

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