Jumping joints

How your body’s healthy hinges keep you moving

E-Health (9/4/2002)

Brion's comments:
'It happens to all of us - the older we get, the less cooperative our joints become. But this phenomenon doesn't happen overnight. In fact, it can be slowed down dramatically. This piece, down for E-Health magazine, tells you how.'

Feature article:

Whether you’re a world-class athlete, a weekend warrior, or just want to stroll along the beach with your kids (or grandchildren), the ability to move enriches your life. The key to continued mobility is sound joint health. All joints, from the weight-bearing hinges at your ankles, knees, hips, and back, to the shoulders, elbows, and wrists of your upper body, are engineering marvels - complex pivots that marry two or more bones with supporting ligaments, cartilage, muscle, tendons and nerve tissue. In short, they’re built for action.

“We equate the joints to an older vehicle,” says Rick Silverman, MS PT, director of the Ipswich Center for Sports Medicine & Physical Therapy in Massachusetts, and an ultra-endurance athlete. “If the vehicle is just sitting in the garage, even though it’s in good shape, the seals are going to go bad. It will become dysfunctional. It’s the same with the body. It needs to be used – not abused, but used.”

You can reduce the likelihood of joint injury by focusing on several lifestyle issues. The first – weight control – may surprise you. According to Dr. Kevin R. Stone, chairman of the Stone Foundation for Sports Medicine and Arthritis Research in San Francisco, your knees absorb five times your body weight with each step. So every additional pound above your optimal body weight adds undo stress. “Think in terms of body mechanics,” says Stone. “You take one to three million steps per year. At five times your body weight, if you lose 10 pounds, it can be as much as 50 pounds off your knee with each step. Now, multiply that by three million steps per year.”

Conversely, moderate weight-bearing activity provides the necessary stress to prevent osteoporosis, says Dr. Andrée Claire Phillips of Concord Orthopaedics in Concord, New Hampshire, a fellow of the American College of Rheumatology and former competitive runner. Just don’t overdo it. “To protect your joints, you want to respect your symptoms of pain,” she says. “When you do have pain in the joint, you want to moderate what you’re doing, modify it, or avoid it.”

Nutrition, starting with a well-balanced diet, is another significant factor. Stone, who markets a glucosamine-based drink, Joint Juice (www.jointjuice.com), is an avid supporter of the popular supplement. Phillips advises stockpiling calcium, and Vitamin D, to ward off osteoporosis, while Silverman is a proponent of proper hydration. Phillips also cautions against smoking and excessive alcohol consumption.

Third, experts advocate strength training, flexibility, and aerobic activity. “We can’t keep you alive forever, but we can keep you active until the day you drop if you have the right motivation,” says Stone. “If we can get our patients to see their activities of life, whether it’s exercise or simply walking to the store, as a sport and train for it, then they’ll get more enjoyment out of the years they have left.”


Strength - Joints work best when bones don’t have to do all the work. “As you do strengthening exercises, and you build up that muscle, more of the force goes through the muscle instead of the joint itself,” says Stone. “So you diminish the impact on the surfaces of the joint.” Strength training doesn’t necessarily mean weight training. Isometric exercises, such as squats, lunges and straight leg raises, reinforce joint muscles while using your own weight for resistance.

Flexibility - “The first component of joint health is normal range of motion,” says Silverman. “You want to maintain the joint’s flexibility.” Stone agrees, adding that the less flexible a joint is, a smaller surface area bears the full brunt of weight bearing, which increases the rate of wear and tear and accelerates cartilage loss. To retain or improve flexibility, Silverman suggests the following stretches (all should be held for 30-45 seconds, without bouncing, and repeated 3-4 times):

1. The hamstrings. Put your leg up on a two-foot block, keeping the back fixated and straight, and then pivot at the waist. Don’t try to bring your head to your knee, but move your chest down while pivoting at the hip, feeling the hamstring stretch.

2. The back (Preacher Stretch). Get on your hands and knees, and gently rock back onto your heels while reaching forward with your hands, stretching your lower back.

3. The hips (Pretzel Stretch). Lying down on your back, flex one knee to about 90 degrees, and take that leg and cross it over your second leg, stretching the side of the hip.

Aerobic exercise, in addition to its cardiovascular benefits, helps lubricate your hinges by supplying blood to the joints. Remember, proper warm-up is essential before beginning any exercise session, especially if you already suffer from osteo-arthritis. “There can be a tremendous amount of fluid on the joint, due to inflammation,” says Phillips. “The fluid itself is actually very viscous, and when the joint is warm and active, it’s a lot less stiff. That’s why we feel stiff in the morning, because we haven’t been moving.”

Walking – Less punishing than running, a brisk walk provides most of the same benefits. Consider small hand weights to ensure a full-body workout. “I think walking is great exercise, especially for people with joint problems,” says Phillips. “You don’t need to join a club, you can do it anywhere, you can do it with a friend, you can do it for life.”

Cycling – If you’re fitted properly to your bike, with you weight evenly distributed between pedals, handlebars and saddle, cycling provides an excellent aerobic activity without stressing your joints. “It’s very difficult to hurt you knees on a bicycle,” says Stone. “No matter how arthritic they are, we usually can get our patients bicycling for many miles and many hours, and provide a lot of strengthening, range of motion and good feeling in the joints.” Silverman also recommends a slide board (which simulates ice skating), the new generation of elliptical trainers, and spinning classes as excellent low-impact training tools.

Swimming pool exercises – Perhaps the ultimate in low-impact exercises, swimming pools provide buoyancy while you work your muscles and joints against the water’s resistance. “But pool exercises can be boring,” says Stone. “Do it in a class, rather than trying it on your own.”

The bottom line? Keep moving, but in moderation. Your joints will thank you.

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