If you're over about 25, your spine is deteriorating. But because you're unique, so is the rate and way it's deteriorating.
Osteoarthritis, or degenerative changes in one or more joints, is "probably one of the most common things we see," according to Roger Petersen, director of physical therapy at The Orthopedic Specialty Hospital. "There are ways we can better prepare that joint to accept loads and forces and not be as painful, by maintaining the agility of the joint."
Osteoarthritis is the topic of today's Deseret Morning News/Intermountain Healthcare Hotline from 10 a.m. to noon. Petersen and Dr. Scott Johnson, a sports medicine, physical medicine and rehabilitation expert, will answer called-in questions.
The goal is to "create less force as you maintain more movement and less trauma over time," said Petersen. "A lot of what we want to do is maintain flexibility."
It's common for someone who feels the pain of osteoarthritis to become less active, and that leads to general weakening. "One of the main mechanisms of absorbing force in the joints is muscles, so as they weaken, you load it more and there's more trauma and wearing of the joint. You need to maintain strength."
He's not talking about bulk or hard-core exercise. Instead, the emphasis is on lower-load, high-repetition activities. Such exercises bathe the joint with the fluid that provides nutrients to the joint. And it works the muscles for better endurance, more force absorption and the ability to last longer.
Choosing the right activities is important, Petersen said. The goal is to find activities that someone will incorporate into his life to have mobility. That might be riding a bike or working out on an elliptical, "which are not so pounding."
Water is a wonderful exercise tool for arthritic patients, who can get a resistive workout in a pool, for example, while tolerating the load very well. "You can get a lot of exercise without a lot of trauma to the joint." It's especially helpful for hips and knees.
It all depends on which joints are involved with the osteoarthritis and where the pain is. If it's painful between the tibia and fibula, for instance, weight-bearing exercise is not as good. You need to strengthen the muscle around it without overloading the joint.
Joints that don't bear weight, like those in the hand, may wear from repetitive activity or injury. "In the hand, you really want to maintain mobility and some strength, but be careful about lifting and carrying. Same with the shoulder." With arthritic shoulders, a great deal can be done to provide mobility and strength without loading it a lot, he said. That's harder for the lower extremities.
One key with joints like those in the fingers is controlling inflammation, which is a healing response to injury "but tends to be a negative in joints over long periods of time."
He tells his patients to be consistent in their strengthening and mobility exercises.
He also sees people who feel like they have to give up activities and "it may be true," but they should think about replacing them, he said. Maybe basketball isn't an option, but "that surely doesn't mean I can't ride a bicycle. Or maybe I play basketball less frequently."
Physical therapy is important to develop a stretching program and learn targeted exercises and the right way to do them. That's the biggest part of arthritis care — educating patients so they can manage it themselves, he said. "This is a lifelong thing. So one big piece is telling them what's going on in the joint."
Heat can be used to increase blood flow and improve flexibility. As people age, their collagen gets a little stiffer and warming the joint with heat or exercise helps. Cold can break the inflammatory cycle.
The most important thing is learning what helps control pain and maintain strength and mobility, based on individual cases, he said.
E-mail: lois@desnews.com