Have Arthritis? Take a Swing at Golf for Better Health

Have Arthritis? Take a Swing at Golf for Better Health

Could golfing be good medicine for arthritis?

Yes, according to researchers who found that for people with osteoarthritis, golfing lowered psychological distress and improved general health when compared with the general population.

“Golf is a health-enhancing source of physical activity, particularly for older adults,” said lead researcher Brad Stenner, an occupational therapist at the Alliance for Research in Exercise, Nutrition and Activity at the University of South Australia, in Adelaide. “Golf is fun, affordable and a sport for life, with clear physical and mental health benefits.”

For people with osteoarthritis (often called the “wear and tear” form of arthritis), golf helps maintain joint range of motion, strength and endurance, and contributes to mental health and well-being. Playing golf is also associated with lower levels of chronic diseases, such as diabetes, obesity and heart disease, Stenner said.

“We found that golfers both with and without osteoarthritis had higher quality of life and, significantly, lower levels of psychological distress, which is an indicator of anxiety and depression,” he noted. “Golf appears to help improve well-being via a number of factors, including exercise, community, friendship and a sense of belonging.”

Many people with arthritis stop playing sports altogether, but the impact of arthritis on playing golf is unknown, Stenner said.

“Our study looked at benefits for those with arthritis, not factors that may be barriers. It would appear from our findings at least, that those with osteoarthritis can continue to play golf given its relatively low impact on the joints, and enjoy the benefits of doing so,” he added.

For the study, Stenner and his colleagues surveyed 459 golfers with osteoarthritis. More than 90% of golfers rated their health as good, very good or excellent, compared with 64% of those in the general population who didn’t golf, the investigators found.

Moreover, among people with osteoarthritis, 22% of non-golfers reported high to very high levels of psychological distress, compared with just 8% of golfers.

The report was published recently in the Journal of Science and Medicine in Sport.

It may seem counterintuitive that physical activity can help reduce pain and improve the well-being of people suffering from osteoarthritis, but that’s exactly what doctors recommend, said Dr. Ariel Goldman, an orthopedic surgeon at Northwell Health in Great Neck, N.Y.

“Because osteoarthritis … is a degenerative disease of the cartilage in the joints, which provides gliding and shock absorption, you wouldn’t expect patients to have better reports of their pain if they’re more physically active,” he said.

“But actually patients with arthritis who play golf have lower reports of arthritic pain than those that don’t, and that goes along with other studies that show that more activity allows patients to deal with their osteoarthritis better,” Goldman explained.

Regular physical activity can help improve pain, quality of life and reduce risk factors such as obesity, he added.

Golf is a relatively low-impact sport and can play a role in maintaining mental health and overall well-being, especially if you walk the course and don’t use a golf cart, Goldman advised.

Other low-impact activities that may have the same benefits as golf include yoga, Pilates, tai chi, bowling, pickleball and just taking a walk, he said.

“This study, like many other studies, shows that low-impact physical activity helps the physical and emotional well-being of patients suffering from osteoarthritis,” Goldman said.

More information

The Arthritis Foundation has more on osteoarthritis.

SOURCES: Brad Stenner, PhD, lecturer and occupational therapist, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide; Ariel Goldman, MD, orthopedic surgeon, Northwell Health, Great Neck, N.Y.; Journal of Science and Medicine in Sport, March 2023

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Reducing Home Hazards Cuts Seniors’ Risk of Falling

Reducing Home Hazards Cuts Seniors’ Risk of Falling

Nearly one-third of older people fall each year, most of them in their own homes. But it’s possible to reduce those numbers by a quarter, according to a new study.

Five steps can cut the risk of falls by 26%, the researchers reported in the March 10 issue of the Cochrane Database of Systematic Reviews. Those steps are: decluttering; reducing tripping hazards; improving lighting; and adding hand rails and non-slip strips to stairs.

“Falls are very common among older people. They can cause serious injury or even death, but they are preventable. In this review, we wanted to examine which measures could have the biggest impact on reducing falls among older people living at home,” lead author Lindy Clemson, professor emeritus at the University of Sydney, Australia, said in a journal news release.

The review found that people most at risk of falls, such as those recently hospitalized for a fall or those needing support for daily activities, such as dressing, would benefit the most from decluttering.

Other measures — such as having the correct prescription glasses or special footwear — didn’t make a difference. Neither did education about falls.

For the study, the researchers analyzed 22 studies that included data on more than 8,400 people living at home.

Taking measures to reduce falls around the house reduced falls by 38% in people who were at a higher risk.

The reviewers estimated that if 1,000 people who had previously fallen had followed these measures for a year, there would have been 1,145 falls instead of 1,847.

“Having had a fall or starting to need help with everyday activities are markers of underlying risk factors, such as being unsteady on your feet, having poor judgment or weak muscles,” Clemson said. “These risk factors make negotiating the environment more challenging and increase the risk of a trip or slip in some situations.”

Clemson added that support from an occupational therapist is an important intervention for many people living at home.

People tend to not notice the clutter in their home or to realize that continuing to climb ladders as they always have comes with a potential fall risk if their mobility or balance is diminished, she noted.

“Preventing falls is a really important way of helping people to remain healthy and independent as they grow older, and our review also highlights the need for more research in this area,” Clemson said.

More information

The U.S. National Institute on Aging has more on falls and fractures in older adults.

SOURCE: Cochrane Database of Systematic Reviews, news release, March 10, 2023

Copyright ©2023 HealthDay. All rights reserved.
Does Running Bring on Arthritic Knees?

Does Running Bring on Arthritic Knees?

New research offers up some good news for diehard marathon runners: You don’t necessarily have to give up running if you are experiencing hip or knee pain.

Contrary to widespread opinion, running marathons does not increase your risk for developing hip or knee osteoarthritis, the wear and tear form of the disease, a new study of seasoned Chicago marathoners showed.

“You don’t develop knee or hip osteoarthritis simply because of how fast you run or how many miles you put on your body,” said study author Dr. Matthew James Hartwell, an orthopedic surgery sports medicine fellow at the University of the University of California, San Francisco.

So, what does increase a runner’s risk for hip or knee arthritis?

Basically, the same things that up these risks in non-marathoners, Hartwell said. This includes advancing age, family history of hip or knee arthritis, and previous injuries or knee surgery, as well as higher body mass index (BMI), a measure of body fat based on height and weight.

For the study, more than 3,800 Chicago marathoners (mean age: nearly 44) answered questions about their running history, including number of marathons, number of years spent running, and average weekly mileage. They also answered questions about known risk factors for knee and hip arthritis.

Participants completed an average of 9.5 marathons, ran 27.9 miles per week, and had been running for around 15 years, the survey showed. Fully 36.4% of runners had knee or hip pain in the past year, and 7.3% received a diagnosis of hip and/or knee arthritis.

The bottom line? Running history wasn’t linked to the development of knee or hip arthritis on its own, the study showed.

Most runners planned to run another marathon, even though 24.2% said their doctor told them to run less or stop running altogether.

Health care providers should rethink this blanket advice, Hartwell said.

“Telling someone to stop running for sake of joint health is not the answer,” he said. “Even with small aches and pain, you don’t have to stop running.”

If you have persistent pain in your hips or knees, talk to your doctor and see if you need an X-ray to check for signs of arthritis, Hartwell recommended.

The new research is scheduled for presentation Thursday at a meeting of the American Academy of Orthopaedic Surgeons (AAOS), in Las Vegas. Studies presented at medical meetings are considered preliminary until published in a peer-reviewed journal.

The findings reinforce the advice that Dr. Matthew Matava gives his patients who run. He is a professor of orthopedic surgery and physical therapy at Washington University School of Medicine in St. Louis and an AAOS spokesman.

“A long-held myth is that cumulative running mileage causes osteoarthritis of the knee and hip, [but] distance running doesn’t cause osteoarthritis in an otherwise healthy person without prior joint injury or surgery,” said Matava, who was not involved with the study.

Running can make preexisting arthritis worse in folks who already have it to some degree, he noted.

Most causes of lower extremity joint pain in runners are due to overuse and follow the “rule of toos” — too many miles, too little rest and too fast, Matava said.

“Treat the pain symptomatically with ice for no more than 20 minutes at a time and use Tylenol or an over-the-counter, anti-inflammatory medication for a short period of time,” he said.

It may also be time to invest in a new pair of running shoes.

“Each pair of running shoes can withstand 350 to 500 miles of running before their outsole [rubber sole] loses its cushioning effect,” Matava said.

If a runner experiences swelling, catching or locking in the joint or doesn’t improve with conservative care, Matava said he or she should see an orthopedic sports medicine specialist to see what may be going on.

More information

The American Academy of Orthopaedic Surgeons provides more on knee osteoarthritis.

SOURCES: Matthew James Hartwell, MD, orthopedic surgery sports medicine fellow, University of California, San Francisco; Matthew Matava, MD, professor, orthopedic surgery, physical therapy, Washington University School of Medicine in St. Louis; presentation, American Academy of Orthopaedic Surgeons meeting, Las Vegas, March 9, 2023

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Sleep Apnea Linked to Weaker Bones, Teeth

Sleep Apnea Linked to Weaker Bones, Teeth

People who have sleep apnea may have another issue to worry about — weaker bones and teeth.

Known as low bone-mineral density, the condition is an indicator of osteoporosis and can increase the risk of fractures and cause teeth to become loose and dental implants to fail, according to new research from the University at Buffalo (UB) in New York.

To study this, researchers used cone beam computed tomography (CBCT) — a type of X-ray — to measure bone density in the heads and necks of 38 adults. Half of the study participants had sleep apnea.

These scans found that participants with sleep apnea had significantly lower bone-mineral density than the participants without the condition.

Sleep apnea can cause difficulty breathing while asleep, which can lead to low levels of oxygen in the body, inflammation, oxidative stress and shortened breathing patterns.

These symptoms may each have a chronic negative effect on bone metabolism and eventually bone density, said senior author Dr. Thikriat Al-Jewair. She is an associate professor of orthodontics in the UB School of Dental Medicine and director of the school’s Advanced Education Program in Orthodontics.

“While the link between obstructive sleep apnea and low bone-mineral density has yet to be fully explored, this study offers new evidence on their connection that could have several implications for orthodontic treatment,” Al-Jewair said in a university news release.

“If a patient has been diagnosed with sleep apnea, this can influence treatment planning and management. CBCT imaging has become an integral part of daily orthodontic practice and could be used as a screening tool for low bone-mineral density,” she said.

“Orthodontists could then inform their patients of their propensity for low bone-mineral density and encourage them to seek further consultation with their physician, as well as warn the patient of possible adverse outcomes, increased risks and effects on treatment time,” Al-Jewair added.

Al-Jewair also suggested future research needs to be done with larger sample sizes.

The findings were published recently in The Journal of Craniomandibular and Sleep Practice.

More information

The U.S. National Heart, Lung, and Blood Institute has more on sleep apnea.

SOURCE: University at Buffalo, news release

Copyright ©2023 HealthDay. All rights reserved.
Even Light Exercise Can Help Arthritic Knees

Even Light Exercise Can Help Arthritic Knees

Even short bouts of light exercise can help the millions of people with knee osteoarthritis reduce pain and improve their range of motion.

Knee osteoarthritis, the wear-and-tear form of the disease, occurs when the cartilage between your bones breaks down, causing pain, stiffness and swelling.

Researchers in a new study compared high-dose and low-dose exercise in 189 people with knee osteoarthritis. Everyone exercised three times a week for 12 weeks. Exercises included indoor cycling and various lower body exercises such as de-loaded squats and knee extensions. De-loaded exercises use bands or pulleys to take weight off the knee joint and minimize pain.

Folks in the high-dose group performed 11 exercises in 60- to 90-minute sessions. Folks in the low-dose exercise group performed five exercises during 20- to 30-minute sessions.

The result? Everyone showed improvements on a standard scale measuring knee osteoarthrosis pain and function at three, six and 12 months. People in the high-dose group did show greater improvements in knee function during sports and recreation at six months, suggesting that a high-dose program may be better for athletes and weekend warriors.

The study, led by Wilhelmus Johannes Andreas Grooten, a physiotherapist at the Karolinska Institute in Stockholm, was published Jan. 24 online in the Annals of Internal Medicine.

Outside experts are quick to point out that the best exercise plan for someone with knee osteoarthritis should fit in with their lifestyle, goals and capabilities.

Jack Fitzgerald is a physical therapist at the Hospital for Special Surgery in New York City. He routinely designs and implements exercise plans for people with knee osteoarthritis.

Calling the new study results “music to any physical therapist’s ears,” Fitzgerald pointed out that participants in the study showed meaningful improvements in knee symptoms and that adherence to their program was excellent across both groups.

This is at least partially due to the fact that exercise was prescribed on a minimal/no pain basis, Fitzgerald said.

“Regardless of the exercise dosage, when we are capable of prescribing exercise within pain-free limits, there is more hope that patients will respond well to the treatment,” he said.

“If you are prescribing exercises for these patients with their best interest in mind, the program should be specific to the likes and goals of the patient keeping in mind loading principles to manage pain,” Fitzgerald added.

Exercise is an essential part of knee osteoarthritis treatment, said Dr. Sonali Khandelwal, an associate professor of internal medicine at Rush Medical College in Chicago.

“A component of knee osteoarthritis is weakening of the muscles surrounding the knee, and exercise strengthens these supporting muscles,” she said.

Many people worry that exercise will make knee OA worse, but this isn’t true, Khandelwal said.

“It’s important to assess a person’s risk of falls and history of exercise when prescribing a plan,” she said. “For people who have never done any exercise, just moving and walking tends to go a long way.”

Conservative measures such as physical therapy and exercise are first-line treatments for knee osteoarthritis pain, Khandelwal said. Next up are steroid or hyaluronic gel injections and pain-relieving medication like non-steroidal anti-inflammatory drugs or acetaminophen.

“When conservative measures don’t work, pain is a 10 out of 10, and you can’t perform activities of daily living, surgery can be considered,” she said.

“It’s great to see studies like this as surgery results don’t last forever,” Khandelwal said.

Dr. David Pisetsky, a professor of medicine at Duke University School of Medicine in Durham, N.C., agreed.

“For people with knee osteoarthritis, activity is important to maintain strength and range of motion,” he said. “Exercise should be easy to perform … walking is a good way to go.”

Other options include swimming, riding a stationary bicycle, and exercising with light weights.

More information

The Arthritis Foundation provides more on knee osteoarthritis, including its causes and treatments.

SOURCES: Jack Fitzgerald, DPT, physical therapist, Hospital for Special Surgery, New York City; Sonali Khandelwal, MD, associate professor, internal medicine, Rush Medical College, Chicago; David Pisetsky, MD, PhD, professor, medicine, Duke University School of Medicine, Durham, N.C; Annals of Internal Medicine, Jan. 24, 2023

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