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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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

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

Preventing and Treating Indoor Cycling Injuries

Preventing and Treating Indoor Cycling Injuries

Indoor cycling is a great workout. But it can cause aches and pains if you’re not positioned on the bike correctly. Follow these tips to stay safe while cycling!

Indoor cycling has skyrocketed in popularity, and it’s not hard to see why. During the pandemic, people sought a home-based workout alternative and rushed to buy indoor cycling equipment. Today’s indoor bicycles are interactive and allow you to work with an online trainer, which makes the workout more fun and less solitary. Plus, you don’t have to worry about the weather. You can exercise anytime of year in the comfort of your own home

As a cardiovascular workout less stressful on the joints, indoor cycling can’t be beat. But it can lead to pain and injuries if you don’t follow the correct technique and form. Before hopping on the bike, learn how to pedal the right way for a pain-free workout.

Preventing common indoor cycling injuries

Just because indoor cycling is a low-impact aerobic activity doesn’t mean your joints won’t ache after a session. Specifically, your knees, back, shoulders, wrists, and feet may feel sore, mostly because you’re not correctly stationed on the bike. But you can have a pain-free ride by getting into the proper position. Here are some tips:

Knees. Do you feel pain along the inside or front of your knee? It could be because you’re sitting too low and/or too far forward on the bike. To get in the right position, raise the seat up so that when the pedal is at the bottom of your stroke the knee is bent at a 30 degree angle. Move the saddle forward or backward to position the front of the knee above the front of the shoe. You can also lower the resistance, or shorten your workout, to further prevent knee pain.


Back & shoulders. Hunching too intently over the handlebars strains your back and shoulders. But the fix is simple: Raise the handlebars or move them closer to your midsection. And always keep your torso bent at a 30-degree angle. And remember to relax your neck and shoulders as you cycle.


Wrists. You may not realize it, but you stress your wrists and hands when you lean forward or bend them too much during a ride. Try to maintain a slight bend at the elbow and keep your wrists straight when holding the handlebars. The goal is to not put too much weight on your wrists and hands. Another option is to wear gloves when pedaling.


Feet. Ill-fitting shoes can lead to a common cycling injury known as metatarsalgia. It’s also called hot-foot syndrome because the balls of your feet will feel hot. The solution is to wear well-fitted, padded shoes. Your feet should be secure in the pedals, but not so squeezed it causes pain.

Prepping for your ride

Like any other workout routine, indoor cycling requires some prep time. Exercises to build strength and flexibility in the mid-back region can get you into the right position when riding and help prevent injuries. Try these two:


Quadruped thoracic extension. Get down on your hands and knees, making sure your spine is in a neutral position. Move your elbows and forearms down to the floor and bring your hands together in a triangle. Then, lower your chest to the floor and shift your weight back toward your knees. Hold for 30 seconds.


Bird-dog exercise. Position yourself on your hands and knees, with your hands under your shoulders and your knees under hips. Keep your neck and spine in a neutral position. With your shoulders and hips parallel to the floor, lift your right leg straight behind you as you lift your left arm up with the thumb pointing up. Hold for five to ten seconds, and return to the original position. Do on the opposite side. Aim for two to three sets with between eight and twelve repetitions.


If pain persists, see an orthopedic physician who may send you to a physical therapist. They may be able to pinpoint where your positioning on the bike is off and suggest adjustments. A physical therapist can also guide you through exercises to strengthen the muscles used during a ride. And if you do suffer an injury, your physical therapist will help you recover with an individualized therapy plan. After investing in an indoor bicycle, you’ll want to get the most out of your workout, and that means a pain-free session.

Retired Olympians Face Higher Odds for Arthritis

Retired Olympians Face Higher Odds for Arthritis

Olympic athletes aren’t like the rest of the population — but this time it’s in a far less positive way.

Two new studies show that athletes who performed at the top of their sport have a higher risk of developing arthritis and joint pain in later life. The linked studies found that 1 in 4 former Olympians dealt with these issues.

Those who’d been injured during their sporting career had a higher chance of knee and hip osteoarthritis when compared with the general population. These athletes also had an increased risk of lower back pain overall.

“High performance sport is associated with an increased risk of sport-related injury and there is emerging evidence suggesting retired elite athletes have high rates of post-traumatic osteoarthritis,” said lead author Debbie Palmer, from the University of Edinburgh’s Moray House School of Education and Sport in Scotland.

“This study provides new evidence for specific factors associated with pain and osteoarthritis in retired elite athletes across the knee, hip, ankle, lumbar and cervical spine, and shoulder, and identifies differences in their occurrence that are specific to Olympians,” Palmer said in a university news release.

The international research included almost 3,400 retired Olympians, averaging about 45 years of age, who’d participated in a total of 57 different sports.

Researchers asked about the health of their bones, joints, muscles and spine, as well as if they were experiencing joint pain and whether they had been diagnosed with osteoarthritis.

The research team also surveyed more than 1,700 people from the general population who were about age 41.

The researchers used statistical models to compare the prevalence of spine, upper limb and lower limb osteoarthritis and pain in retired Olympians with the general population, considering factors that could influence risk such as injury, recurrent injury, age, sex and obesity.

Knees, lumbar spine and shoulder were the most injury-prone areas and the most common locations for osteoarthritis and pain for Olympians. After sustaining a joint injury, the Olympians were more likely to develop osteoarthritis than someone in the general population who had a similar injury.

The findings may help people make decisions about recovery and rehabilitation from injuries to prevent recurrences, the researchers suggested. It may also help inform prevention strategies.

The two studies were published in the British Journal of Sports Medicine. The World Olympians Association funded the studies with a research grant from the International Olympic Committee.

More information

The U.S. Centers for Disease Control and Prevention has more on osteoarthritis.

SOURCE: University of Edinburgh, news release, Nov. 23, 2022

Copyright ©2022 HealthDay. All rights reserved.
Tips on Keeping Joints Limber, Healthy as You Age

Tips on Keeping Joints Limber, Healthy as You Age

For many people, it is possible to slow the loss of joint cartilage as they age and avoid surgery to boot.

Certain steps can help with that, said one orthopedic surgeon from the Mayo Clinic in Rochester, Minn., who offered tips for maintaining joint health and also for managing pain in those who are already experiencing osteoarthritis.

Dr. Joaquin Sanchez-Sotelo said cartilage, that shock-absorbing, slippery tissue at the ends of bones, degenerates for various reasons.

Those reasons include being born with abnormally shaped bones or a tendency toward weaker cartilage. Obesity, overuse and injuries from accidents also can damage joints and cartilage.

“When cartilage degenerates, the body forms bone spurs,” Sanchez-Sotelo said. “This is a reaction to the main underlying problem, cartilage degeneration. Bone spurs can hit each other and become painful. Many patients get obsessed with bone spurs, but just taking them out won’t cure the problem, except in very rare circumstances.”

Osteoarthritis can cause symptoms such as achy and painful joints, stiffness and loss of movement. Sanchez-Sotelo often sees patients with osteoarthritis when they reach their 60s.

In the years before that, people can protect their joints by building strong muscle, which can take some of the pressure off joints. But those muscles should be built without intense exercise such as football or bodybuilding because those sports come with higher risks of developing arthritis.

“You have to exercise within reason,” Sanchez-Sotelo said. “Find that point where your muscles are healthy, flexible, strong and will protect the joints, but don’t overdo it.”

Sanchez-Sotelo also suggests maintaining a healthy weight. He’s not so sure about glucosamine and chondroitin, which are popular supplements for joint pain, because of a lack of evidence that they actually work.

People with arthritic pain can modify their activities. If the trouble is a knee or hip joint, try bicycling instead of running, the doctor suggested.

Use a cane to lighten the load on a sore hip, knee or ankle joint. A type of knee brace worn outside of clothes can shift the load to the healthier side of the knee joint, Sanchez-Sotelo advised.

Consider over-the-counter medications — including acetaminophen (Tylenol) and ibuprofen (Motrin, Advil) — for persistent pain. These can lead to ulcers, kidney or heart issues, he warned. Avoid narcotics for osteoarthritis.

Someone whose pain persists could consider injections into the affected joint with cortisone or Toradol (ketorolac) to relieve pain. In addition, hyaluronic acid can help lubricate joints when injected, especially in the knee.

Although some choose injections with stem cells and platelet-rich plasma, referred to as “regenerative medicine,” they are experimental without firm evidence that they work, he said.

“In the past, older people just accepted joint pain,” Sanchez-Sotelo said in a Mayo Clinic news release. “Now people are living longer and want to remain active as they age. We are not all destined for joint replacement. There are some people in their 80s and 90s who have great joints.”

More information

The U.S. Centers for Disease Control and Prevention has more on osteoarthritis.

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