Vigorous Exercise Safe for Those at Risk of Knee Arthritis

Vigorous Exercise Safe for Those at Risk of Knee Arthritis

TUESDAY, May 12, 2020 (HealthDay News) — People at high risk for knee arthritis don’t need to avoid jogging and other types of vigorous exercise, a new study suggests.

Some folks hold back on physical activity because they fear it will increase their chances of developing knee arthritis, so researchers from Northwestern University’s Feinberg School of Medicine in Chicago took a closer look.

“Our study findings convey a reassuring message that adults at high risk for knee [arthritis] may safely engage in long-term strenuous physical activity at a moderate level to improve their general health and well-being,” said study author Alison Chang, associate professor of physical therapy and human movement sciences.

The study included nearly 1,200 people from several U.S. cities, ages 45-79, who were at high risk for knee arthritis but had no evidence of the condition.

Obesity, previous joint injury, surgery, aging and chronic knee symptoms increase the risk of developing arthritis of the knee.

Participants were followed for up to 10 years. Chang and her colleagues found that long-term participation in strenuous physical activities such as jogging, swimming, cycling, singles tennis, aerobic dance and skiing was not associated with risk of developing knee arthritis.

In fact, those who did vigorous exercise had a 30% lower risk of knee arthritis, but that’s not considered statistically significant, according to the authors.

Lots of sitting wasn’t associated with either an increased or reduced risk of arthritis.

“People suffering from knee injuries or who had arthroscopic surgical repair of ACL or meniscus are often warned that they are well on the path to develop knee [arthritis],” Chang said in a university news release.

“They may be concerned that participating in vigorous activities or exercises could cause pain and further tissue damage. To mitigate this perceived risk, some have cut down on or discontinued strenuous physical activities, although these activities are beneficial to physical and mental health,” she said.

The bottom line? “Health care providers may consider incorporating physical activity counseling as part of the standard care for high-risk individuals at an early stage when physical activity engagement is more attainable,” Chang said.

The study findings were published May 4 in the journal JAMA Network Open.

More information

The American Academy of Family Physicians has more on arthritis.

SOURCE: Northwestern University, news release, May 4, 2020

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How to Manage Your Osteoarthritis

How to Manage Your Osteoarthritis

(HealthDay News) — Osteoarthritis is the most common form of arthritis, affecting about 31 million Americans, and is the leading cause of disability among adults.

Known as OA, it causes pain and other symptoms in joints, which can affect the ability to do everyday tasks. There’s no known cure, but there are treatments that can relieve pain and maintain joint function, according to a rheumatologist at Wake Forest Baptist Health in Winston-Salem, N.C.

“Osteoarthritis is the thinning or wearing down of cartilage, which is the cushion between the separate bones in a joint,” Dr. Francis Luk said in a health system news release. “When your doctor says you have arthritis, most often they are referring to osteoarthritis.”

The main risk factors are aging, obesity, prior injury, repetitive stress on a joint and genetics. OA can occur in any joint, but the most common are knees, hips and hands.

“Symptoms vary from person to person but someone with osteoarthritis of the knee typically will have pain when they stand up from a seated position or when they’re walking, especially when going up and down stairs,” Luk said.

“With osteoarthritis of the hands, people typically experience pain when they do things that involve gripping — washing dishes, holding a wrench, opening a jar, things like that,” he added.

Treatments include over-the-counter drugs such as acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs, or NSAIDs, such as aspirin, ibuprofen (Advil, Motrin) and naproxen sodium (Aleve).

Other nonprescription options include topical creams and gels, such as those containing trolamine salicylate (Aspercreme), and the use of heating pads and ice packs.

Assistive devices such as canes, shoe orthotics, jar openers and tools with thicker handles can help with routine tasks.

For more advanced cases of OA, there are prescription pills and creams and steroid injections. The last resort is joint replacement surgery, especially of knees and hips.

“We always try to delay turning to surgery for as long as we can,” Luk said. “However, if you get to a point where you can’t walk from your living room chair to the bedroom, it would be a good idea to see an orthopedic surgeon.”

And, remember, two of the best ways to combat OA are maintaining a normal weight and getting regular exercise, he said.

“I tell people to do as much as they can tolerate until they have some pain and then rest,” Luk said. “I never recommend completely stopping activities, because the downside of inactivity is worse than osteoarthritis.”

More information

The American Academy of Family Physicians has more on osteoarthritis.

SOURCE: Wake Forest Baptist Health System, news release, Oct. 10, 2019

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Get Moving: Exercise Can Help Lower Older Women’s Fracture Risk

Get Moving: Exercise Can Help Lower Older Women’s Fracture Risk

FRIDAY, Oct. 25, 2019 (HealthDay News) — Older women who get even light exercise, like a daily walk, may lower their risk of suffering a broken hip, a large study suggests.

A number of studies have linked regular exercise to a lower risk of hip fracture — a potentially disabling or even fatal injury for older adults. Each year, more than 300,000 people in the United States aged 65 or older are hospitalized for a broken hip, according to the U.S. Centers for Disease Control and Prevention.

The new study, of more than 77,000 older U.S. women, took a deeper look at the types of exercise that are related to the risk of hip fracture and other bone breaks.

The researchers found that, on average, women who regularly exercised at any intensity — from walking, to doing yard work, to jogging — had a lower risk of hip fracture over 14 years, compared to inactive women.

It all suggests that even light activity is enough to curb the risk of these serious injuries, said study leader Michael LaMonte, a research associate professor at the State University of New York at Buffalo.

“We were happy to see a strong relationship between walking and lower hip fracture risk,” he said. “As we get older, we naturally do less-strenuous physical activity. This suggests that to lower your risk of hip fracture, you don’t need to do anything fancy. It can be as simple as walking.”

The findings “strongly support” longstanding recommendations for people to fit physical activity into their daily routine, according to Dr. Richard Bockman.

“Get out there and walk,” said Bockman, chief of the endocrine service at the Hospital for Special Surgery, in New York City.

Lower-impact activities do not have a big effect on bone density. But Bockman, who was not involved in the study, said that while bone density matters in hip fracture risk, other factors are also involved. They include muscle strength in the lower body, balance and agility, since broken hips are almost always the result of a fall.

The findings, published online Oct. 25 in JAMA Network Open, come from the Women’s Health Initiative — a study begun in the 1990s at 40 U.S. medical centers. It involved more than 77,000 women who were between the ages of 50 and 79 when they enrolled.

At the outset, the women reported on their usual physical activities, among other lifestyle factors.

Over an average of 14 years, one-third of the women suffered a bone fracture. When it came to hip fractures, women who’d reported higher amounts of physical activity at the study’s start typically had a lower risk.

For example, women who regularly got moderate to vigorous exercise, such as brisk walking or jogging, had a 12% lower risk of hip fracture than those who were less active. But there was also a link between “mild activity” — like slow dancing, bowling or golfing — and lower hip fracture risk. And the more often women walked, at any speed, the lower their risk of a broken hip.

The news wasn’t all good: Women who exercised at moderate to vigorous intensities had a relatively higher risk of a wrist or forearm fracture, compared to less-active women.

It’s not clear why, but LaMonte offered a guess: When women with more “functional ability” do fall, they may be more likely to stretch out an arm to break the fall, which is how wrist and forearm fractures often happen.

One question the study cannot address, LaMonte said, is whether starting exercise at an older age reduces hip fracture risk. Study participants who were physically active may have been active their whole lives.

But, he said, it is clear that “sitting less and moving more” is key in older adults’ overall health, with benefits such as better control of blood pressure and diabetes, and a lower risk of heart disease.

Besides exercise, older adults can take other steps to reduce their hip fracture risk, LaMonte noted. They include getting bone mass measurements as recommended by your doctor, and following a healthy diet with adequate amounts of calcium and vitamin D.

More information

The American Academy of Orthopaedic Surgeons has more on hip fracture prevention.

SOURCES: Michael LaMonte, Ph.D., M.P.H., research associate professor of epidemiology and environmental health, State University of New York at Buffalo; Richard Bockman, M.D., Ph.D., chief of endocrine service, Hospital for Special Surgery, and professor of medicine, Weill Cornell Medical College, New York City; Oct. 25, 2019, JAMA Network Open, online

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Your Noisy Knees May Be Trying to Tell You Something

Your Noisy Knees May Be Trying to Tell You Something

THURSDAY, Oct. 17, 2019 (HealthDay News) — Ever hear your joints clicking, creaking or crunching? Now, researchers say a new technique that listens closely to knees may help doctors diagnose and monitor osteoarthritis.

In the new study, researchers attached small microphones to participants’ knees, which allowed them to listen for high-frequency sounds as the person repeatedly stood up and sat down again.

Computer analysis of the sounds then provided information about the health of the knee, the study authors explained.

This study is the first to assess this technique in a large number of people with knee osteoarthritis. It was found to distinguish between healthy knees and those afflicted by this “wear-and-tear” form of arthritis.

The findings move the technique a step closer to use by doctors and in research, according to the report published Oct. 16 in the journal PLOS ONE.

“This work is very exciting because it involves scientists and clinicians working together as a team to develop an entirely new approach,” said project leader John Goodacre. He’s an emeritus professor at Lancaster University, in the United Kingdom.

“Potentially, this could transform ways in which knee osteoarthritis is managed. It will enable better diagnosis, and will enable treatments to be tailored more precisely according to individual knee condition. It will also enable faster, bigger and better clinical trials of new treatments,” Goodacre said in a university news release.

The next step for researchers is to develop a non-invasive portable device that health care providers could use to assess whether patients’ knees are changing or are responding to treatment for osteoarthritis.

This technique could provide a quicker, cheaper, more convenient and more accurate assessment than current methods, the study authors said.

More information

The American Academy of Family Physicians has more on osteoarthritis.

SOURCE: Lancaster University, news release, Oct. 16, 2019

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Humans May Possess Ability to Regrow Cartilage

Humans May Possess Ability to Regrow Cartilage

WEDNESDAY, Oct. 9, 2019 (HealthDay News) — Humans may lack the salamander skill of regrowing a limb, but a new study suggests they do have some capacity to restore cartilage in their joints.

The findings run counter to a widely held belief: Because the cartilage cushioning your joints lacks its own blood supply, your body can’t repair damage from an injury or the wear-and-tear of aging.

And that, in part, is why so many people eventually develop osteoarthritis, where broken-down cartilage causes pain and stiffness in the joints.

But that lack of blood supply does not mean there’s no regenerative capacity in the cartilage, according to Dr. Virginia Byers Kraus, the senior researcher on the new study.

In fact, her team found evidence that human cartilage can, to some degree, renew itself, using a molecular process similar to the one that allows a salamander to grow a new limb.

The researchers are calling it the “inner salamander capacity.”

“For the first time, we have evidence that the joint has the capacity to repair itself,” said Kraus, a professor at Duke University School of Medicine, in Durham, N.C.

Specifically, she explained, that capability exists in a “gradient.” It’s greatest in the ankle, less apparent in the knee, and lowest in the hip.

And that makes sense if this repair capability is an artifact of evolution, according to Kraus. Animals that regenerate tissue have the greatest capacity for it in the distal portions of the body — the parts “most likely to get chewed off.”

Dr. Scott Rodeo, an orthopedic surgeon not involved in the study, said the findings raise some interesting questions.

For one, he said, could this be a partial explanation for why osteoarthritis is common in the knees and hips, but not the ankles?

“It’s been assumed that it’s related to the biomechanics of the joints,” said Rodeo, an attending surgeon at the Hospital for Special Surgery, in New York City.

But this study, he said, suggests there might be intrinsic differences in the joints’ ability to repair cartilage.

The other major question, Rodeo said, is whether this newfound human capacity can translate into new treatments for arthritis. “Can we better understand the basic biology, and harness it?” he asked.

For the study, Kraus and her colleagues analyzed proteins in samples of joint cartilage that had been removed from patients having surgery. The researchers developed a method for gauging the “age” of those proteins, based on the premise that young proteins have little to no evidence of “conversions” of amino acids (the building blocks of proteins), while older proteins have many conversions.

Overall, the investigators found, ankle cartilage showed the greatest number of young proteins. Knee cartilage looked more middle-aged, and hip cartilage had relatively few young proteins and plenty of old.

In addition, the study found, molecules called microRNAs seem to regulate the process. They were more abundant in ankle cartilage than tissue from knees and hips, and in the top layers of cartilage, versus the deeper layers.

As it happens, microRNAs also help salamanders regrow lost limbs.

The findings were published online Oct. 9 in the journal Science Advances.

It all raises the possibility that the innate repair capacity in cartilage can be augmented, according to Kraus. Could, for example, injectable microRNA drugs be used to boost cartilage self-repair?

No one is saying science is close to helping humans grow new limbs. But, Kraus said, understanding the fundamental mechanisms behind tissue regeneration — figuring out what salamanders have that people are missing — could eventually lead to ways to repair various tissues in the human body.

Rodeo agreed. “Can we learn lessons from animals that do regenerate tissue, and apply that to humans?”

Both he and Kraus said there is a “huge” need for innovative ways to treat osteoarthritis, which affects roughly 27 million Americans, according to the Arthritis Foundation. There is no cure, and current treatments are aimed at managing symptoms.

When people are disabled by arthritis, Kraus noted, that can also raise their risk of other major health problems, including type 2 diabetes and heart disease.

More information

The Arthritis Foundation has more on osteoarthritis treatment.

SOURCES: Virginia Byers Kraus, M.D., professor, Duke University School of Medicine, Durham, N.C.; Scott Rodeo, M.D., attending orthopedic surgeon, Hospital for Special Surgery, New York City; Oct. 9, 2019, Science Advances, online

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Health Tip: Preventing Backpack Injuries

Health Tip: Preventing Backpack Injuries

(HealthDay News) — Backpacks are a practical way for people to carry books and other supplies. They are designed to distribute the weight of these items among the body’s muscles, says the American Academy of Orthopaedic Surgeons. But when used incorrectly, backpacks can harm muscles and joints.

To prevent injury when using a backpack, the academy suggests:

  • Always use both shoulder straps.
  • Tighten the straps to keep the load closer to the back.
  • Organize items so that heavy things are low and toward the bag’s center.
  • Only carry items that are required for the day.
  • Lift properly by bending at the knees when picking up a backpack.
  • Consider using a crossbody bag as an alternative.
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