Shake ‘em but Don’t Break ‘em

On his run through city streets every day, Don frequently passed a person moving slowly and in obvious pain from arthritis.
“They’re old runners,” his inner voice teased him. And he became more sensitive to the slightest discomfort in his knees and hips. Fortunately his worry didn’t make him give up his exercise routine.
A national telephone survey recently found that 19 percent of respondents had arthritis-like pain virtually every day. These individuals may find it difficult to roll out of bed and get dressed, let alone exercise.
Recreational athletes like Don are not immune to arthritis, but they are not destined to wear out their joints just because they use them every day.
Inactivity, in fact, is a major risk factor for osteoarthritis. Muscles atrophy quickly from disuse and become unable to provide structure and support that joints need. The cartilage in the knee requires the movement of muscle over bone to get a blood supply to nourish it.
The human body is built to move. Exercise reduces the risk of heart disease, diabetes and cancer; weight-bearing activity strengthens bones, protecting against the falls, fractures and disability that frequently occur with advancing age.
Persons already suffering from arthritis need to know how to protect their joints so they can continue to exercise. Those with healthy joints need to understand how to keep them that way.
CHOOSE YOUR ACTIVITY: Most competitive sports are fraught with danger. Soccer requires sharp cuts and turns that stress lower body joints. Repetitive motions in tennis put stress on the elbow and shoulder. Basketball involves jumping–not a favored activity for joints in the lower body, which absorb an impact several times body weight with each landing.
The biggest risk in competitive sports, however, is lack of conditioning. Anyone who suddenly bursts onto the field after spending many months on the couch is asking for trouble.
Running and jogging have excellent cardiovascular benefits but are usually classified as high impact and risky for the joints. Yet many runners do quite well over the long term.
It’s often a matter of form; some runners have a shuffling gait that may actually put less stress on joints than a power walking stride. The greatest risks come from downhill running, workouts on hard surfaces such as concrete and worn-out or poorly chosen shoes.
Walking is often touted as the ideal low-impact exercise. It does not raise heart rate as much as running, however, and a gait irregularity, such as favoring either the heel or the toe, can lead to joint or muscle problems. Gait problems often follow a stroke or brain injury and can be treated through physical therapy.
A Swiss study of patients who had undergone knee replacement surgery found that bicycling and easy walking could be performed without damaging or over-stressing the orthosis. Jogging and downhill hiking, on the other hand, created problems.
The stair stepper machine in the health club is popular because it gives a challenging aerobic workout with little or no pounding. Stair climbing, however, increases the force on the knee joint up to four times body weight. To protect your joints, don’t use the stair stepper two days in a row, reduce the speed and pay attention to pain or swelling in your knees.
The rowing machine is another good low-impact activity, but it’s important to learn and follow proper form in order to avoid putting too much stress on the lower back. The ideal low-impact activity is swimming, and water exercise is usually recommended as part of treatment for arthritis.

DON’T EXCEED YOUR LIMITS: What anyone is able to do in terms of exercise is determined primarily by conditioning. If you try to do too much too fast, your muscles tighten and put extra strain on surrounding joints.
Nagging pain during exercise or after you stop is a sign that you’re overdoing it. Muscles, tendons, ligaments and joints first become inflamed, then start breaking down. Treat injuries promptly with rest, ice and anti-inflammatory medications.
Some athletes, particularly long distance runners, tend to rely heavily on the quadriceps (the muscles in the front of the thigh) during exercise, leaving the hamstrings in back relatively undeveloped and creating the potential for joint injury. Your hamstrings should be 60 to 70 percent as strong as your quads, and you can accomplish this through appropriate strength training exercises.
Strength training is a crucial part of an exercise plan at any age and is particularly important after age 50 when muscle mass is on the decline.

JOINT PROTECTION: The best thing you can do to protect your lower body joints is to keep your weight at a normal level. The more you weigh the more stress you place on your joints with every step. One study found that losing as little as 11 pounds resulted in a 50 percent reduction in arthritis risk.
Conversely, when you’re experiencing structural problems in your feet, you’ll feel it all the way up to your knees and hips. It’s worth going to a specialist store to buy shoes that give you the shock absorption, cushioning and motion control you need. And replace your shoes promptly when they’ve lost their cushioning and show wear on the soles that could magnify any imperfection in your gait.
Whatever imperfection you may have–high arch, low arch, pronating, supinating–you can probably correct it through orthotic shoe inserts. By supporting the arch and centering the heel, the orthotic balances the body’s weight in a proper alignment, taking stress off joints and muscles all the way to the hip. Inserts are available either by prescription or over the counter.
Women with very broad hips may have a wide Q-angle–the angle between the hips and the knees–that causes them to run or walk with the knees pushed inward (knock kneed). This creates stress on the knees which can usually be corrected with orthortic shoe inserts or knee braces.
Prolonged standing can be harder on the feet and the joints than walking or running. If you have aches and pains from standing on your feet all day at work, the answer may not be to plop down on the couch but rather to hit the treadmill.