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Reduce Arthritis Symptoms By Improving Joint Stability & Bone Density

Written by: Nick Jack
Category: 2014
on 25 December 2015
Hits: 10182

Most people think of arthritis, osteoporosis, and bone density problems as an “old person’s” condition, but it can affect many younger people and even sporting athletes causing serious pain and damage to the body. Poor nutrition, our sedentary modern lifestyle, and a lack of understanding as to the importance of moving well and strength training are the main reasons why these conditions are becoming more prominent each year. Even in younger people! The need for strength training has become more important every year as more technology is invented to make our life even more sedentary than ever. As mentioned earlier this is no longer a problem limited to old people, with many younger people now being diagnosed with osteoarthritis and bone problems. The good news is these conditions can be improved and even reversed by implementing a well designed program with your exercise and nutrition that focuses on improving joint stability, muscle strength and bone density. In this article we discuss in great detail the things you can do to help get on top of your arthritis.

Explaining Arthritis

Arthritis is divided into two primary types: Osteoarthritis which is the most common form of arthritis and associated with wear-and-tear from poor movement, and rheumatoid arthritis, which is an auto-immune disease. 

These two forms of arthritis are completely different, even though they appear to be the same with symptoms of joint stiffness, pain, inflammation, and swelling. Many people make the mistake of thinking there is nothing they can do about it when they are told they have severe osteoarthritis, and resort to a lifetime of avoiding movements that hurt them and using anti-inflammatory medication to reduce their pain. Some people even resort to extreme options of hip or knee replacement surgery in their early 50's instead of addressing how they move and applying strength principles to treat the problem.

Read more about the danger of this in the article - What you need to know about osteoarthritis hip and knee replacement surgery

Having a better understanding as to what your condition is, and more importantly how you developed it, will help identify what action is best to take to deal with the condition at the root cause instead of treating symptoms.

First let's define the two types more clearly.

Osteoarthritis

This is a degenerative joint disease and commonly affects joints like the hips and the knee as seen in the pictures above.

It has also been shown to cause pain in the joints at the end of your fingers and toes, not the middle ones. You typically you may have it on just one joint, or on one hand or foot and not the other. I myself have experienced issues with my left knee, right wrist and big toe at different times before getting on top of my problems. I suffer with Psoriasis which is an auto-immune skin disease that causes causes red, itchy scaly patches, most commonly on the knees, elbows, trunk and scalp. Psoriasis also causes joint pain similar to arthritis and it is important to address issues with nutrition and vitamin D to get to the root cause. More on this later.

This type of arthritis is now seen in younger people due to poor bio-mechanics, inactivity, poor posture and lack of muscle that now sets up joints to be worn out and exposed to all types of problems. This is very common with knee pain where we see people presenting with severe pain and quadricep stiffness in their legs. After implementing a well designed strength program that teaches them how to move correctly their pain reduces and in some cases completely disappears! The body was using stiffness to protect the joint from wearing out the cartilage, tendons, and ligaments and severely limiting their ability to move. 

Although osteoarthritis occurs in people of all ages, it is most common in people older than 65. Common risk factors include increasing age, obesity, previous joint injury, overuse of the joint, weak muscles, and genes.

  • One in two adults will develop symptoms of knee OA during their lives.
  • One in four adults will development symptoms of hip OA by age 85.
  • One in 12 people 60 years or older have hand OA.

Rheumatoid Arthritis

This is a lot more severe and is an autoimmune disease that causes your body to break itself down. Aggressive medications and use of acupuncture and Vitamin D supplements are common for this condition. It tends to affect both sides of the body and is associated with joint deformities, especially your hands and fingers. It can be very crippling, and people can die from rheumatoid arthritis! A much more difficult condition to treat but there is still things you can do apart from medication to help relieve the severity.

Treating Rheumatoid arthritis requires great care and can be very difficult to use a traditional strength training approach. Depending on where the joints are affected you will have to be creative with the types of exercises you use. Often the hands and fingers find gripping weights or cables very painful, and body weight exercises even harder with joints like the hips and knees. However if you apply some sensible strategies and improvise you can come up with some great solutions.

With all the people I have worked with with this condition, those who try to find a way to do something are ALWAYS much better than those who do nothing. In some cases the strength exercises can reduce their pain significantly once you get through the painful stage. Just keep in mind that there is more things at play here with the immune system than just a lack of exercise. A very complex disease that requires expert advice to treat.

Now that you are clear on the two different types of arthritis let's explain what to do about it.

Osteoarthritis Is Not Caused By Getting Old

 

I really love the quote above by Dr Evan Osar as it really sums up what really causes osteoarthritis.

Osteoarthritis is a degenerative condition of the joints, which over time become painfully inflamed. If you have joint degeneration without pain, the condition is known as osteoarthrosis. With both conditions there is deterioration of the joint ‘cartilage’ – a smooth substance that covers bone endings, allowing bones to glide over each other with minimal friction. Cartilage also cushions force as it is transmitted through the joints and when you have used it up, there is no way to create more!

Research on footballers and rugby players suggests that they are at increased risk of osteoarthritis around their knees, hips and ankles during and after their playing careers. This risk is significantly increased if they have sustained an injury in those areas or a lack of stability that they ignored and compensated around. Although contact sports appear to carry the greatest risk of degenerative joint disease, non contact sports like tennis and track and field, with their constant pounding of joints, can also lead to problems in later life.

But what about the person who never plays sport, how do you explain how they develop osteoarthritis? They may never have had any previous injury or the wear and tear from playing sports year in year out so how did they develop this problem. The simple answer is they do not move well and it is just a matter of time.

This means that osteoarthritis IS NOT caused by old age. For if it was due to old age how do you explain the people who do not have osteoarthritis? Are they just lucky?

The real reason we see osteoarthritis surface in older adults is that the length of time the person has spent moving poorly eventually ends up completely wearing and tearing the joints, cartilage, ligaments to a point where pain sets in. Added on top of this is a lack of muscle and you now have the perfect recipe for unstable joints that create stiffness, osteoarthritis and eventually pain. This is how a person who has never played sports before can suffer with pain from just activities of life like walking.

Bone Density & Sarcopenia

Many younger people will think this is not relevant to them, but if you are someone who is overweight, does not do any form of resistance training, have a sedentary job and would rate their life as fairly stressful, then there is a good chance you will be developing early signs of arthritis and bone density problems. It is no longer just an old person's disease. Peak bone mass is reached at around 25 years of age and normally remains relatively stable until around the age of 50. After the age of 50, progressive losses of of bone mineral density begins to occur.

As bones lose their density they become weaker and the risk of fracture during regular activities increases. If this person were to fall they would likely break a hip, wrist or vertebrae in their spine! If bones become brittle enough (severe osteoporosis) they can break during even normal weight-bearing activities. In older populations broken bones are potentially lethal. The seriousness of this cannot be underestimated. Hip fractures are the number one cause of nursing home admission and approximately 50% of those who suffer a hip fracture never fully regain their mobility and independence and 50% of those die within the first year!

You can read more about this in the article - How to prevent falls with older adults

What we are seeing more often these days is symptoms of Osteoporosis in people aged in their early 40's and some even in their 30's! Osteoporosis is now so common I am working with many clients with severe postural problems causing severe injuries like disc bulges in the lower back and neck due to their bones becoming so weak and brittle. 

Osteoporosis is causes the gradual loss of bone density and strength and when the thoracic vertebrae are affected like in the picture above, there can be a gradual collapse of the vertebrae. This results in kyphosis, an excessive curvature of the thoracic region. This causes what is known as a Dowagers Hump! Not very attractive, but even worse than how it looks is the damage it creates to rest of the body. Multiple injuries begin to surface when this poor posture is left untreated. It is a very long slow process to correct this condition, it is so much easier to prevent it from happening.

Watch the videos below that provide great detail as to how to address this postural condition.

The reason Women are 3 times more likely to develop Osteoporosis than men is due to their overall lack of muscle mass to begin with, the aging process combined with menopause, poor lifestyle and lack of resistance training just speeds up the problem. But did you know that about 20% of people with Osteoporosis are men!

Sarcopenia which is the loss of muscle mass as we age plays a significant factor in the development of all these problems. There has been countless studies and research that have proved the capability of people as old as 100 years to build muscle through high-intensity resistance training.

It is clear that we must add muscle by using strength training methods and exercises. However, you must learn to move well first for your exercise efforts could easily backfire on you.

Learn To Move Well First

If osteoarthritis is caused from poor joint stability then it makes perfect sense to address this first. Sure, there is undoubtedly a lot of muscle weakness present that needs to be addressed with strengthening exercises but you must ensure you know how to move correctly. 

Modern fitness equipment allows us to train our body in sitting positions that do not demand high levels of coordination, stability, and posture. We learn it is possible to avoid learning these fundamentals before lifting loads or moving fast and the principle of “earning the right” is not needed. A classic example is the leg press where someone can start lifting incredible loads on the first day, yet be barely able to complete an effective squat with their own body-weight that demands stability and coordination. You will not address the instability of the joints if you try to do this for you will still move during the day with the compensatory movement that is causing your problem.

You can read more about this in the article - Why you should never sacrifice exercise technique

Obviously there are many things to consider and it is impossible for me to give you a template of what to do as we are all so different. It can be quite difficult in the beginning especially when you have pain and stiffness limiting your ability to move. To help you out there is a great free report you can download below with some information to guide you on assessing your body for the fundamental movement patterns.

You will find great articles about stability and movement shown below.

The Secret To Making Bone Respond Quickly

Now that you know how to move well it is time to strengthen the muscles and more importantly the bones. 

Tissue adapts when it is faced with a challenge that is beyond what it encounters in everyday life. This is the beauty of strength training as it can be easily manipulated or altered to create new challenges. The overload produced from the exercise challenge is the stimulus for tissue change. Constantly changing exercises, intensity, tempo and methods are just some of the variables you can use to promote this overload. One big secret is to use exercises that challenge the body in multi directional angles and directions.

Research has found that multi directional exercises with load improve bone density and bone strength faster due to the fact that they incorporate so many of the structural lines needed for everyday life moving. By forcing challenges with these exercises with either load or speed these lines adapt and create a structural change to the bones. This is one reason why machine training provides little to no effect. Even exercises like bicep curls will produce little change to the body in terms of muscle development.

It is not always about lifting heavier weights, sometimes completing more repetitions, performing the exercise for a longer period of time doing the exercise faster or slower can be all you need to enforce change. The key is to use a lot of various methods to continually overload the body’s systems so that you continue to make improvements.

Unfortunately many people do not understand this concept. They either think that what they are doing is “good enough” or that working out harder will be dangerous for them. It is a real myth that mature adults should only use light dumbbells or easy resistance bands because they might become injured. The muscles of older adults need to be challenged in order to grow just as the muscles of younger adults. If anything more so than younger adults! This is the phase where most programs start to go wrong, and can you now see why this causes so many problems?

The focus is really on the end result that we are after – improved human movement and function. This takes advantage of how the neuromuscular system is designed to work in the first place which is in a highly coordinated manner. Very, very rarely to muscles work in complete isolation or anywhere close to it. Some muscles contract to provide movement while some muscles contract to provide stability. This is all done at the same time. The don’t work separate to each other. In addition to this it must not be forgotten that the more co-ordinated and complex movements have a greater effect on the brain.

Below are two videos that provide perfect examples of where we use multi-directional exercises to achieve the goal of building muscle, bone density, and functional movement skills used in daily life. These exercises can be modified for all types of conditions but our end goal MUST be to get to this point as this is what you need for life! Sitting on a machine or lying on the floor may build some muscle but it will not improve your ability to do these movements.

You will find more examples in the articles shown below.

For Bones To Adapt There Must Be Sufficient Nutrition

Now for all of our exercises and programs to have the best chance of succeeding their must be adequate nutrition provided to allow the repair and recovery process to take place. Developing new bone or muscle is what is known as the anabolic process. Your body requires you to eat foods that contain the necessary building blocks to repair the damage caused from your workout. Proteins contain all the essential amino acids required for this process and is the reason why body builders carry protein shakes everywhere because they know how important high quality protein is to reap the rewards of their training.

Unfortunately older adults and even many younger people eat not enough high quality protein and too much high refined processed foods or sugar laden food that does the exact opposite of the anabolic process and create a catabolic process.

Calcium is a very important vitamin to address problems with arthritis. We all know how important calcium is for infants to build strong bones, well the same is true for older adults. Calcium is needed to regulate heart rate and maintain bone mass, but unlike children where they soak it up like a sponge, absorption declines with age.

The risk of low calcium levels expose the older adult to fractures and weakening of bones leading to osteoporosis. People aged 50 and over should aim to get 1200 mg of calcium per day.

What foods provide a stack of calcium? The first thing people think of is milk and while it does provide calcium there are many other foods of equivalent value. Foods like sardines, Greek yoghurt, ricotta cheese & sardines have been shown to have higher levels of calcium than milk. Check out the full list of calcium-rich foods provided by the National Osteoporosis Foundation by clicking here.

Also do not underestimate the value of Vitamin D here as well.

Due to our sedentary lifestyle and being stuck indoors to often combined with poor nutrition a lack of Vitamin D now causes massive problems. Completing any kind of construction requires raw materials to build the structure and vehicles to deliver the raw materials. In this case calcium is the main material needed for building bone along with magnesium and phosphate but the vehicle to deliver them from the digestive system to the building site in the bones is where Vitamin D comes in.

Vitamin D facilitates the absorption of calcium, magnesium and phosphate through the intestinal wall and into the bloodstream. Below is a great video to watch with explanation of how valuable this can be to providing your body with what it needs to get on top of your problem. This is a big part of my treatment for Psoriasis that I mentioned at the start and helps to keep my body from reacting with skin lesions and joint soreness.

Do You Need More Help?

There is obviously a lot of information and great exercises I have not included in this article and I do suggest to grab a copy of our latest report that covers everything you need to know about older adults health. This report provides you with detailed pictures, instructions of over 50 exercises and some excellent workouts and tests to use for measuring your improvement. Many of the exercise pictures shown in this report are of clients who in their 70’s and 80’s who currently train with us at No Regrets. We also feature several of their stories for you to see how they changed their life by adopting the methods explained in this report. I hope you enjoy reading this and it helps you to enjoy your golden years.

Conclusion

I hope this article sheds some light on the value of strength training and improving overall nutrition and lifestyle habits to prevent what are some of the most common diseases and chronic conditions facing many people today. As I always say "it is far easier to prevent problems than to fix them later". It is also far less expensive or invasive to complete a strength training program 3-4 times per week than having invasive surgery or taking medications that only treat symptoms. 

Always remember to move well before you move more. And the older you are the more important strength training and eating quality nutrition becomes. Osteoarthritis is not something we should just accept as a part of getting old and we must recognize it is a result of inactivity and poor movement. 

If you live in Melbourne and would like to know more about our Stronger For Longer, Lift For Life or even just one on one Personal Training click the image below and I will get back to you within 24 hours to schedule a Free consultation to discuss how we can get you into top health and fitness.

About The Author

Nick Jack is owner of No Regrets Personal Training and has over 15 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specialises in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise.

References:

  • Bending the Aging Curve - By Joseph Signorile
  • Movement - By Gray Cook
  • Corrective Exercise Solutions for the hip and shoulder - by Evan Osar
  • Diagnosis & Treatment Of Movement Impairment Syndromes - By Shirley Sahrman
  • Low Back Disorders - by Stuart McGill
  • Knee Injuries In Athletes - by Sports Injury Bulletin
  • The ACL Solution - by Robert G Marx
  • Understanding & Preventing Non-Contact ACL Injuries - American Orthopaedic Society For Sports Medicine
  • Anatomy Trains - by Thomas Meyers
  • Motor Learning and Performance - By Richard A Schmidt and Timothy D Lee
  • Assessment & Treatment Of Muscle Imbalance - By Vladimir Janda
  • How To Eat, Move & Be Healthy by Paul Chek
  • Scientific Core Conditioning Correspondence Course - By Paul Chek
  • Advanced Program Design - By Paul Chek
  • Twist Conditioning Sports Strength - By Peter Twist
  • Twist Conditioning Sports Movement - By Peter Twist
  • Twist Conditioning Sports Balance - By Peter Twist