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Core Knowledge

Injury/Pain

Osteoarthritis: A Primer

Overview

Osteoarthritis (OA), also called degenerative joint disease, is one of over 100 varieties of arthritis. It is characterized by the loss of cartilage tissue that covers the ends of bones and makes movement fluid. Dr. John Bergfeld, an orthopaedic surgeon at the Cleveland Clinic, describes knee OA this way: “Arthritis is a disruption in the smooth gliding surfaces of the knee joint. Think of it as a road that was once smooth but is now beginning to break up and develop potholes.”

Osteoarthritis is a condition that will affect almost everyone sooner or later. It may affect athletes more often and sooner than non-athletes, but the process is more likely to have begun because of an injury than with normal use, even over a long period of time.

How It Happens

In younger athletes, knee OA usually develops as a result of a knee injury (it could develop as a result of a torn ligament) or overuse (as when a runner unnecessarily puts in too many miles). The articular cartilage that covers the ends of bones either wears away gradually or is damaged by taking a blow (or repeated blows) to the knee. A history of knee injuries, instability in the joints or being overweight can all accelerate the onset of osteoarthritis and cause disability. In older athletes, the joint surfaces tend to be worn away, but again, the wear and tear is almost always injury-related. That’s why they call it “degenerative” arthritis.

By the Numbers

20,000,000
Number of Americans affected by osteoarthritis.

40-45
Age at which most people show signs of OA, although caused by a previous injury, not age.

Who’s At Risk

Football players, soccer players, tennis players, and runners are all at risk, either because of repeated contact or overuse. But according to research published in the British Journal of Sports Medicine, there seems to be little risk associated with recreational running even though it would appear reasonable that runners are at great risk from pounding the pavement. The condition is also reported in older athletes who play or used to play a sport that exposed their knees to injuries. 

Symptoms

  • Gradual onset of symptoms
  • Joint aches and pains, especially early in the day
  • Limited range of motion
  • Joint stiffness, especially after staying in one position for a long time
  • Swollen joints
  • Symptoms worse after heavy use

Initial Treatment

  • Stay off the affected leg until debilitating symptoms subside or change from a heavy-load activity to one that places less stress on the knee (swimming or cycling instead of jogging, for example).
  • Apply heat before exercise to increase circulation and ice afterward to reduce swelling.
  • Apply creams or gels for temporary relief.
  • Try a knee brace to support the joint, minimize pressure and control swelling.
  • Aspirin, ibuprofen, and naproxen may relieve pain and reduce inflammation.

Comeback Strategy

Knee osteoarthritis is not an acute injury, so returning to action depends mostly on a person’s ability to manage and tolerate the pain, as well as the absence of symptoms that negatively affect performance.

Prehab

These prehab exercises might speed your return to action and help lessen the discomfort you experience while training:

  1. Standing Quadriceps Stretch
  2. Foam Roll - Quadriceps
  3. Mini Band Walks - Straight leg  (to strengthen your hips and help take  pressure or stress off of the knees during movement)

How to Avoid It

There is no known way to prevent osteoarthritis of the knee or any other joint, but there are ways to lessen its effects or delay its onset. Here are a few suggestions:

  • Change or alternate types of physical activity (swimming instead of jogging, for example) to lessen the load placed on your knees.
  • Observe the 10 percent rule: Do not increase training intensity, frequency or duration more than 10 percent a week.
  • Schedule active rest/regeneration days into your weekly training routine.
  • Get treatment early following a knee injury to prevent later development of OA.

Movement Prep

Incorporate these exercises into your warm-up routine:

  1. Massage Stick - Quadriceps
  2. Active Insolated Stretching - Bent Leg Hamstring
  3. Glute Bridge

Jim Brown, Ph.D. has written 14 books on health, medicine, and sports. His articles have appeared in the Washington Post, New York Post, Sports Illustrated for Women and Better Homes & Gardens. He also writes for the Duke School of Medicine, UCLA School of Medicine, Cleveland Clinic and Steadman-Hawkins Research Foundation.


Tags: Injury Prevention, Regeneration, Longevity, Injury, Prehab, Reduce Pain, Knee Pain, Knee

References

  1. Sue Falsone PT, MS, SCS, ATC, CSCS, 
Director of Performance Physical Therapy, Athletes’ Performance
  2. American Academy of Orthopaedic Surgeons
  3. American Journal of Sports Medicine
  4. Arthritis Foundation
  5. British Journal of Sports Medicine
  6. Journal of Athletic Training
  7. University of Washington Orthopaedics and Sports Medicine

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