OA is known as a wear and tear disease so repetitive movement with poor alignment over time may cause stress on the joint and lead to suffering.
What is Osteo arthritis?
According to www.arthritis.org.au Osteoarthritis is defined as:
A condition that affects the whole joint including bone, cartilage, ligaments and muscles. The area predominantly affected is the cartilage (the protective covering over the ends of your bones), which degenerates, or breaks down. This cartilage is what stops the bones in your joints from rubbing against each other. Damage to cartilage and surrounding structures can cause your joints to:
- Become painful, stiff or swollen
- Feel like they might lock up or give way
Sometimes you can have osteoarthritis and not feel any symptoms at all. The most common sites to feel pain are your hands, spine, hips, and knees, these being the most used joints in every day life.
Australian Osteoarthritis is the most common form of arthritis in Australia. An estimated 2.2 million (9.3%) Australians have this condition, according to the Australian Bureau of Statistics (ABS) 2017-18 National Health Survey (NHS). Osteoarthritis represented over half (62%) of all arthritic conditions in 2017-18 (ABS 2019).
Statistics from Australian Institute of health and welfare https://www.aihw.gov.au/
- 1 in 11 Australians (9.3%) have osteoarthritis, approximately 2.2 million people in 2017–18
- There was a 38% rise in the rate of total knee replacements for osteoarthritis from 2005–06 to 2017–18
- 3 in 5 people who have osteoarthritis are female
- People with OA were twice as likely to describe their health as ‘poor’ among those ages 45 and over.
Osteoarthritis has no specific cause, however several factors contribute to the onset and progression (Chapman & Valdes 2012), including:
- being female
- genetic factors
- excess weight
- joint misalignment
- joint injury or trauma (such as dislocation or fracture)
- repetitive joint-loading tasks (for example, kneeling, squatting and heavy lifting).
OA is known as a wear and tear disease so repetitive movement with poor alignment over time may cause stress on the joint and lead to suffering. OA can occur in any joint and will often be felt in an area of excessive use which will be dependant on a persons daily tasks.
I recently presented at a dental conference and a common area of OA for attendees were their hands. Dental hygienists hold tooth cleaning instruments in their hands all day long and if the instrument is not held properly, over time this can lead to OA in the joint. I was amazed at the lack of understanding these specialists had in correct holding and postural techniques to save from wear and tear in their hands.
Although osteoarthritis affects people of all ages, the prevalence increases sharply from the age of 45 years. 1 in 5 Australians (22%) over the age of 45 have osteoarthritis. It is most common in adults aged 75 and over, with just over one-third (36%) of people in this age group experiencing the condition
In 2017–18, 54,102 knee replacements (218 per 100,000 population) and 32,929 hip replacements (133 per 100,000 population) were performed in hospitalisations with a principal diagnosis of osteoarthritis. The rate of knee or hip replacements was lowest in people aged under 40, increased with age to 75–79, and then decreased among those aged 80 and over
Illnesses do not come upon us out of the blue. They are developed from small daily sins against nature. When enough sins have accumulated, illness will suddenly appear – Hippocrates
Factors leading to OA
- Poor lifestyle and diet
- Inflammatory lifestyle
With the leading factors pointing to lack of exercise, Pilates can play an impressive role in managing the pain associated with OA. Pain is caused by inflammation (click here for my article on inflammation) which leads to inactivity because it hurts to move which then leads to worse pain as the unused muscles get weaker and the sufferer spirals into a never ending cycle of discomfort and poor choices.
Pilates is gentle on the joints and we can load the persons joints up safely while prescribing specific exercises to strengthen the muscles that support the damaged joint. Performing exercises on the Pilates machines has a wonderful way of creating ‘space’ in the joints where there isn’t any, which in turn takes pressure off the affected joint(s) so that the person can exercise comfortably and be able to load up more so than if they were trying to do free form exercises.
We see very positive results in the Pilates studio working with people with OA. Being able to perform functional exercises, increasing load as the muscles strengthen and teaching the person how to move better is the first step to living with OA.
Since OA is a wear and tear issue, often related to poor joint alignment, Pilates plays a pivotal role in teaching correct joint placement to encourage better movement practice and longevity in movement. OA is painful and people who live with pain often avoid movement which becomes their nemesis and causes even more wear and tear and often leads to people making the decision to go down the road of joint replacement.
The best thing a person with OA can do is strengthen the joint which will help ease the discomfort. Not only can improved alignment and strength prevent surgery, even if the person ends up on the butchers table, the muscles surrounding the joint to be replaced will have the strength necessary to recover from surgery.
With so many tens of thousands of hip and knee replacements performed every year, the most promising results we see are with people who start Pilates as a preventative to surgery. As a Pilates teacher our job is to not only keep people off of the butchers table for as long as possible by getting them stronger and more capable but also preparing their body to be able to endure surgery if that’s the best option for them.
Surgery should always be the last possible option but sometimes it certainly is the best option. A hip or knee replacement, for some people could mean the difference between living their best life and just living. But surgery is also just one part of a very long process that should involve at least 6 months of pre operative strengthening and 6 to 12 months of post surgery movement retraining and strengthening. And the great thing with people who commit to a pre surgery exercise approach often either don’t need surgery or if they do go ahead, their recovery is faster and easier than those who don’t.
Surgery for OA most often involves replacing an entire joint (usually the hip or knee joint but sometimes both) but it doesn’t deal with the muscle deterioration caused by lack of mobility from living in pain. Which is why we see such a marked difference between people who prepare and those who go in with the notion that the replacement is all there is to the procedure. Strength comes down to two things. Commitment and consistency, and relies on one fact – educated support. The stronger and more capable a person goes in to surgery, the stronger and more capable they come out of surgery – and as morbid as it may sound, the less likely they are to have issues with the surgery or recovery, or worse.
What happens in a Pilates class for OA?
The teacher works closely with the person to give them a home program that can be practiced daily. The home program may change over time depending on the clients needs and can be practiced to support daily activities such as sit to stand, getting in and out of the car, walking up and down stairs and whatever other activities the person performs day to day.
If the client is preparing for surgery, the exercise program will be appropriate immediately after surgery so that the client can get back on the horse so to speak as soon as they wake up (yup, we want you moving that joint like a well oiled machine).
Ideally we want to see a person with OA in the studio at least once a week, preferably twice. For most people, by the time they get to the Pilates studio, they have been living with OA for a time and the muscles around the joint can be very weak and the joint itself in poor alignment.
Two weekly sessions mean that the teacher can help release tight muscles and strengthen the entire body with a focus on the affected joint(s). Each time the client visits the studio, the teacher will assess movement, discuss any progressions or regressions the client is experiencing and individually tailor the session to push the muscles at a level that will safely strengthen and align without exacerbating the pain.
People who come to Pilates for OA report feeling lighter, less compressed, freer and more able. Pilates aligns bones by educating people on good movement, decompresses joints by strengthening supporting muscles and gives people confidence to move more. And just as importantly, Pilates is often the catalyst to other lifestyle changes which can make a huge impact on whole body health.
Most importantly we must recognise the body’s innate ability to heal from all diseases. While pain or disease may be common, it is not normal and the natural state of being is a state of good health. With proper support, education and commitment to self, the body can certainly heal from Osteo arthritis and the choices a person makes in their lifestyle are imperative for those changes to occur.
Looking to start Pilates to support your body? Contact us for a discovery session today and make positive changes in your life that support better health.