Osteoarthritis – Aging And Your Body
In this post thought we should turn our focus to the elderly – an ever-growing population. Did you know that there are approximately 700 million people in the world aged 60 and over? And did you know that it is estimated that by 2050, there will be around 2 billion people on the planet that fall into this age bracket? That’s just over 30 years away! That’s quite difficult to comprehend, but with people beginning to work and live longer, it’s important that the elderly population get the attention and care they need to stay healthy and active; so they can enjoy the quality of life they deserve.
You might think that as people get older, they become less active and therefore are less likely to injure themselves. This may be true to a degree, especially once reaching retirement age, but the elderly population are generally an active population and are just as much at risk of injury as the next person. A 60-year-old person might not play footy or run around the basketball court as much as a teenager might, but they have other things to contend with – an ageing body with years of gradual degenerative change and weakening that we all experience at some point as we go through life. One of the most common causes of injury in the elderly is falling. Unfortunately, as the body ages, it becomes more prone to falls. This usually boils down to a combination of individual factors (i.e. having multiple diseases, poorer eyesight, or general weakening of the body) and environmental factors (e.g. trip hazards around the home setting). Some of the most commonly seen injuries sustained from falls include fractured hips, arms and forearms, cuts and lacerations, as well as head injuries.
In a clinical setting, us osteos see our fair share of older patients. It’s less likely we’ll see someone in the acute setting immediately following a trauma like a cut, laceration or in many instances where a fracture is suspected, but it does happen. It is much more likely however, that we will see patients experiencing pain related to postural strain (think about the retiree who sits around a lot), or from degenerative changes in the body. A common degenerative condition affecting the elderly population is osteoarthritis (OA). This most commonly affects the joints in the hips, knees and spine – particularly those of the neck and lower back. It’s no coincidence that these are the main weight-bearing joints of the body.
So what is OA?
OA is a condition affecting the synovial joints in the body (the joints between two bones in the body that have a lubricating fluid between them). It is characterised by changes to the cartilage and underlying bone, as well as inflammation and irritation to the soft tissues that help to hold the joints together – known as the synovium – it’s the tissue that forms the lubricating fluid that sits between the joints.
Primary OA refers to changes in the joints that relate to the ageing process. It will often run in the family, so if your granny or dad has it, you may be more at risk to develop it. Secondary OA is arthritic change from any other cause. For example, following on from trauma, repetitive stress, poor posture, or from diseases such as gout.
Signs & Symptoms
The main symptoms (things the person experiences) of OA include pain, stiffness, poor joint function and muscle weakness. Signs (things we look for in the clinical setting) that a joint is degenerated include popping and clicking, poor range of motion, bone and joint swelling, deformity and instability.
What to do if you have or think you have OA
First things first, book an appointment to see your local osteo. After questions and assessment, we’ll get to work on your body and putting you on a pathway to moving better. There is a good chance your arthritic joint is paining you because you aren’t moving well, and the joint is being loaded incorrectly. The good news is, we know how you should be moving, and what needs to be done to get you there. We’ll aim to reduce your pain down by releasing tight and over-worked muscles and mobilising your stiff joints. Mobilising the joints helps to increase range of motion and will help promote production of the lubricating synovial fluid that sits between the joints to allow smooth fluid movement. You should get off the treatment table feeling less pain and moving better. There is a good chance you’ll need to do some form of strengthening to the surrounding weakened muscles, so the joint is more supported when you move it. More good news, we know which exercises will be beneficial to get you on the path to stronger muscles. Unfortunately, we cannot claim to cure your OA, but we can certainly get you moving with less pain or in an ideal situation, no pain at all.
What’s the outlook with OA?
More often than not, if caught early, significant changes can be made to stunt the progression of this degenerative condition. So, don’t ignore pain, it’s your body’s way of telling you something isn’t right. With early treatment, the best possible outcome will be achieved. If you pop into the clinic and we determine your issue is not OA-related, we can provide you with a sense of relief and get you on the right track for your situation (a positive outcome, either way!). In severe cases, you may require the opinion of a specialist orthopaedic surgeon. Sometimes people require joint replacements and can go on to live a very good quality of life with a new hip or knee for example. Always see your osteo first though. Using our skills, we can possibly keep you from having to go under the knife a bit longer, and maybe even at all. Worth a shot don’t you think?!
- United Nations. 2019. International day of older persons – 1 October. [Online]. Available from: https://www.un.org/en/events/olderpersonsday/. [Accessed 04 Sept 2019].
- 2017. Falls in the elderly: Causes, injuries, and management. [Online]. Available from: https://reference.medscape.com/features/slideshow/falls-in-the-elderly#page=1. [Accessed 04 Sept 2019].
- Arthritis Australia. 2019. Osteoarthritis. [Online]. Available from: https://arthritisaustralia.com.au/types-of-arthritis/osteoarthritis/. [Accessed 04 Sept 2019].
The Importance of Movement
arent or sibling), then we start to get rudimentary use of our upper limbs, then we learn to lift our head and role onto our stomach, and now we can use our arms to push ourselves up and our neck muscles to support our head. Then we start to get stability in our trunk muscles so that we can sit and start to reach out, and then we are crawling, toddling and eventually running.
In other words we go through a sequence of learning where we move with increasing complexity, from simple reflexes to the ability to stabilise ourselves against gravity and then the ability to perform complex volitional activity such as eating or running.
This means that if we need to restore movement, say after an injury or an illness, we need to think in terms of this hierarchy, reflexes - stability - complex movement.
Humans are unique in that we have a complex postural system that enables us to stand upright on two unstable pins, that's why it takes us three years to learn to walk efficiently. But it is under constant stress and it's ability to perform this task starts to deteriorate as we age unless we take steps to keep it in top condition.
In research published in Queensland: Falling is not just for older women: support for pre-emptive prevention intervention before 60 (J.C Nitz and N.L Low Choy 2008), the researchers assessed women between the ages of 40 and 80 for the risk of falling. 8% of women in their forties, 14% in their 50s, 25% in their 60s and 40% in their 70s had fallen in the previous 12 months. In addition, the risk of falling increased significantly if the woman had other health problems.
Their conclusions was that for women over 40 years old, the number of illnesses increase the risk of falling and the risks increased still further if they were over 60. Preventative program participation aimed at maintaining good health appears vital to prevent falls.
To put it another way, our stability starts to drop in our 40's. Falls are a natural consequence of reduced stability but they are not the only consequence. The early consequences are less efficient use of posture which leads to stiffness and back pain.
So, in order to perform any meaningful activity, we must first be stable. Stability is really the ability to maintain balance while we shift our weight. When it starts to drop it means that we have less ability to generate momentum to move forwards. And if we are unable to generate as much momentum, then our step gets shorter, and if our step gets really short we require a stick to help support ourselves. Thus our ability to move becomes compromised.
So as we get older we get stiffer and less stable, which leads to weight bearing changes. It also leads to restriction in movement. It's important therefore to not only keep mobile but also work on keeping yourself stable. Exercise that can help this includes dance, yoga and Tai Chi. It is also important to work on your posture. Posture is basically how well you control your relationship to the ground and how efficiently you are able to shift your weight in order to generate momentum.
Perfect Posture Program
If you want to lean more about posture and how to keep yourself mobile and pain free, then we have an educational program that maybe for you. Our Perfect Posture Program has been developed from 25 years of rehabilitation of chronic back pain, and 10 years of measuring balance and analysing posture with computerised posturography. The purpose of the program is to teach you how your postural system works, so that you can use it in any situation, whether you are standing at a meeting, sitting at your desk or putting your child in the back of the car. This six week program is suitable for anyone who wishes to improve their posture from children aged eight and above, right through to seniors.
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