This has got to be right up there in the top 5 questions that I get asked as a physio by patients. “Wear and tear” is a common way people describe joint pain caused by osteoarthritis (OA) but is one that I feel is unhelpful in understanding how our bodies function and why we experience pain.
“Wear and tear” sounds like something your car mechanic might say when he’s talking about your tires or your engine which leaves you with two choices stop driving or replace the offending part.
Now this analogy of your body as a machine doesn’t fit with what we know about the human body and it’s response to being used (i.e. exercise).
Your body is living tissue that has an amazing capacity to regenerate and adapt to the forces that we subject it to during normal movement and exercise.
Ask yourself these questions:
- DOES YOUR CAR HAVE THE ABILITY TO REPAIR ITSELF AFTER YOU’VE REVERSED IT INTO A WALL?
- DOES YOUR CAR GROW BIGGER TIRES IF YOU DRIVE IT OFF ROAD?
- DOES YOUR ENGINE GET STRONGER AND MORE POWERFUL AFTER LONGER DRIVES?
If the answer’s yes to any of those I need to know what you’re driving!
However your body’s tissues can do some of these things:
- REPAIR THEMSELVES AFTER INJURY
- YOUR MUSCLES AND BONES GET STRONGER AND BIGGER WITH RESISTANCE TRAINING
- YOUR HEART GETS STRONGER WITH ENDURANCE TRAINING
In order to offer a more accurate description of why you might be getting joint pain it’s first useful to look at what OA is:
Osteoarthritis starts with a roughening of the cartilage (the hard shiny substance that covers the bone ends). This can then lead to body trying to “repair” itself resulting in:
- SMALL EXTRA BITS OF BONE (OSTEOPHYTES) THAT CAN FORM AT THE EDGE OF THE JOINT
- A THICKENING OF THE FLUID INSIDE THE JOINT
- INCREASED STRETCHING AND INFLAMMATION OF THE JOINT CAPSULE
- A REDUCTION IN THE JOINT SPACE (THE SMALL GAP SEEN BETWEEN YOU BONES WHEN LOOKING AT AN X-RAY.
The pain that osteoarthritis produces can make people want to use the joint less which can lead to a reduction in the strength of the muscles around that joint. The pain can also inhibit or switch certain muscles off which means they get weaker quicker than others.
As the muscles get weaker they provide less support to the joint which in turn can then lead to increased roughening of the cartilage and the problem progressively gets worse.
Belief that the joint is just wearing out combined with the pain when moving can lead people to reduce their activity levels which in the longer term can make the problem worse.
Another example of this analogy of the body as a machine is the commonly held belief that running wears out your knee joints. We now have good research that suggests exactly the opposite, that regular running at a recreational level can actually reduce your risk of developing knee osteoarthritis rather than making your knees wear out quicker.
We know exercise is very, very good for people with OA especially if it’s gradually increased over a number of months.
Starting to exercise when you have OA can be painful and is hard work. Seeing a therapist who can assess your condition, establish a baseline for how much exercise you can cope with and understand what you are wanting to achieve is key. Once we know where you are at present and where you want to be we can provide you with a treatment plan to help to reach your destination and be on hand throughout the journey keep you on track.
If you are suffering with joint pain caused by OA then book an appointment with one of our therapists by calling our reception team on 01539 725220 or click here to book an appointment online.
Written by: Richard Clarke physiotherapist
