Smart joint strategies for keeping you moving well

Understanding risk and modifying your activities can cushion your joints from damage.


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Joints are a little bit like couch cushions. Over time, the padding between your bones, called cartilage, gets worn out and flattens down — a condition known as osteoarthritis. Unfortunately, dealing with worn joints is not as simple as fixing or replacing a couch. And whether your joints wear out may not be entirely in your control.

"Unfortunately, a lot of your risk depends on your genes," says Dr. Scott Martin, an orthopedic surgeon and associate professor of orthopedic surgery at Harvard Medical School. "If you have a history of arthritis in your family, you may get arthritis in your lifetime. That's one factor you can't control." Dr. Martin is the faculty editor for the Harvard Special Health Report Knees and Hips (www.health.harvard.edu/knees).

But while your DNA may foretell future joint problems, that doesn't mean you are entirely powerless when it comes to your joint health. You can take steps to keep your joints working well for as long as possible. Below are some strategies you can use to protect them.

Know your risk factors. Several factors increase your risk of osteoarthritis. In addition to family history, your sex matters — women are more prone to the condition than men. There are also non-genetic risk factors, such as a past injury to a tendon or cartilage. Experts believe that an injury that results in joint damage sets off a process known as apoptosis, which is essentially the death of cartilage cells in the injured area, says Dr. Martin. But the cells in the cartilage don't die off right away. This cell damage may occur many years after the injury — sometimes 10 to 20 years later. Knowing that a past injury may lead to arthritis in your future can help you adjust your activities to protect your joints, says Dr. Martin, which brings us to our next tip...

Avoid activities that put heavy stress on joints. If you suspect you're at risk for osteoarthritis, you might want to avoid activities that unnecessarily tax susceptible joints. This might include long-distance running, deep squats and lunges, dead lifts, and using heavy weights or kettlebells. "These exercises are good for your glutes, but not your joints," says Dr. Martin. Rather, opt for gentler activities, such as swimming, cycling, workouts on low-resistance elliptical trainers, or a walking program on level ground.

Maintain a healthy weight. Much like lifting heavy weights can put a strain on your joints, the same is true when you add extra pounds to your frame. "If you have a normal joint and you have some weight gain, it's probably not a big deal," says Dr. Martin. But if you have an abnormal joint, gaining weight can trigger a problem. Many women gain weight when they go through menopause. Even an extra 10 to 20 pounds can put a huge amount of extra stress on your joints.

Distinguish between different types of arthritis. Not all cases of arthritis are osteoarthritis. Some joint problems are triggered by a faulty immune system response, including rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis. Significant swelling of the joint is your tip-off that you are experiencing this form of arthritis. Early treatment won't cure the existing arthritis, but it can keep it from getting worse.

Consider supplements. For a long time, many physicians were skeptical of claims about glucosamine and chondroitin sulfate, two supplements credited with reducing joint pain, says Dr. Martin. But research has shown that they do seem to work, although no one is really sure why. "It's probably similar to someone taking aspirin to reduce pain 100 years ago," he says. "They weren't sure why it worked, but it did." However, be skeptical of claims that they can reverse or prevent joint damage. "Whether they do what they claim regarding preserving or restoring your joints is questionable," says Dr. Martin. "There's not a lot of good evidence of that."

Try physical therapy. If you have a problem joint, it can help to work with a physical therapist to strengthen the surrounding muscles. Stronger muscles can better support the joint and lessen pain by absorbing some of the pressure that would otherwise be placed on the joint.

Take a conservative approach. If you experience an injury, it's not necessarily best to rush to a surgical solution — particularly if you're over 40. Older patients might be better off taking a conservative approach when possible, and opting against certain joint surgeries, says Dr. Martin. However, when joints wear out and someone is suffering physically and mentally, it may be worth considering joint replacement.