Vitality - Healthy Aging NewsletterSpring 2013

How to Keep Joints Healthy as You Age

Do your knees crackle and pop? Are you stiff when you get out of bed or when you rise from a chair?

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You aren't alone. By the time we're in our 60s and 70s, most of us have joint problems.
As we age, the connective tissue and cartilage that provide cushioning between the joints wear down and become thinner, leading to conditions such as osteoarthritis that cause pain and inflammation. Genetics and age are primary factors in joint deterioration, but there are steps you can take to extend the life of your joints and protect knee or hip replacements.
First, manage your weight. "This is the most important thing you can do, because excess body weight strains joints, particularly knees," says Group Health orthopedic surgeon Jean Walsh, MD. "Obesity is a significant risk factor for developing arthritis in your leg joints and having major complications with surgery."

Watching your weight also includes avoiding carrying heavy loads, such as grocery bags, and protecting your smaller joints. For example, lift with the muscles in your hands and arms rather than just using your fingers, and when standing, use your thigh muscles rather than your hands to push off from a chair.

Next, keep moving. Joints are meant to be used, but if we don't warm up before exercising and stretch often to avoid getting stiff, we'll be creaking like the Tin Man in The Wizard of Oz.

"One of the goals of exercise is to maintain the strength and range of motion of joints," says Dr. Walsh. "This is more challenging when you have arthritis, because exercise can aggravate the condition. Choose activities that are easier on your joints. Bike rather than walk, or swim rather than use the elliptical."
Choose activities that also safeguard aging tendons and ligaments. Sports like basketball and racquetball, where you pivot, twist, or stop and turn suddenly, can cause a torn meniscus or ACL (anterior cruciate ligament) in the knee. Repetitive movements like weeding or swinging a golf club can result in tendonitis.
Explore your options. If you like to garden but have trouble bending or squatting, build raised beds and use long-handled tools," says physical therapist Brian Nakagawa, who practices at the Group Health Capitol Hill Campus. "If you want to hike but have a weak knee or hip, use trekking poles. Sometimes people get discouraged because they don't know what's available to them.”
Member Gerald Seligman of Seattle says that although age hasn't slowed him down, he has made some changes. "I don't play basketball or tennis anymore, but I still ski, bike, hike, and kayak. I'm just more cautious because I'm getting older and have had a hip replacement. Physical activity is a must — in moderation."

Remember to pace yourself. When you start a new activity, build up gradually to reduce the risk of injury. If you work out too hard too fast, you risk inflaming or stressing joints before the muscles are strong enough to support them.

"Forget the old high school coach's advice of 'no pain, no gain,'" says Dr. Walsh. "Listen to your body and know when enough is enough. There is no benefit to overuse."

How much is too much? "If you experience increasing pain during an activity, stop,” says Nakagawa. "If pain or discomfort haven't gone away within 30 minutes after exercising, cut back. And if you have arthritis, be aware that pain will often decrease with movement. It's all about finding the fine line between too little and too much."
Other exercise tips include wearing shock-absorbing shoes, using appropriate safety equipment such as knee pads or wrist splints, and learning proper techniques. "Swimming is great, but poor form can hurt your shoulders," says Nakagawa.
Finally, drink plenty of fluids. Hydration aids joint health because it helps with shock absorption and boosts endurance levels. If your muscles tire quickly, you may be dehydrated.

If you have pain, Dr. Walsh recommends acetaminophen (Tylenol). "Taken as directed, acetaminophen is safer than nonsteroidal anti-inflammatory drugs such as ibuprofen," she says. "And, according to studies, it's equally effective." Applying ice packs and topical analgesics can also help reduce pain. If none of these work, ask your doctor about prescription drugs, cortisone injections, or whether it's time to consider joint surgery.

You can view treatment options for hip and knee osteoarthritis on a patient education video, available on our Videos About Treatment Options page. (You must be registered to view treatment videos online.) You may also request a video copy through your Group Health doctor's office.

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