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Canada.com News Your joints can take it JILL BARKER Despite the wealth of data heralding the health benefits of regular exercise, an ugly little rumour continues to circulate suggesting those who play now, pay later. Too much intense physical activity, claim the naysayers, leads to joint pain later in life. Are runners, skiers, soccer, hockey and football players, by virtue of the high-impact nature of their sport, more prone to osteoarthritis, a degenerative disease of the joint? Yes and no, say the experts. Osteoarthritis is a progressive disease found in adults middle-age and older. One of the most common types of arthritis, it affects one in 10 Canadians. A thinning of the cartilage that cushions the ends of bones, it results in pain, stiffness and occasional swelling due to bone rubbing against bone. Located most often in the spine, hips, knees and fingers, the disease tends to run in families and is more prevalent in older women than older men. It's also a common complaint among the obese. Because of the reputation of exercise as being hard on the joints, the medical community has often wondered whether some types of exercise lead to an increased risk of osteoarthritis. These musings have led to the suggestion an active lifestyle harms rather than helps joint health. Yet for the most part, the opposite is true. Like it does to muscles and the heart, exercise actually strengthens joints. The stress of impact causes the joint to adapt positively, thereby improving its overall health. There is, however, a threshold if surpassed exceeds the normal wear and tear a joint can endure. Pinpointing exactly what level of exercise exceeds a safe range, however, continues to puzzle researchers. Part of the difficulty rests with the varied nature of physical activity and the degree to which it is practised or played. Both of these variables are thought to be major determinants as to whether exercise slowly erodes joint health. A 1994 study from the Helsinki Research Institute for Sports and Exercise Medicine studied former elite male athletes who had represented Finland between 1920 and 1965 in international competitions, in an attempt to see whether they had a greater incidence of osteoarthritis than the general population. Interestingly, they did. The rate of admission to hospital for osteoarthritis among those participating in team sports (soccer, hockey, basketball), endurance events (long-distance runners and cross-country skiers) and power sports (boxers, wrestlers, weight lifters) was slightly higher than among less active and less competitive individuals. The high rate of osteoarthritis of the knee in elite soccer players has been well studied and is thought to be related to previous knee injuries. A number of studies on retired athletes have indicated that prior tendon, ligament or meniscus damage is associated with an increased risk of knee and hip osteoarthritis. In fact, past anterior cruciate ligament or meniscus injuries lead to a five-fold rise in osteoarthritis. For those who play soccer below the elite level, however, and manage to avoid joint injury, there is little increased risk of joint wear or pain later in life. In elite runners, the data is not as conclusive as it is for elite soccer players. That's because most running injuries tend to be the result of damage to the soft tissue, not the joint itself. When compared with the traumatic knee-wrenching injuries among athletes in team sports, knee injuries in runners are relatively minor, rarely require surgery and heal quickly. So far, a small bank of evidence suggests that as training starts to creep closer to 90 kilometres a week, an accelerated breakdown of the weight-bearing joints can occur. That being said, numerous studies have shown little or no signs of osteoarthritis in marathon runners, despite their reputation as high-mileage athletes. For runners who train at moderate levels, somewhere around 20-40 kilometres a week, there is no reported increased risk of poor joint health. In fact, when compared to their sedentary partners, a 1995 study from Stanford University School of Medicine, indicated senior runners reported less chronic joint pain and swelling. As further testament to the benefits of pounding the pavement, the Stanford study showed runners make fewer visits to the hospital than non-runners. They also spend 33 per cent less time in the hospital, miss half as many work days, have lower blood pressure and resting heart rates. Better than sheer statistics, runners gave themselves higher perceived health ratings than sedentary individuals. Which means that runners feel better than non-runners. So while elite athletes and those whose joints have suffered previous injury might be more prone to osteoarthritis in their later years, it's clear that most recreational athletes can exercise without fear of future reprisal. That's good news for anyone who loves to exercise but worries that their habit might come back to haunt them as they age. Overall health benefits incurred from regular exercise still outnumber the slight risk of osteoarthritis associated with high-intensity, high-volume training. Add that to the decreased risk among active individuals of osteoporosis, heart disease, obesity, diabetes, depression and some forms of cancer, and it's time to put that ugly little rumour to rest. Exercise is good for your heart, lungs, bones and joints. |