People with osteoarthritis can (and should) do physical exercise.

By Danielle Sanches, from Agência Einstein - It may seem contradictory to encourage someone with joint pain to exercise, but the activity is considered beneficial and an essential part of managing the symptoms of osteoarthritis. Also known as osteoarthrosis, this degenerative disease arises from the wear and tear of the tissue that lines the ends of bones (cartilage) and is most common in the hands, knees, hips, and lower back.

According to Ana Paula Simões, orthopedist and president of the São Paulo Society of Sports Medicine, those diagnosed with osteoarthritis should work on their muscles to gain more strength and cushion the movement of the joint. This protects the "hinge" and prevents it from wearing down further. 

"Sport is the best remedy for any health problem, and that includes osteoarthritis," explains the specialist, who is also an instructor and assistant physician in the Sports Traumatology group at Santa Casa de São Paulo. 

The problem is that, often, the pain caused by inflammation — in the acute phase of the disease — causes the patient to avoid physical activity for fear of further injuring the joint. "But this is bad because the muscles will weaken, there may be weight gain, and even a worsening of mood, aggravating the problem," assesses the orthopedist. 

Symptoms and culprits

The condition can affect any joint in the body and manifest similar symptoms. In the knees, for example, it usually causes cracking sounds when moving, pain, swelling, limited movement, and a sensation of "stabbing" or "burning." Additionally, the person may feel pain when initiating a movement, which subsides shortly afterward. 

The causes of the problem are varied: excess weight, genetic conditions, and even physical trauma can cause cartilage wear. Diagnosis is made clinically by a specialist who assesses the possibility of inflammation in the joint. Imaging tests such as magnetic resonance imaging (MRI) and X-rays may be requested to confirm the diagnosis. 

How to practice safely

According to the orthopedist, the most suitable exercises are those that do not overload the knees or the area affected by the condition. This list includes weight training, CrossFit, Pilates, and the use of resistance bands to promote muscle strength and endurance. "For an elderly person, this might seem daunting, but nobody starts by lifting 10 kilos. The idea is to start slowly, from scratch, and gradually increase the weight," she says. 

To ensure that all of this is done safely and to minimize risks, it is recommended that people with osteoarthritis begin strengthening exercises under the supervision of a physiotherapist. This step is important to ensure that the individual has recovered from the inflammatory flare-up and does not feel pain when starting the training movements. 

To relieve pain, cold compresses, anti-inflammatory ointments and sprays, ultrasound, acupuncture, and bandages may be indicated, in addition to the use of oral anti-inflammatories (only when prescribed by a doctor). 

Once the patient gains body awareness, training can continue with a physical education professional. "But annual follow-up is important to assess the progress of the condition and, in some cases, also use oral medication to help control the disease," says the orthopedist. 

During the pandemic, this monitoring can also be done online with good results. This is what a... study from the University of Melbourne, Australia, and published in the journal Annals of Internal MedicineIn the randomized trial, researchers found that virtual monitoring improved pain perception and functionality in people with knee arthritis, overweight, and obesity.

What if the pain doesn't go away? 

When osteoarthritis causes a lot of pain, it becomes very difficult to practice any physical activity. Therefore, the recommendation is that the patient should get out of the inflammatory flare-up before starting to move around. 

When the pain is severe and doesn't subside even after using medication and starting muscle strengthening exercises, surgery becomes an option to "clean" the joint or even replace it with a synthetic version. Only a specialist doctor can evaluate and recommend the procedure.

According to Simões, the important thing is to try to find ways to stay active. "The benefit is also mental, as the patient is able to socialize and also experiences cardiorespiratory improvements, enhancing overall health."

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