Pray it Off Meeting April 22, 2010 Osteoarthritis, Weight and Exericise WITH VIDEO

Osteoarthritis Weight Management
by Susan Bartlett, Ph.D.
http://www.hopkins-arthritis.org/patient-corner/disease-management/osteoandweight.html (Edited)

Joint Pain is Strongly Associated with Body Weight. Being only 10 pounds overweight increases the force on the knee by 30-60 pounds with each step.
Osteoarthritis is the most common joint disorder with symptoms in the hands, knees, hips, back, and neck. It is unclear exactly how excess weight influences OA. Clearly, being overweight increases the load placed on the joints such as the knee, which increases stress and could possibly hasten the breakdown of cartilage. For example, it is estimated that a force of nearly three to six times one's body weight is exerted across the knee while walking; an increase in body weight increases the force by this amount. However, overweight has also been associated with higher rates of hand OA in some studies suggesting the involvement of a circulating systemic factor as well.

Obesity Is a Risk Factor for Osteoarthritis. Overweight women have nearly 4 times the risk of knee OA; for overweight men the risk is 5 times greater.
Being overweight is a clear risk factor for developing OA. Population-based studies have consistently shown a link between overweight or obesity and knee OA. In a study from Framingham MA, overweight individuals in their thirties who did not have knee OA were at greater risk of later developing the disease. Other investigations, which performed repeated x-rays over time also, have found that being overweight significantly increases the risk of developing knee OA. It is estimated that persons in the highest quintile of body weight have up to 10 times the risk of knee OA than those in the lowest quintile.

The Benefits of Weight Loss. Even small amounts of weight loss reduce the risk of developing knee OA. Preliminary studies suggest weight loss decreases pain substantially in those with knee OA. If obesity increases the development and progression of knee OA, can weight loss reverse these effects? In the Framingham study, Felson and colleagues noted that among women with a baseline body mass index (BMI) greater than or equal to 25, weight loss was associated with a significantly lower risk of knee OA. For a woman of normal height, for every 11 lb weight loss (approximately 2 BMI units), the risk of knee OA dropped > 50%. Conversely, a comparable weight gain was associated with an increased risk of later developing knee OA (odds ratio 1.28 for a 2 BMI weight gain). The investigators concluded that in elderly persons, if obese men (i.e., BMI greater than 30) lost enough weight to fall into the overweight category (BMI 26-29.9) and men in the overweight category lost enough weight to move into the normal weight category (BMI less than 26), knee OA would decrease by 21.5%. Similar changes in weight category by women would result in a 33% decrease in knee OA. A handful of studies have indicated that weight loss substantially reduced reports of pain as well. Thus, weight loss potentially offers an important modifiable factor in the behavioral treatment of knee OA.

1. Body Mass Index (BMI)
The use of BMI as an indicator of overweight is based on extensive research linking BMI with associated health risks.
According to the new guidelines, overweight is a BMI of 25-29.9 while obesity is a BMI of 30 or greater. (A BMI of 30 is about 30 lbs overweight). It is recommended that BMI be calculated in all adults to assess overweight and those who are normal weight should be reassessed every 2 years.

2. Waist Circumference
Waist circumference is another measure which provides important information about the associated health risks. Waist circumferences is closely linked with abdominal fat (i.e., having an "apple" shape), which is an independent predictor of disease risk. A waist circumference of greater than 40 inches (102 cm) in men and greater than 35 (88 cm) in women signifies increased risk in those who have a BMI of 25 to 34.9.

3. Risk For Obesity-Related Diseases
Additional markers of health risk also need to be taken into consideration. Be certain to evaluate risk factors such as elevations in blood pressure or blood cholesterol, or family history of obesity-related disease. At a given level of overweight or obesity, people with additional risk factors are considered to be at higher risk for health problems, and would benefit from weight loss as well as modification of risk factors.

• Participate in moderate physical activity, progressing to 30 minutes or more on most or preferably all days of the week.

• Cut back on both dietary fat and total calories. While reducing dietary fat can help reduce calories and is heart-healthy, this method alone - without reducing calories - will not produce weight loss.

• Make weight-maintenance a priority after the first 6 months of weight-loss therapy.
The clinical guidelines suggest that all patients try lifestyle-based approaches for at least 6 months.

What If A Person Is Not Willing to Lose Weight?

Because lifestyle changes are ultimately required for successful weight maintenance, your readiness to make these changes and willingness to commit to them over the long-term are crucial. Studies have shown that health promotion messages are most effective when specifically targeted to the person’s level of readiness. For people who are not ready to lose weight at this time, the goal should focus on strategies to avoid further weight gain through healthy eating and more physical activity. Because level of readiness changes over time, it is important to reassess motivation periodically.

How Exercise Helps Osteoarthritis

Find out how to get started with an osteoarthritis exercise program that's right for you and can help relieve your osteoarthritis symptoms.
By Chris Iliades, MD Medically reviewed by Niya Jones, MD, MPH
http://www.everydayhealth.com/osteoarthritis/exercise-to-help-osteoarthritis-symptoms.aspx

While researchers still don’t know the exact cause of osteoarthritis, we do know that being over the age of 60, carrying excess weight, and being out of shape all significantly increase your risk. If you already have osteoarthritis, or you want to decrease your risk of getting it, a regular exercise program can help.

Osteoarthritis: The Benefits of Exercise

There are many benefits to starting an exercise program — whether you have osteoarthritis or not — but for people with arthritis pain, there's added incentive to get moving. Regular exercise can help to:

• Reduce joint pain.

Osteoarthritis destroys cartilage, special tissue that cushions our joints. “Exercise increases the lubrication to the cartilage of the joint, thus reducing osteoarthritis symptoms of pain and stiffness,” says Anne Menz, PhD, a physical therapist at Massachusetts General Hospital, in Boston, Mass. It may seem counterintuitive, but not exercising actually leads to stiffer joints and worse osteoarthritis.

• Strengthen muscles.

As we get older the muscles and tendons that support our joints tend to get weaker. “Exercise strengthens the muscles around the joints to protect the joints and provide [extra] support,” says Menz.
• Decrease pressure on joints.

Studies show that being even 10 pounds overweight greatly increases the stress across your knee joints with every step you take. “Exercise can aid in weight loss to decrease pressure on joints,” Menz says.

• Improve overall health.

Osteoarthritis symptoms can keep you from being active, which not only aggravates your osteoarthritis, but is also bad for your heart. “Exercise decreases all the health risks associated with a sedentary lifestyle,” like high blood pressure, diabetes, certain cancers, heart disease, and stroke, notes Menz.

Osteoarthritis: Starting an Exercise Routine

“First, check with your doctor to get the green light,” advises Menz. She suggests starting slowly and finding enjoyable ways to incorporate exercise into your daily routine. “Start a walking program in your neighborhood, take ballroom dancing lessons with your spouse, or join an exercise class,” she advises. The more you enjoy the activity you choose, the more likely you are to stick with it.
Menz also recommends keeping an exercise journal; “A log will help keep you accountable and also provide motivation as you see you can do more each week.” For people who have not exercised in a long time or whose osteoarthritis symptoms make it too painful to jog or walk long distances, low impact exercise in a swimming pool can be very effective. “A water aerobics exercise class causes less stress on the joints, and most people can tolerate this type of exercise. Later on you can progress to land-based exercise,” says Menz.

Osteoarthritis: The Best Types of Exercise

People with osteoarthritis should consider adding the following types of exercise to their workout routine:

• Range of motion exercise.

Stretching exercises are effective in preventing the osteoarthritis symptom of joint stiffness. You can get this type of conditioning exercise in a yoga or Pilates class.

• Aerobic exercise.

Jogging, brisk walking, and swimming are all examples of exercises that get your heart rate up and increase blood flow to your muscles. They are very effective in helping to control the symptoms of osteoarthritis.

• Resistance training.

Weightlifting and resistance-band training are strengthening exercises that help build up the muscles and tendons that support your joints.
“Your goal with osteoarthritis exercise training is to eventually work your way up to 30 minutes of aerobic exercise five days a week. This could be a stationary bike, walking, swimming, or dancing. You should also do strength training two to three days a week in an exercise class, or weights at the gym,” advises Menz.
If you are having trouble getting started, ask your doctor for a referral to a physical therapist. “A physical therapist can put together a program for you that includes pain relief strategies, range of motion exercises, stretching, and strength training,” says Menz.

Research shows that a good exercise program can slow down the progression of osteoarthritis and relieve osteoarthritis symptoms like pain and stiffness. Unfortunately, research also shows more than half the people who start an exercise program for osteoarthritis drop out within one year.

Ask your doctor or a physical therapist for tips on getting started and sticking with the program you choose. Then get out there and do your best to commit! “The most important thing is to be consistent. It may take six to eight weeks to see results. Listen to your body and balance activity with a good amount of rest,” says Menz. Remember that a good exercise program is one of the best ways to manage your osteoarthritis symptoms.