Osteoarthritis (OA) is considered the outcome of cumulative wear and tear on our joints. Generally speaking, it is a non-inflammatory degeneration of cartilage with symptoms such as pain and stiffness in joints, most commonly hands, feet, spine and large weight bearing joints. It is associated with aging and injury; however many people live long lives unaffected by OA.
Some degree of aging and degeneration is to be expected. Balance this with the perspective that there are no absolutes; we don’t know everything. However, the better we understand things and work together with nature, the more we can defy self limiting expectations of our healing potential.
This article is aimed at those who are looking to prevent osteoarthritis or further progression early on. There are many contributing factors, but in-depth analyses of disease progression, risk factors and complex treatment options will not be covered here. Some basic synovial joint physiology will be highlighted, in order to convey one simple message: move and stretch often.
The synovial joint basically consists of bone junctions, buffered by cartilage, and surrounded by a synovial membrane that produces fluid to lubricate, nourish and cushion the joint. The specifics vary according to each joint; and surrounding connective tissue such as tendons, ligaments and muscles, contribute to the joints dynamics. Joints are notoriously slow metabolizers, mostly due to the fact that they have minimal blood supply and rely a lot on mechanical forces and diffusion for their nutrient/waste exchange. Cartilage in fact has no blood supply throughout it’s structure. The biological makeup of cartilage allows it to function much like an elastic sponge- designed to hold water, reduce friction, be pliable and absorb shock.
Degeneration is a process whereby damage exceeds the ability to repair. Keeping in mind that blood supply is critical to repair: bringing in repair resources and eliminating damaging waste products. Think of your joints like a fish tank, the more wastes accumulate the poorer the fish do, and the less oxygen and nutrient available to the fish, the less they thrive. So now it’s important to understand just how joints exchange wastes and nutrients to thrive, and optimize their repair. Mechanical compression is the simple answer. The synovial fluid is the conduit for bringing nutrients from the blood to the cartilage and carrying wastes back out to the blood vessels within the synovial membrane. Diffusion is where nutrients slowly go from high concentration to low concentration through fluid, and this is aided by compression and release or movement of the joint acting to pump and mix the fluids. The cartilage, imagining a sponge, needs compression and release in order to draw the nutrient rich fluid in, and flush the toxic fluid out. The only way the full surface of that spongy cartilage can be compressed is if the joint is free to move in it’s full range of motion.
Regular movement as we know helps keep things pumping. The more regular you are with activity, the more your body adapts blood supply, tissues and repair mechanisms to combat damage; while it also maintains regular pumping and nutrient/waste exchange. Equally important is the power of stretching to keep the joint moving in it’s full range of motion. Allowing all surfaces of the cartilage to be compressed and nourished, and minimizing chronic tension across the joint. Talk to your health care provider to get guidance on common restriction patterns or stretching protocols best for you. Keep in mind that for those with osteoarthritis, some contraindications apply for exercise and stretching, particularly in the spine or where osteophytes (bony projections) have developed.