What is osteoarthritis? Here are 3 things to know about treatment

Osteoarthritis is inflammation of the joints that comes from years of wear and tear. When bones come together to form joints, the ends are covered with a Teflon-like covering called articular cartilage.

Over time this covering may gradually wear down, and if the joint is injured the process can be greatly accelerated. When the covering is destroyed, bone rubs on bone, which is very painful, and the pain can be so intense it inspires you to quit moving the joint. While this seems logical, it’s not. If you don’t exercise arthritic joints, they will get worse.

Joints stiffen when they don’t move. Older folks know this quite well, and waking up each morning reminds us. When I get out of bed, the osteoarthritis in many of my joints causes my body to feel stiff and achy. But once I start moving, the stiffness and pain subsides.

How does moving joints help osteoarthritis?

Why does moving help the joints? It lubricates them. Remember the Tin Man from "The Wizard of Oz?" He couldn’t move until his joints were lubricated with oil, and so it is with us humans. Joints are wrapped in a capsule of connective tissue that secretes synovial fluid as a lubricant when the joints are moved. That’s why the initial movements may be stiff and painful, but if you keep moving, lubrication helps the joints move more easily.

Not moving your joints takes a toll over the long haul, because the surrounding muscles will atrophy (get smaller and weaker). If the muscles are strong, they provide more support for the joint, which means less stress directly on the joint. Not moving the joint also reduces flexibility. Much of what we do, especially with our hands and shoulders, requires that the joints move freely and through the full range of motion. If you lose strength and flexibility, simple everyday movements can become difficult and painful.

Should you lift weights to help with Osteoarthritis?

I realize that, logically, lifting weights would seem to be the very last thing you would want to impose on arthritic joints. But it’s good medicine because it strengthens the surrounding muscles. However, it would be best if you were careful because you can easily overstress the joints and do more harm than good.

As we age, even without osteoarthritis, the joints deteriorate, “drying out” in a manner of speaking, and they don’t lubricate as effectively as they did when we were younger. This points to two things you need to consider. One, invest considerable time warming up with easy movements that gradually extend and eventually go through the entire range of motion of the joint. And two, don’t make the mistake of thinking just because the muscles can handle the challenge of exercise that the joints can keep up. Chances are the joints will be taxed too much if you push your muscles to lift too much weight.

With this in mind, it raises an important issue. If you are going to engage in resistance training, and your goal is to get stronger, you need to fatigue the muscles by pushing them to failure. This means to the point where you cannot do one more rep. Simply going through the motions and stopping well before the muscle is fatigued won’t result in positive change.

Muscles will change only when pushed out of their comfort zone of everyday life. In response, muscles will make changes in anticipation of being pushed again in the same way. However, next time because of the changes, they will be able to handle the challenge more easily.

This is all well and good, but what if your joints are “drying out” or worse, you have arthritic joints that can’t handle a heavy enough load to push the muscles to fatigue and failure? Is there anything you can do?

Yes.

What is the 'pre-exhaustion' approach to weightlifting?

I wanted to keep training hard as I aged despite osteoarthritis in both shoulders and elsewhere originating from severe injuries that accelerated the arthritic process. This caused me to experiment with various forms of resistance exercise and exercise equipment. Ultimately, I had to admit defeat when it came to lifting heavy enough to challenge my muscles because when I lifted heavy and taxed the muscles, the resulting joint pain was agonizing.

This led me to experiment with what I call the “pre-exhaustion” method. Let’s assume I can lift X pounds for 10 repetitions (reps) to failure when I’m rested and fresh. If so, it makes sense that if I pre-exhaust the muscle with only 60% of X pounds, I can arrive at the same point of fatigue, but with much less stress on the joint.

Here is a concrete example. Let’s assume that lifting a 25-pound dumbbell in the biceps curl (bend your elbow and lift the weight from the thigh to the chin) is what you need to strengthen your muscles. However, using that much weight bothers your wrist or elbow. So, instead, first, lift 15 pounds (60%) and do as many curls as possible, perhaps 20 to 30 reps, working the biceps to failure and exhaustion. Rest only briefly with a few deep breaths then lift 20 pounds (a 20% reduction in weight). You may be able to perform only a handful of reps with 20 pounds, but that’s OK because the biceps muscle is “pre-exhausted.” In this way, 20 pounds will feel much heavier and challenge the muscle in the same way (and possibly even more) than 25 pounds would if the muscle were fresh.

The lighter weight can still impose sufficient stress on the muscles to promote the desired change while imposing less stress on the joints. Experiment with differing weight combinations to find what works best for you.

Reach Bryant Stamford, a professor of kinesiology and integrative physiology at Hanover College, at stamford@hanover.edu.

This article originally appeared on Louisville Courier Journal: What is osteoarthritis? Here are 3 things to know about treatment