The key to managing Osteoarthritis (OA) and to maintaining high quality of life is to keep moving. But how to do that when your joints are painful?
It is well known that exercise is essential for health and physical fitness including strength building. However, many people don’t know that exercise also improves joint cartilage quality and health, and reduces inflammation. Nordic walking is the perfect exercise activity to help manage OA because it allows you to keep moving while protecting your joints.
Sir Isaac Newton established that ‘for every action there is an equal and opposite reaction’. When we push down and back into the ground through our poles, our body weight is lifted up and forward. Effective use of the poles thereby reduces impact on our lower body joints.
Good technique is key; performed properly Nordic walking will:
- Reduce impact on the lower spine, hips, knees and ankles;
- Improve gait pattern and joint alignment;
- Reduce effort required of the Achilles tendon;
- Improve stability/balance;
- Assist with weight control;
- Promote a sense of ‘ability’ over ‘disability’,
- Improve cardio-vascular fitness; and
- Raise confidence so you can walk further, faster and more often thereby improving overall health and wellness.
What is Osteoarthritis (OA)?
OA is a common joint condition most often affecting the knee, hip and hands. As many Canadians know (OA affects ~ 10% of our population), OA is painful; and can really slow down otherwise healthy active people in or approaching their senior years. Efforts to avoid pain often result in avoiding walking. And sadly, reduced physical activity levels leads to many other, often preventable, health problems.
OA involves degradation and inflammation of all structures within affected joints including: cartilage, bone, joint capsule and supporting musculature. Confusingly, there is no link between pain and structural damage. This means the symptoms you may experience, including pain, morning stiffness, swelling, cracking noises and/or sensations of instability and weakness, are not accurately reflected on x-ray or MRI. Do not allow an x-ray or MRI reading of your joints to limit your lifestyle; there are simple positive changes you can make.
Keep the joints lubricated and healthy!
As we walk our lower body joints are rhythmically loaded and unloaded. The load/unload cycle pumps nourishing synovial fluid in and out of the cartilage stimulating healthy regeneration. Think of it as a squirt of lubricating oil with each step!
The challenge is finding the right balance between activity and rest such that the joint is regularly nourished through the load/unload cycle but is not overloaded. Nordic walking helps successfully meet this challenge as the poles reduce impact on the major weight bearing joints. You benefit from the load/unload cycle while reducing joint impact!
Weight Control important to OA management
Weight loss is a critical OA management strategy for many. A high body weight increases the load on your joints. Obesity has also been found to alter the body’s natural inflammatory response leading to degenerative joint changes. Research shows that, where indicated, weight loss of 5% over 20 weeks can positively impact OA symptoms.
Regular Nordic Walking assists with gradual healthy weight loss. Working the large muscles of the upper body (pushing through the poles is purposeful!) while walking requires a higher cardiovascular effort and burns more calories. All this benefit is achieved without a significant increased effort perception in comparison to walking without poles.
Poles also enhance stability, comfort and confidence allowing you to walk longer durations with increased frequency. As your muscle strength and cardiovascular endurance improve, so do mental and physical health, and often, weight loss.
A Guideline for Staying Strong
Strong muscles play an important role providing shock absorption and joint protection when walking. Reducing your activity level to ‘spare or protect’ your joints, will actually make things worse because the muscles will weaken and lose their protective ability
Many people worry that being active will harm their joints. The opposite is true: appropriate levels, and types, of physical activity help manage your condition over time. How do you know what is an appropriate level, and type, of physical activity?
Use this important evidence-based guideline:
Research shows that joint pain while exercising with OA is ok as long as it stays at an acceptable level; it should be less than 5/10 (if 10/10 is the worst pain you can imagine and 0/10 is no pain at all). The pain level should return to ‘normal’ or pre-existing pain level within 24 hours of activity.
OA symptoms often fluctuate, that is, the pain, swelling or stiffness intensity vary daily. Use the guideline above and adjust the length and intensity of your Nordic walking program depending on how you feel each day.
OA Treatment and Management
Everyone living with OA should be treated with education, exercise and, for many, assistance with weight control. Nordic walking can help!
Second line treatment may include heat for stiffness, ice for swelling, or health professional prescribed medication, taping or a brace, supportive footwear and/or a walking aid. Traditionally, walking aid options were limited to a cane, or single walking stick. We now know that walking with 2 poles designed to evenly offload the lower body joints, and with rubber tips for a safe grip, vastly improves biomechanics and alignment over a single cane or walking stick. It evens out and normalizes the gait pattern, provides more support and stability, and promotes a sense of ‘ability’ over ‘disability’. The entire body including the spine and shoulders benefit because you are not leaning to one side as commonly seen when using a single cane, and you are swinging your arms through a natural gait pattern.
In severe cases, the 3rd and final line of OA treatment may include surgery. Both before and after surgery, Nordic walking is an excellent way to rehabilitate muscle strength, joint movement & cardiovascular fitness to help with overall recovery.
This article provides the theory, but some things are best experienced in order to fully understand.
Book a lesson to learn more about how Nordic walking can help you prevent or manage the symptoms of OA.
