Reduce your risk of arthritis

Younger people are getting knee-replacement surgery. The greatest increase in knee replacements is in people between the ages of 45 and 64 according to data from the Canadian Institute for Health Information. In many cases, degenerative arthritis is the root problem.

Osteoarthritis (OA) is the most common form of arthritis. It damages the cartilage that helps our joints move smoothly and cushions our bones. When someone has OA, the pain and stiffness and swelling in their joints can their limit day-to-day function and make it hard to walk and climb stairs. It can also lead to disability and lower quality of life.

Wait times for knee replacements are falling, but we need to think about how to help people manage their OA to delay — or eliminate — their need for surgery. This will help our health-care system and, more importantly, bring relief to people with this debilitating condition.

Chronic pain is bad enough, but it isn’t the only consequence of OA. People with the condition are more likely to have heart disease and type-2 diabetes. Studies also show higher death rates among people with that combination of illnesses.

Though many people think of OA as an old person’s problem, it doesn’t happen only as we age. Genetics can play a role, particularly in cases involving multiple joints. Placing added strain on your joints also raises your risk. Workers in high-demand physical occupations, such as flooring installers, are more prone to OA because of the added loads on their knees.

Some people set the stage for OA in their teens or 20s, when they injure a part of their knee called the anterior cruciate ligament (ACL) playing sports like soccer or basketball. Many athletes who tear their ACL develop knee OA within 10 to 15 years. But there are things you can do to reduce your risk of developing the condition.

Maintain a healthy body weight to reduce the strain on your knees. Losing10 pounds can help off-load stress on your joints. There is also an inflammatory component to OA linked to obesity. Fat can release chemicals, prompting an inflammatory process that contributes to cartilage deterioration.

Keep moving. You don’t need to become a body builder, but it is important to walk and gradually build muscle strength so you can remain active. Even though many people believe that more exercise means more symptoms, there is evidence that activity reduces pain and improves function in people with OA. If you feel pain, don’t ignore it.

Orthotic footwear or inserts for your shoes can also be helpful. If your foot position is off, there can be a ripple effect that affects your knees and other parts of your body. In many cases, orthotics are used with other exercises and treatments.

Doing exercises to build strength and using proper technique in everyday activities is critical. Something as simple as keeping your knee aligned over your foot while climbing stairs limits the stress on the knee joint and in turn limits symptoms.

I’d love to see physical literacy — an awareness and confidence in movement — become part of our daily lives, just like brushing our teeth. If we can take good care of our joints and bodies, we can live healthier, more pain-free lives. Dr. Aileen Davis is a professor in the departments of physical therapy and surgery at the University of Toronto’s Faculty of Medicine. She also has school of graduate studies appointments in the Rehabilitation Science Institute, the Institute of Medical Science and Dalla Lana School of Public Health’s Institutes of Health Policy, Management and Evaluation. Dr. Davis is also a senior scientist in the division of health care and outcomes at the Toronto Western Research Institute. Doctors’ Notes is a weekly column by members of the U of T’s Faculty of Medicine. doctorsnotes@thestar.ca