Joint Health

Healthy joints allow us to walk, squat, bend, grip, and lift across the lifespan. In this article, we will share relevant strategies for older adults to keep their joints healthy as they age. Fortunately, many of these strategies (i.e. exercise, diet, and sleep) have wide-reaching benefits across the entire body.

Joints are connections between bones in the body, which combine to form larger functional units of our skeletal system. Joints must withstand compressive loads from gravity and contracting muscles, while maintaining some balance of stability and mobility.

Keeping joints healthy long-term is a central goal of our community. With arthritis affecting 1 in 4 adults and with the number of hip and knee replacements expected to triple in the next 20 years, it is essential to learn practice strategies that promote joint longevity and reduce risk of joint-related disease.

Below are some key insights from recent research that will help get you started on a path towards healthier joints, healthier movement, and a healthier life.

1. Joints & Cartilage Respond Well to Load

Cartilage is the smooth layer of tissue cushioning the ends of bones that combine to form joints. While the breakdown of cartilage over time is an underlying feature of osteoarthritis, cartilage is living, adaptable tissue that can maintain its strength and function under the right conditions.

We can imagine our cartilage as spongy tissue that responds to (and benefits from) loads placed upon it. With cyclic weightbearing activities such as walking or running, our joints expel waste products and take in new nutrients.

Movement is how we deliver nutrients to our joints and cartilage.

Higher impact activities such as resistance or plyometric training can also be used to intentionally deliver additional load to the joints and muscles, which serve as a signal to the body to strengthen its internal environment to prepare for the demands of future loads.

2. Combining Tai Chi & Resistance Training

Using a combined approach of multiple exercise modalities can help promote joint stability (through muscle strength, balance, and coordination) and joint mobility (through exploration of full ranges of motion and tissue extensibility).

This article examined the effects of a combined Tai Chi and resistance training program on strength, mobility, and balance of their diverse subjects aged 50 or older. They found that these programs, which lasted between 3-12 months, led to significant improvement in upper and lower extremity muscle strength, aerobic endurance, balance, and mobility. Joint performance and function was not specifically targeted for observation, but we can appreciate the positive effects of joint stability and mobility with a varied, multi-modal exercise approach.

3. Obesity & Osteoarthritis

While it has been thought that obesity accelerates osteoarthritis (OA) because it adds extra weight onto our joints, it turns out inflammation may be a key contributing factor to OA symptoms.

Excess fat tissue can lead to increased production of inflammatory biomarkers in the body, which can ultimately contribute to higher levels of systemic inflammation in the body. Our joints are sensitive environments that respond to these chemical changes, and osteoarthritis symptoms can develop over time as a result.

A key target for treatment and prevention of osteoarthritis is diet. By reducing highly processed, high fat, and high sugar foods in our diet, we can both manage our weight as well as the resultant systemic inflammatory effects across the body. We can also replenish healthy gut bacteria by eating prebiotic foods such as oats, barley, asparagus, garlic, onions, bananas, berries, and beans.

Making these dietary changes can support long-term joint health and reduce risk of osteoarthritis by lowering levels of systemic inflammation in the body.

4. Normal Age-Related Changes

All bodily tissues undergo change over time – whether in our skin, our hair, or our joints. Importantly, these changes are not always associated with pain.

Advancements in diagnostic imaging (X-rays, MRIs, CT scans, etc.) have enabled medical providers the opportunity to take a detailed glimpse inside our bodies.

And while this technology is essential to swiftly and accurately diagnose life-threatening conditions, imaging can be harmful when not used with appropriate language and context when discussing findings.

This article examined imaging findings for 3110 asymptomatic individuals to determine the prevalence of different forms of spinal degeneration in different age groups.

Decade of life: % w/ "disk degeneration" finding

• 20-29 y.o.: 37%

• 30-39 y.o.: 52%

• 40-49 y.o.: 68%

• 50-59 y.o.: 80%

• 60-69 y.o.: 88%

• 70-79 y.o.: 93%

• 80-89 y.o.: 96%

These results are staggering considering these are asymptomatic individuals. In this case, these "degenerative" findings are not associated with pain. However, by labeling these normal tissue changes problematic or pathologic, healthcare providers can instill fear and maladaptive beliefs in their patients.

Since pain functions to communicate actual or perceived threat (like an alarm system), it makes sense why symptoms may increase as a result.

Like “wrinkles on the inside” (a phrase coined by Dr. Tim Flynn), age-related changes are normal, developing naturally over the course of a long life. Let's not be fearful of imaging findings that often use fear-inducing language to confirm what we already know – body tissues undergo change over time.