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If you’re active, chances are you’re going to experience joint pain at some point.
It’s important to warm up before exercising, so you can protect your joints.
An orthopedic surgeon can help treat your pain through medication, physical therapy or, if those fail, surgery.
One of the joys of living in the western part of the United States is the area’s strong culture of outdoor recreation. If you like to hike, run, cycle or ski, there are thousands of other like-minded people who are right there with you.
Leading an active life can go a long way toward protecting you from experiencing joint problems. Unfortunately, it can also put you more at risk for certain types of issues, such as a painful ligament tear resulting from participation in sports or exercise.
Initial joint problems can result from overuse, a sudden injury from impact sports, a fall, or routine wear and tear from an active lifestyle. But aging, genetics, trauma or a combination of all three can lead to more serious joint damage, says David Ibrahim, M.D., an orthopedic surgeon at Providence Swedish Orthopedics in Seattle.
“In general, living in Seattle, we see a lot of people engaged in hiking, running and cycling,” Dr. Ibrahim says. “The majority of patients are active until pain starts impeding activities.”
According to the 2021 American Joint Replacement Registry Annual Report, women were more likely to need hip and knee replacement surgeries than men. Hip patients were an average of 66 years old, while knee patients were on average 67 years old.
“We can’t prevent degeneration from happening, but we can prolong the time until joint replacement is necessary,” Dr. Ibrahim says.
Protecting your joints
Your joint is the part of your body where two or more bones meet to allow movement. Flexible tissue (cartilage) covers the bones’ ends at a joint, while bendy bands (tendons) connect muscles to bones. Ligaments connect the bones’ joints, acting as stabilizers.
Whenever you run, forces transmit upward and downward to the hip, knee and ankle, compressing joints from two directions. As a result, marathon runners and people who routinely engage in high-impact activities may have a higher likelihood of earlier degeneration than someone with a more casual running routine, Dr. Ibrahim says.
One way to combat this problem is to invest in shoes that absorb shock from the ankle up. Or, if you have chronic joint pain, you could instead pursue low-impact activities, such as swimming, cycling or using elliptical machines.
Regardless of what type of exercise you do, you need to warm up beforehand. Otherwise, Dr. Ibrahim says, it’s like “starting a car and revving it when it’s still cold. Your body needs a warm-up to get going.”
Once you’ve completed the activity, be sure to cool down to let your joints, muscles and ligaments settle down after vigorous exercise.
While braces can provide mechanical stability to your joint, and a sleeve can help control swelling, you shouldn’t rely on them too much, Dr. Ibrahim says. These devices often simply “give feedback to your brain — your brain thinks the joint is tidy, but the brace doesn’t actually stabilize the joint,” he said.
So, while a brace around your knee or ankle might make you feel better, that brace often indicates that it’s time for an orthopedic surgeon to take a look at it.
Typically, an orthopedic surgeon will start by examining X-rays of your joint. They may also use advanced imaging such as computed tomography (CT) or magnetic resonance imaging (MRI) to provide more detail if necessary.
If you have a family history of early-onset arthritis and or genetic conditions, you could consider making an appointment with an orthopedic surgeon before you’re in great pain. “It’s never too early to get in for an evaluation with a joint surgeon,” Dr. Ibrahim says. “By catching arthritis early, we often have more conservative options to offer patients to get them back on the road.”
But just because you’re meeting with an orthopedic surgeon, that doesn’t mean you need surgery. You could find relief through over-the-counter medication, physical therapy or traditional cortisone treatments, which provide first-line anti-inflammatory relief within the joint.
Other joint treatments are newer but more controversial, including hyaluronic acid, platelet-rich plasma and stem cell therapy. Dr. Ibrahim says patients often ask about these treatments, but research hasn’t yet proven whether they truly do help.
When more conservative treatments fail, however, joint replacement surgery and minimally invasive arthroscopic surgery are both tried-and-true methods for pain relief.
Dr. Ibrahim specializes in minimally invasive surgical approaches and robotics in hip and total knee replacements. “Robotics and computer-assisted surgery can help us do hip and knee replacement and partial knee replacements with improved accuracy and precision,” he says. “This imaging-based surgery helps us customize the surgery and implant positioning through more meticulous, patient-specific planning and surgical cuts.”
Compared to traditional surgery, robotic-assisted surgery can be easier to undergo. “Data suggests there’s less pain medication required due to less bone and soft-tissue trauma,” Dr. Ibrahim says. “You’re not doing surgery in a cookie-cutter fashion.”
The key takeaway is that you should keep up the excellent work of regular exercise, Dr. Ibrahim says. Even a daily walk boosts your joint health and prevents cartilage atrophy and some other common joint issues.
David Ibrahim, M.D., is an orthopedic surgeon at Providence Swedish Orthopedics in Seattle.
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