Osteoarthritis; to lift or not to lift

This is not medical advice.

Weights, that is… that is the question.

There are some big debates going on as to what causes osteoarthritis. The narrative in the general public is that “wear and tear” is what causes OA. Most strength coaches and physical therapists will say no, weight lifting, sports and activity have nothing to do with OA.

I’m going to present my anecdotal experience with patient’s that I’ve treated with OA.

Impressions

I think the strength coaches and PTs have some good arguments and studies, that wear and tear does not cause OA.

• Anecdotally, I have treated many patients with severe OA in their knees, shoulders, spine, etc. who had never done exercises or hard manual labor.

• And, I’ve seen the opposite; people who worked very hard physically their whole lives, who have severe OA.

Injuries vs wear and tear

Where I do tend to see an increase in OA, is a previous history of injuries. One of the orthopedic doctors taught me how important joint alignment is. The cartilage needs to be lined up correctly to do its’ job of protecting repeated joint motion. People who have had skiing, football, running, work related, etc, injuries tended to have progressively worse OA over the years.

So people who have never done some type of resistance training, can have an increased likelihood of poor joint function and alignment. That also leads to an increased progression of OA over the years.

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The Addiction

Many of the arguments against the wear and tear arguments, come from people like me who are addicted to exercises in some manner. Are we biased towards our opinion? If I’m being honest, most of my exercise addiction is about vanity, not the other health benefits that I’m aware of.

Many of the health professionals railing against the wear and tear argument are runners addicted to running, and weightlifters addicted to heavy weightlifting. I would argue these are good addictions, but maybe some moderation for the general public is warranted.

Running on dirt or grass, and landing on the ball of our foot may also help mitigate any presumed increase in joint damage. Landing on our heels and running on concrete may not be the best type of running for joint health.

Good form and control during weightlifting is critical. If we lift too heavy with poor form, I am going to argue that those joint injuries could be correlated with increased risk of joint OA. But again, better than doing nothing.

Diet

I don’t think the science is settled on this. It makes sense that if we eat nutritious foods, that we should have less ailments of any kind. Is the junk food lobby going to sponsor research for this? Unlikely.

There are many narratives about certain foods causing increased inflammation in the body, which in turn increases symptoms of OA. That narrative is too broad, and the opinions vary too wildly, to do justice in this article.

Anecdotally, I have see some cases where people cut out foods they thought were increasing the OA symptoms, like dairy and diet soft drinks. In both cases their flair ups of OA decreased substantially. Again, unproven on a large scale, but worked for their own personal health.

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Hormonal response

Reasonable weight training offers an increased hormonal response. These hormones increase bone density. In the absence of a stimulus (gravity or resistance,) our bodies will spend little effort on maintaining bone and muscle density.

Moderation

Maybe the answer is moderation. I’m in my 5th decade, so when I lift heavy weights, I do have increased joint pain. If I am reasonable with my resistance choices, I always feel better later.