Sports injuries and osteoarthritis:  Is there a link?

Exercise is a wonderful thing, head to toe. It gives you increased muscle strength and endurance, enhanced range of motion of your joints, as well as improved balance and bone strength.  It can even improve your sleep, self-confidence and ability to manage stress and depression. However, sports injuries can also lead to an increased risk of osteoarthritis (OA), so it’s crucial to both be aware of what sports carry higher levels of injury, and of ways to prevent injury so you can keep on doing the activities you love. Here’s what you need to know about arthritis and sports injuries.

How can a sports injury lead to OA?

Sports injuries often affect the joints, especially the knee, the hip and the ankle. Research suggests that fast, vigorous activities that involve lots of twisting, turning or jumping can damage the joint and especially the articular cartilage, which is the smooth white connective tissue that covers the ends of bones. When this cartilage is healthy, it absorbs shock and allows joints to move over each other with little friction. When the cartilage is damaged, either from sports injuries or other mechanisms that traumatize or compromise a joint, there is a strong likelihood that OA will develop.

Take care of your knees

One of the more common sports injuries is an ACL injury (ACL refers to the anterior cruciate ligament, one of the major ligaments in your knee). Biomechanical force resulting from quick turns and jumps can tear the ACL. “Those who injure their ACL, whether or not they have surgery to repair it, have a higher incidence of OA later in life,” says Dr. Julia Alleyne, a sport and exercise medicine physician in Toronto, and former Chief Medical Officer for Team Canada at the 2012 Summer Olympics and 2015 Pan Am/Parapan Am Games.

Soccer, wrestling, long-distance running and weight lifting are all sports that may increase your risk of developing knee OA. Female athletes have a higher incidence of ACL injuries, in part because of the physical makeup of women’s knees. One study of female soccer players who had sustained ACL injuries 12 years earlier found that more than half (51%) of the athletes had OA detectable by x-ray. And of course, elite athletes tend to be at higher risk than recreational athletes.

It’s crucial to train properly to help prevent an injury in the first place, and if you tear your ACL, it’s important to be aware of the long-term impact and possibility of OA so you can follow the right treatment plan.

What can you do to prevent sports injuries?

Get balanced

"Neuromuscular exercise, which is essentially balance, coordination and mindful movement combined with dynamic movement, is a key component in the prevention of OA," says Dr. Alleyne, adding that yoga and tai chi are examples of neuromuscular exercise. “It’s more than stretching and strengthening; it is stretch, strength, endurance and balance.” Because soccer tends to have a higher incidence of injuries, for instance, many young players follow a neuromuscular warm-up program called FIFA 11+. Dr. Alleyne also points to a program called GLA:D®,  or Good Life with osteoArthritis in Denmark®, which she states “has been shown to reduce OA progression, to reduce pain and to increase function for people with knee and hip pain.” You can also build endurance and stability through resistance training, using body weight, weights or bands.

For high-impact sports

“In sports that are high impact, such as running three or four times a week, you want to make sure you have a preventative program of strengthening, flexibility, balance and endurance training,” Dr. Alleyne says. “Go swimming or cycling a couple times a week to maintain your training and conditioning but with less impact on the joints.”

For endurance sports

“You’re going to have a higher risk of OA with overuse,” says Dr. Alleyne. “Overuse is too much, too soon, too hard, too fast.” So, increase your activity gradually, by 10% in terms of time or weight, every one to two sessions, assuming there are no overuse symptoms like pain. “You want to build up distances and endurance in a way that the body accommodates versus stressing the joints.”

Do smart stretches

Before your activity, do a dynamic stretch that takes your body through a range of motion, such as a warm-up like walking, then walking with a longer stride, then a walk-jog. Save the more intense stretches for after your workout. “We actually know that those deep, long hold stretches inhibit muscles [and can lead to] increased injuries. At the end of a workout where your muscles are quite warmed up, that’s where a deeper stretch can be useful for reducing tension,” says Dr. Alleyne.

Rest and recover

“Recovery is just as important as training. Even with my Olympic athletes, no one does sport seven days a week,” says Dr. Alleyne. That means you should have a day off between workouts, as well as lighter days and short periods to recover within your workout routine. “That seems to be a key component for people who are new to exercise or starting at an older age. They’ll get a lot further with treating recovery as part of their routine.”

Visit the Arthritis Society’s online module for more information on Staying Active.

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