Saturday, August 19, 2017

Can Sports Injuries Lead to Osteoarthritis In Your Joints?


Picture by Liji Jinaraj from Flickr
The first question I get always get asked when an injured athlete sees me in our clinic is "How quickly can I get back to training?"

Actually it's not just the athletes, every single weekend warrior or physically active patient that I see will ask when they can get back to their usual activity or exercise.

I'm guilty of doing the same. That's exactly what I asked my doctor after my bicycle accident.

There is now evidence to show that if you rush to get back to playing, whether as part of a team or elite sport or simply just your usual weekly recreational tennis game or jogging you may not allow the injured joint to heal fully.

Adequate recovery includes strengthening the structures the support the injured joint. This will allow joint stability to reduce risk of re-injury and stave off irreparable joint damage. If you're not careful, irreparable joint damage can eventually lead to post traumatic osteoarthritis (OA).

OA is a degenerative joint disease. It happens when the protective articular cartilage lining the surfaces of bones wear out. This causes pain, stiffness, swelling and often disability that diminishes one's quality of life.

Post traumatic OA don't just happen to older patients. It can affect adolescents or young adults too.

Researchers suggest that acute joint damage can lead to a deterioration of the surface of the bone itself and structures that cushion and stabilize bones of a joint like the knee (Anderson et al, 2012).

That same study found that OA can develop in more than 40 percent of people who seriously injure their ligaments, the meniscus in the knee or articular surface of a joint.

They also found that people with a history of knee trauma are three to six times more likely to develop knee OA.

In order to better manage post traumatic OA, a group of Athletic Trainers (ATC) has suggested a more aggressive approach to both preventing and managing post traumatic OA. Especially in younger patients who get injured playing sports.

They suggested that having less deficits (between both legs) in muscle strength, endurance, balance movement quality and stability will reduce a person's risk of getting injured. After the initial injury, it should be properly managed to prevent additional injuries to the same joint or other joints to minimize OA developing. Ideally a structured rehab program should be maintained for six to nine months.

So don't be too impatient to return to your usual physical activity especially after a joint injury. You may have to modify the activities you do in order not to place unnecessary repetitive stress on the injured joint. Remember our articular cartilage likes and needs weight bearing forces for nutrition. Inactivity will cause the articular cartilage to deteriorate.


References

Anderson DD, Chubinskaya S, Guilak F et al (2012). Post-traumatic Osteoarthritis: Improved Understanding And Opportunities For Early Intervention. J Ortho Res. 29(6): 802-809. DOI: 10.1002/jor.21359

Palmeri-Smith RM, Cameron KL, DiStefano LJ et al (2017). The Role Of Athletic Trainers In Preventing And Managing Post Traumatic Osteoarthritis In Physically Active Populations: A Consensus Statement Of The Athletic Trainers' Osteoarthritis Consortium. J Athl Train. 52(6): 610-623. DOI: 10.4085/1062-6050-52.2.04.

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