Osteoarthritis is Preventable, and in Many Cases, Reversible

Osteoarthritis is a simple disease. The joints are wearing away faster than they are rebuilding. If the right exercises are performed, this can be reversed. If the key cartilage has not been completely worn away, osteoarthritis is reversible.osteoarthritis-knee

Osteoarthritis is degradation of the joints due to mechanical stress. Rheumatoid arthritis is different, and is a deterioration due to inflammation. In osteoarthritis, inflammation is the result, not the cause of the damage. Osteoarthritis is by far the most common sort.

There are several types of joints. The ones that cause problems are the ones that can move a lot, and these are called synovial joints. We’ll need to look at these in a bit of detail. Lets dissect the knee joint, since it is a notorious troublemaker.

For specific exercises that reverse arthritis, click here.

The ends of the bones that meet to form the knee are covered with a thick smooth tough protective layer called the articular cartilage. You have seen this on the end of chicken bones. It doesn’t look like the rest of the bone, and is shiny, hard, smooth and white. The articular cartilage is manufactured by a cell type called chondrocytes, which come from the bone. They are first cousins of the bone making osteoblasts, both of which descend from the mesenchymal stem cells located intsie the bone..

The articular cartilage on these bones are 2-4 mms thick. The cartilage-making chondrocyte cells migrate from the bone to the surface, building and rebuilding the tough smooth collagen matrix. The cells on the outermost layer are squashed flat by the joint pressure. As they wear, they are replaced by those below. The middle part of the articular cartilage is somewhat rubbery, which absorbs shock and helps spread the load. The layer next to the bone is a tough layer resistant to compression.

The articular cartilages in the knee joints have tough pads inserted between, called the meniscus, which further helps distribute the load. The joint is then enclosed in a flexible sort of pouch, capsule or covering called the synovial cavity. This pouch is key to joint health. The wall of the pouch is made up of two types of cells, one of which secretes thick lubricating fluid which fills the cavity. So the now well-lubricated articular cartilages slide against one another and the meniscus in the synovial cavity. The synovial cavity is sometimes called the joint cavity. Besides lubricating, the lubricating synovial fluid also contains nutrients.

Joints health depends on replacement cell activity, yet joints have no blood supply.

Now a problem arises in joints, and the solution is a little strange. The articular cartilage has a lot of chondrocytes, replacing and maintaining the tough structure, but no blood supply to feed them. But the articular cartilage is quite critical to joint health, so how do the cells eat?

Knowing how joint cells get their nourishment is absolutly key to maintaining joint heath.

It turns out that the living, growing cartilage gets its nutrition straight from the synovial fluid. Some of the fluid leaks through the synovial membrane and into the articular cartilage. They get nothing from the bone itself.

osteoarthritis-locationsNo blood=no oxygen. With no oxygen available, the chondrocyte cells have to generate energy from fermentation. This is a lot less efficient. Fermentation is an alternative form of energy generation that most cells can employ. The ‘burn’ you feel after 20 reps of a tough exercise is because your muscles are now experiencing an oxygen shortage and have started using fermentation.

Osteoarthritis Initiation

This feeding system for the articular cartilage is a weak link. If the joints are immobile, hardly any of the fluid leaks through, things just sit, and the articular cartilage starts to starve and doesn’t repair. This is the initiator of osteoarthritis. If there is more weight on the bones, the situation will be worse. Likewise, repeated impact, falls and the like can damage the cartilage.

The key to joint health, besides keeping weight reasonable, is taking care that the cartilage generating chondrocyte cells get nourished. Armed with this knowledge, it is easy to devise exercises that will keep the joints in good shape. Two attributes are needed:

  • The thick fluid in the synovial cavity needs to be compressed and released. This forces synovial fluid into the articular cartilage where it can lubricate and nourish. Imagine squeezing a wet sponge. Squeeze that joint cartilage.
  • The joint needs to go through its full range of motion. The spreads the synovial fluid all about, and spreads the wear as well. Limited ranges of motion will cause certain points to wear out quickly, while surrounding areas may well be perfectly healthy, and completely un-utilized.

Do exercises that embody the two of these and osteoarthritis is unlikely. Furthermore, early osteoarthritis, where the synovial pouch is still intact, and the cartilage not worn completely off, can be reversed.osteoarthritis-exercise

It helps to actually visualize the joint that is getting exercised. Is it getting compressed and released? Is it full range? Getting full range in everyday life is equally important. Walking, standing up and climbing stairs is not enough. You need to go out of your way to incorporate exercises that entail a wide, very full range-of-motion: deep squats, deep deadlifts. Even if it is reaching for the grandkids who are anything but ‘dead’ weight. This forced full range hurts at fist but within weeks motion that brought tears to your eyes from pain will become pain free and fun again.

Other movable joints are different in configuration, but all have the articular cartilage lubricated with synovial fluid. So compression and full motion are essential.

Unlike other degenerative disease, hunter-gatherers do get osteoarthritis. However, we do not have to endure the punishing physical existence they had, so we can avoid it; that is, unless we insist on jogging.

One promising new treatment for osteoarthritis involves injecting mesenchymal stem cells into the knee joint. The cells are harvested from the patient’s own bone, and allowed to reproduce freely in the lab till they are abundant. They are then injected into the joint. This seems to work, and new articular cartilage is generated.

 

  3 comments for “Osteoarthritis is Preventable, and in Many Cases, Reversible

  1. Jim
    April 29, 2015 at 1:50 am

    Potential for joint repair with mesenchymal stem cells – now that is amazing. I can vouch for the use of full range squats – great exercise and always makes my knees feel better.

  2. Jim
    April 29, 2015 at 2:22 am

    Had one more question – what causes joint popping / cracking noises and are these something to worry about? (Actually 2 questions)

  3. Helene
    April 30, 2015 at 12:09 am

    Thankyou for this post. Good reminder that our knees are aging. Or maybe not yet?
    Sometime I have muscle and knee pain after walking for a few miles (I walk a lot and regularly).
    Next day it’s all gone.
    Does it mean that my joint is not as healthy as on the picture? Do I really need ‘deep’ investigation already?

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