Health Options Alan Titchenal  & Joannie Dobbs                    Monday, May 24, 2004

Too fast, too furious exercise is ‘pain, no gain'

"Use it or lose it" is a common adage applied to the muscles and the brain. But what about joints? Do joints need regular use? Can you wear them out with too much use? The answer to both questions is "yes." But there are some important qualifications.

Question: What causes joints to develop problems with age?

Answer: Young joints have a healthy layer of elastic tissue called cartilage that allows smooth movement and protects the underlying bone.

Cartilage tends to degenerate gradually with age, resulting in more joint problems after age 40. Also, normal wear throughout life can lead to an accumulation of damage to joint cartilage that eventually results in painful joint inflammation.

Q: How can exercise help or hurt joints?

A: The effects of exercise on joints depend on the type of exercise and on a person's genetic susceptibility to joint problems. Frequent exercise of low-to-moderate intensity creates conditions that maintain healthy joints. Overly strenuous exercise, however, can damage cartilage. If the damage exceeds the ability of the body to repair and rebuild cartilage, a joint can become inflamed and chronically painful.

Exercise of moderate intensity is thought to stimulate the movement of joint fluids into and out of cartilage. This helps supply specialized cells with nutrients needed to maintain and repair cartilage.

Exercise that is too strenuous for one person may be no problem for another. This can be due to genetic differences, previous injuries or the level of regular training. People who gradually increase their exercise intensity over many months and years are generally less likely to damage their joints than those who abruptly increase exercise with too much vigor too fast.

Q: Can exercise help someone who already has joint problems due to osteoarthritis?

A: Yes. A number of studies have found that properly designed therapeutic exercise programs can reduce the symptoms of osteoarthritis in many people as effectively as commonly used drugs.

The proper dose of exercise for people with joint problems varies, however, so intensity, duration and frequency of exercise must be tailored to each individual. Physical therapists and properly trained personal trainers can help.

As a rule, if exercise is causing joint pain, reduce intensity or stop. Often, when joint pain occurs, a short break to stretch and remove stress on the joint can let fluid flow back into the cartilage and allow the continuation of exercise without pain. Excessive joint pain is a "pain, no gain" situation.

Q: Can nutritional factors help joints?

A: Adequate vitamin C is essential for cartilage formation. Many other nutrients may play a role. Plenty of fluids, adequate protein, B vitamins and a balance of essential nutrients help maintain and repair joints. Also, though not a cure-all, glucosamine supplements are known to benefit joint health for many people.