Welcome to the Osteoarthritis Physical Activity and Exercise Network (OPEN).
OPEN is an exciting new program designed to encourage, support, and motivate you to manage your knee pain and become more physically active! Here you will find the latest research on osteoarthritis and exercise, as well as tools to help you learn, plan, and maintain a physical activity routine that is right for you.
Get started now and register, so you will have access to the complete program.
Remember, getting at least 150 minutes of moderate level physical activity per week is the first step to a healthier lifestyle and reducing your knee pain. The good news is that every 10 minutes you do during the week can count toward your weekly goal!
Here we provide a way for you to set goals and introduce a variety of moderate level physical activities that you may try. These include any leisure time, household, or work-related activities that make you feel a slight increase in heart rate, some minor sweating or a slight increase in body temperature, and a slight feeling of being out of breath.
We’re here to help you get on track!
How To Use OPEN: Part 1
How To Use OPEN: Part 2
Myth: "I can't exercise if I have joint pain"
What types of exercise are appropriate for people with knee osteoarthritis?
Myth: "If I use my joints when they are really painful I will only cause more damage"
Myth: "Osteoarthritis is a normal part of aging"
The role of medication in OA pain management.
Myth: "Cracking your knuckles can cause hand osteoarthritis."
Truth: There is no evidence that cracking your knuckles affects the disease process leading to osteoarthritis (OA). Whether the habit is a new one or is something you have been doing frequently for years, there seems little need to worry that the action will damage any of your finger joints.1
This popular urban legend still circulates since a 1989 research study suggested that the force applied to create the satisfying popping noise was higher than what was believed to cause joint damage.2 However, more recent studies have since been conducted that show this to be untrue. A paper published in the Journal of the American Board of Family Medicine concluded that a history of knuckle cracking, including how long and how frequently it is done, was not a risk factor for hand OA. This means that if you are a knuckle popper, don't stress out about trying to break the habit - the pops are not linked to joint damage.
Myth: "Rubbing an arthritis cream/gel around the sore joint will cure my OA"
Truth: Arthritis creams and gels that are recommended by your pharmacist or doctor are one way to manage your joint pain and can be as effective in controlling your pain as a pill like ibuprofen or aspirin.3 However, don't mistake the lack of pain as an indication that your joint is healed.
Some types of cream block joint pain by distracting it with sensations of heat or cold; most don't control inflammation or even reach inside the joint.4 This means that the damage to your joint is still there, but you feel less pain because the pain signal is blocked. Be sure to let your doctor know of any arthritis creams you use, as some of the ingredients may also be in pills you are prescribed and can cause complications. Research into creams that contain capsaicin, the compound that gives chili peppers spice, have also been shown to address mild to moderate knee OA pain.5 Just be extra careful to avoid touching your eyes or open sores after use, and report unusual skin reactions to your health care team.
Myth: "If I take glucosamine I can cure my OA"
Truth: Recent reviews of research that looked at the effectiveness of glucosamine as a treatment for osteoarthritis found no significant change in pain, function or stiffness in people taking the supplement compared to those taking a placebo (fake pill).6 Although studies in mice have shown a delay in the progression of OA, there is no such evidence in humans.7
Glucosamine came onto the market when it was discovered to be an ingredient of knee cartilage. Knee cartilage helps your joints glide smoothly as you bend and straighten them. In OA, damage to cartilage can cause pain and limit movement. It was proposed that this damage could be slowed or prevented completely by making sure that enough glucosamine was readily available in the body (by taking supplements) to be quickly made into new cartilage to repair any damage caused by the disease.8 Unfortunately, research that used x-rays and MRIs (a form of medical imaging that sees detailed internal structures) to look closely at cartilage, bone marrow and joint capsules in OA knees showed that glucosamine supplements didn't benefit any of these structures.9 It is therefore not as effective a treatment in humans as we might have hoped.
To watch a short video describing a good quality study run out of the Arthritis Research Centre of Canada on the effect of glucosamine supplements on osteoarthritis pain, please click here.
Myth: Active teenagers don't get osteoarthritis
Truth: Unfortunately, this statement is not true. Although being active when you are young can help build muscle and strong bones, as well as contribute to overall good health, many active teens will develop osteoarthritis as they get older.20, 21 This is because one of the major risk factors for developing osteoarthritis is knee injury, and the fact is, injuries can happen when you are active.10,22,23
To help reduce the risk of injury, be sure to check that your kids have the proper equipment for any activities they are involved in, and make sure they understand and follow the rules and guidelines of any games they play.24 Also, recognize that poor balance and weak quadriceps (the large muscle on the front of your thigh) can lead to knee injury whether you are in your teens or older, so consider getting your family involved in activities that can help improve these components of fitness.25,26
Myth: Acupuncture can cure my OA
Truth: There is no scientific evidence that proves acupuncture can cure osteoarthritis or reverse the disease process. However, current research has found that acupuncture may “lead to small improvements in pain and function” in the short term.27 So, if pain is limiting your ability to move, you might consider acupuncture as a way to decrease your pain and enable you to take those first few steps to becoming more physically active.
Acupuncture involves the placement of very thin needles into your skin at precise locations along your body's energy meridians in order to restore optimal functioning, according to traditional acupuncture theory.28 This treatment has been demonstrated to have a very low risk of side effects, but if you do decide to try acupuncture as part of your therapy, be sure to contact the Acupuncture Foundation of Canada to find a registered practitioner.29 Before your treatment, ask to make sure that only sterile, single-use needles are used, and be aware that you might need more than one treatment before you experience any pain relief.30
Myth: Walking with my cane or a walker isn't exercise
Truth: Walking is a form of exercise whether it is done with or without a walking aid. In fact, if you have been prescribed a walking aid such as a knee brace, cane or walker, it is likely to help improve your ability to tolerate exercise by reducing your knee pain.31,32
The purpose of a walking aid, such as a cane or a walker, is to reduce loading through your sore knee by providing a surface onto which you can transfer your weight.31,32,33 By decreasing the amount of force going through your knee, you will be able to walk for longer without pain, thus making it easier for you to reach your activity goals. Be sure to hold your cane on the opposite side from your sore knee - if your right knee is sore, hold your cane in your left hand and advance it in time with your right leg.33 Losing weight can also reduce the amount of force going through your knee with each step, so walking with your gait aid could become less painful as you become fitter.14
Myth: "My weight has nothing to do with my osteoarthritis"
Truth: Body weight has a lot to do with osteoarthritis, especially OA of the ‘weight bearing joints’. These are joints that usually carry your body weight during daily activities. They include your knees, hips and low back. In fact, being overweight is a top risk factor for knee osteoarthritis, especially if the excess weight is put on early in life.2 This excess weight has been linked to changes in the function of cartilage producing cells, as well as an earlier need for knee joint replacement surgery.3-4
Fortunately, there is some good news - recent research has found that even small reductions in weight can have big benefits. For every one pound of body weight you lose, your sore knees feel the equivalent of up to four pounds less impact per step!5After you have lost that pound, every kilometer you walk will have 7,700 pounds worth of impact less on your knees. And the trend continues as you lose even more weight.6Why not start today by making a modest weight loss goal - your knees will thank you!
Myth: "Exercising in cold weather will make my arthritis worse"
Truth: Recent research has shown that weather can influence an individual's joint pain. However, it is important to remember that joint pain is not necessarily an indication of joint damage or disease progression.1 This means that even though changes in barometric pressure or cold temperatures may make your joints feel more uncomfortable, they aren't getting worse any faster due to the weather.1,2,3,4
Researchers have proposed that cold temperature, or changes in barometric pressure that often forecast bad weather, can change the perception of pain in joints affected by arthritis. 1,2,3 For this reason, a chilly day might result in achy joints as the brain starts receiving signals differently from nerves in your knee, but it doesn't mean that the damage is getting worse.
Since one of the best ways to manage osteoarthritis symptoms is to be active, don't let a rainy day keep you from exercising. Consider going to your local recreation centre or indoor pool if the weather is less than perfect. You might find that changing up your routine keeps exercise interesting! Also, consult your doctor to see if there is an appropriate medication or cream that can help if the weather is keeping you from reaching your activity goals.
Myth: I need a blood test to confirm that I have OA
Truth: In fact, a blood test does not supply the information necessary for a diagnosis of osteoarthritis, so don't worry if you haven't had one. Your doctor will likely use the diagnostic criteria recommended by The European League Against Rheumatism in 2010, as a result of their extensive scientific literature review.34
This report stated that a diagnosis is possible when risk factors such as your age, gender (women get OA more often than men), BMI (a measure of weight in relation to your height, since being overweight is a risk factor for OA) and occupation are considered.34 Also important are your symptoms – if you experience “persistent knee pain, brief morning stiffness and functional limitation”, and your physical examination reveals limited joint movement, bony enlargement, or crepitus (crunchiness within the joint), your doctor might make your diagnosis official. X-rays may be taken to include in your file as a way to visualize the joint changes over time, but are not considered a key component of diagnosis.34 A blood test might be considered if you have any unusual symptoms as a way of ruling out other conditions, such as the inflammatory joint diseases.35
Myth: Smoking is not linked to osteoarthritis
Truth: Not only is smoking a risk factor for a number of deadly diseases like cancer, cardiovascular disease and diabetes, it can also directly affect the cartilage in your knees.36, 37 Research has shown that cigarette smoking is associated with an increased loss of cartilage in the knee joint. Since cartilage covers the ends of your bones to allow smooth bending and straightening of your joints, damage to this structure can have serious consequences in terms of your ability to move pain-free.
The old myth that smoking might actually protect against the progression of knee osteoarthritis was debunked when a recent review of the scientific literature proved that papers published supporting the myth were biased or poorly performed.38 This means that smoking does not help to slow down the disease as it was previously thought, and could in fact be causing more damage within your knee joints.37 So if you are thinking about quitting, consider your cartilage and do it sooner rather than later!