The Importance of Movement for Osteoarthritis (Abridged Version)

and my guests as your weekly walking buddies. We'll hear stories from caregivers and gain tips and insights from health experts and advocates who know how important it is to take care of yourself and manage joint pain due to arthritis that often accompanies being a caregiver. Together, we'll find community ourselves and maybe even alleviate some joint pain in the process as we walk together and connect to the

best parts of being a caregiver. Welcome back to Kara Walks, everyone, and thank you for taking time to join us, and thank yourself for taking time to make your self care a priority. As a reminder, right now you're listening to the abridged version of this episode, but if you're looking to get a little extra inspiration, don't miss a minute. Check out the full length version of this episode in your podcast feed. All right, now that's settled, let's dig

into the episode. Today, we're talking about the importance of movement for caregivers living with ostio arthritis to help us better understand how joint pain effects caregiving. I will be joined by Dr Amanda Nelson, a rheumatologist and associate professor at the u n C Thurston Arthritis Research Center. She understands both the challenges and the best strategies from managing o A from her experience working directly with patients, both in clinical care and in research. But before we dig in,

us begin our walk. We're going to focus on staying present within our bodies and within our movement. Think about the contact you're making with the ground. What does that feel like. Be sure to relax your shoulders as you walk, pull them down from your ears and breathe in deeply through your nose. Feel the sensation of your stomach and your chest rising with your breath. And now breathe out through your mouth and let everything in your body relax As you breathe, be aware of the air filling in

your lungs. Can you feel your chest compressing as you slowly release the breath. Take a beat to walk through your five senses. What do you see around you? What sense are filling in the air? What do you notice about the way your body moves as you set your pace? Now, as you settled into your rhythm. I'm going to share my conversation with our guests, and together we're gonna learn a little bit more about how we can all benefit

from keeping our bodies moving. Today I am joined by Dr Nelson, a rheumatologist and Associate professor at the u n C Thurston Arthritis Research Center. She understands both the challenges and the best strategies for managing oway from her experience working directly with patients, both in clinical care and in research. Dr Nelson, thank you so much for joining us on care walks. Oh, thank you very much. I'm

happy to be here. I'm happy you're here too. Could you tell us a little bit about the work that you do and how you have helped joint pain sufferers improve their symptoms. Yeah, So, as you mentioned on my a rheumatologist and I see patients one day a week, and those patients have a range of arthritic conditions and

a lot of them have challenges with mobility. I also do research primarily and osteoarthritis, which is the most common form of arthritis, around a lot of different aspects of risk factors, disparities, issues of imaging and bio markers, how we might tell people do or don't have arthritis, how it might progress, and some novel methodologic approaches to try and understand it better for future clinical trials and clinical care.

The main recommendations around symptomatic improvement is exercise, and we have shown in a variety of different studies that exercise really does improve pain. Often that's not the first thing that happens, so people have to work through some initial discomfort. A lot of times, maybe they haven't been very active and they have to sort of get into the routine and get over some initial joint pain. But over time, being regularly active does improve the pain and symptoms of

arthritis absolutely. Some of our listeners might be new to incorporating physical activity or movement into the routine, and as we all know, well, I mean I speak for myself, but I think also for a lot of other people, just the prospect of starting something like that, it seems intimidating. So what would you say is the simplest and best

way for them to get started? I think a lot of my patients, and certainly in our research studies as well, people are often coming from a position of of no activity. They're very sedentary. They might get up and go to the store, but otherwise, you know, on the couch or not engaged in a regular routine. And so there's a lot of ways to approach that. It depends a lot

on where people start. So if we're starting from a place of I do nothing but sit on the couch, then the first thing we say might be, well, during the commercials on the television, we're going to stand up and we're going to move around, and we're going to do that every single commercial, because there's a lot of commercials,

and so that can get you a long way. If we're from a place of, well, I move around in the house, but I don't really like to go out and walk, you know, then maybe I say you should walk for five minutes a day, you know, three days a week. And I work very slowly up to a goal of maybe thirty minutes a day for three to five days a week, and I actually have a walking prescription where I can write this out for people and say, look, this is the medicine for your arthritis. The medicine for

your arthritis is to get up and walk. But it's extremely important to meet people where they're starting, because if I just start with thirty minutes, five days a week, they're going to have that exact reaction and I say, there's no way I can do that, and I'm not even gonna try. And so understanding where people are coming from, what their barriers are, and really coming up with a plan that's going to work for that person, anyone they're

caring for, you know, working around their schedule. All those things are very important to getting people started and also to maintain because you know, if they do it once and then give up, that doesn't help. Okay, let's talk about possible misconceptions about being physically active. Can already hear somebody saying, well, wouldn't movement just add where and tear to my body and potentially make joint pain even worse.

I get that question all the time because it makes sense, right, you think, well, if the cartilage is breaking down, then what I don't want to do is use the cartilage. But it's not quite how it works. So the cartilage itself doesn't have its own blood vessels. It doesn't get nutrients from the body through the blood like a lot of other tissues. And the way that it gets nutrients in and waste products out is by compression. So the actual loading of the cartilage is how the cartilage stays healthy.

If people are unloaded, you know, for example, having a paralysis event where they really cannot walk, the cartilage degrades because it can't get nutrients, and so walking is healthy for the cartilage. It actually improves the cartilage function. And so it's completely counterintuitive, and I get that, and so

I'm happy to explain that to folks. But the joint wants to be loaded now, it doesn't want to be It's not a jackhammer, right, So it's not looking for high impact major activity, but it does like some periodic loading and unloading, such as we get with walking and what else? What are some other low impact activities that caregivers with joint pain can do besides walking. Yeah, so walking certainly the cheapest, easiest we can all do it. UM. I have a lot of people who benefit greatly from

the elliptical um system. Because there's really no impact so much as that gliding motion can be very helpful. And for people that really have not been moving, have a lot of pain, maybe a lot of other comorbid conditions, a lot of times water therapy is very helpful, whether that's a PT driven aqua therapy program or again like

our threatis foundation class at a local pool. Often the pool is warm, the buoyancy from the water helps to sort of take some of that weight off the joints, but still they're being loaded in a useful way for the physio oology of the joint itself. So there's a lot of different modalities and it very much again depends

on what people want. If if you're terrified of the water, then I'm not going to tell you to do water therapy, but that certainly is a great place to start for people that have access and enjoy that cannot workout be too minimal to see benefits. There's two parts to that.

One is any movement is better than no movement, and so if you're you know, just getting up during the commercials are doing those five minute walks, that's way better than the sitting on the couch was previous to that, we have to start somewhere, and we want to encourage people to start where they are and move forward from that point, and any movement is going to be of

benefit over the longer term. There's still some debate about how much we need, right, So there was the ten thousand steps going around for a while, and then one of my colleagues did a study that showed that maybe six thousand was probably okay for people with osteo orth right, as there are guidelines out there for how active we need to be, that can be very daunting if we start air, so you know, a hundred and fifty minutes a week sounds pretty scary, but again it's it's the

essential piece of just moving. And if that's a very small bit at the beginning, and we're working up, then that's all we can ask anyone to do. We can't leap straight to full maximum healthy adult guidelines and and go from there. That's just not how it is. And how do you know when movement pain is pushing the limits or over extending. So I usually tell people it's okay if you're a little sore the next day, that's kind of again to be expected. If we haven't been

doing too much. But if it's lasting for a few days, or it's really debilitating, like I walked yesterday and I'm in bed today, that was either too much or there's something else going on. If it's a joint pain issue, we shouldn't have red, warm, swollen, angry joints, right, So they might be a little bit puffy if we were just up and about more, and that's okay, that should

go away. But if there's acute pain, new redness or warmth, something that's never happened before, pain in a place that's never happened before, those are things to look out for. But generally, what we expect is that the joints that hurt might hurt a little bit more after the activity, and they might be a little sore the next day, and then we should be back to where we were going or even feeling a little bit better by then. So big changes, though, or or new things that hadn't

happened should be at least evaluated. It might be okay still, but we just want somebody to take a look and make sure that we're not causing a new problem or or you know, maybe our gate isn't quite right and we're generating some new pain issue that we didn't have before, So just being aware of our bodies, where we started, where we're going, and what to expect. Well, thank you so much, Dr Amanda Nelson for talking to me today on care walks. I love the idea of the commercial

movement breaks. I think that's a great starting place. If you're not in the habit of moving just yet, it's important to take it in those little vice sized pieces, you know, just to get yourself going. And I really appreciate having this conversation with you. Thank you so much. Well, thank you, Holly. It's been fun. I want to thank

Dr Nelson again for being my guest today. I really appreciated our conversation and hope you learned as much as I did about finding movement that will help your joint pain and the physical benefits of implementing movement as well as what it does for our mental health. That's it for today's episode, and don't forget to come back next week for another walk with our guest actor and caregiver

Jenny Garth. We're going to talk about her experience as a caregiver for her father and how she now prioritizes self care and manages her joint pain and remember keep walking and don't forget to take care of yourself too. Care Walks is produced by I Heart Radio in partnership with al ter In. Our threatis pain Jail and hosted by me Holly Robinson Pete. Our executive producer is Molly Sosha.

Our head engineer is Matt Stillo. This episode was written and produced by Sierra Kaiser, with special thanks to our partners at G s K Platform, g s K, Weber, Shandwick, and Edelman