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2013-07-15
Joint Health
Joint Health

Joint health has a major impact on overall quality of life.  Our movement function is dependant upon joint health. It is therefore so important to be proactive with regard to joint health.

Topics related to movement function and joint health will be explored through the STAR blog. So we will begin with the most basic physiological principles of body tissues – including those tissues that comprise and control joints, such as bone, cartilage, ligaments, muscles, etc.  The “Physical Stress Theory” (PST) provides the most comprehensive understanding of how body tissues react and change in response to stresses encountered in daily life. A very simple expression of the PST is that body tissues undergo one of 5 different adaptations to imposed stresses: atrophy, maintenance, hypertrophy, injury or death. Normal daily stresses, as long as they are not excessive, will maintain the integrity of the body tissues. However, if stresses are lower than normal, through for example immobilization or disuse, tissues will get smaller or atrophy. On the other hand, when we increase stresses, as long as they are not excessive, tissues will get physically larger or hypertrophy. The best example of this is when we lift weights and stress our muscles in a controlled manner, they will respond by getting bigger and stronger. If we lift weights that are too heavy, however, we can injure our muscles or joints.

Too much or too little stress can result in tissue death.
So it is evident that stress is needed to maintain the integrity of joints.
When a healthy joint is injured, the integrity of the joint is compromised and it is very important to control the stress on the joint during the healing process. Following the tissue-healing phase, the joint is weaker and is more susceptible to re-injury. It is therefore very important to gradually increase the stress on the joint in a controlled way to restore the joint to pre-injury status.  This can be accomplished through therapeutic exercise.

Many chronic joint conditions, like Osteoarthritis, result from either an inadequate healing response following injury, or a gradual decline in joint integrity through disuse. Joints that are weak due to disuse will have much lower thresholds for injury. Thus, a vicious circle ensues because injury will further reduce the integrity of joints, and will subject the joint to repeated injury. Osteoarthritis in particular is a condition that ultimately represents a mechanical breakdown of the involved joint. Once again, a key aspect of treating Osteoarthritis is controlling joint loading. Loading must be reduced initially to facilitate healing, then gradually increased in order to enhance joint integrity.  

Physical therapists are movement specialists, and are the practitioners of choice in the conservative management of joint injury or chronic joint conditions. If you have joint pain, consult your physical therapist today.

Marcia Miller Spoto, PT, DC, OCS
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