EP 72: 3 Arthritis Pain Relief Hacks || WBWL

This is a great episode I made last year that a lot of people got a lot of value from. I wanted to just put this one back on just in case you have missed this.

Have you been told you have arthritis and to limit your activities or "stop doing X"?

Struggling with pain in an area that has confirmed arthritis?

If you said "yes" to any of the top questions, this episode is for you.

Arthritis is NOT a life sentence. In fact, it can be well managed by changing your mindset and understanding the right information!

Too many health practitioners tell their patients to not squat, not run, not lift weights, not do A, B, and C.

I reveal 3 strategies to allow you to do A all the way to Z even with arthritis.

Transcript

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Welcome to the Won Body Won Life Podcast. Hi, I'm your host, Dr. Jason Won lifestyle, physical therapist. I talk about everything health and wellness related. So you too can have a more resilient body and a more fulfilling life. If you haven't yet, please support this channel by hitting that subscribe or follow button. So you never miss out on another podcast episode. Also, if you could please leave a review or ranking before leaving this episode, that way more people will be able to benefit from the content of my podcast. Today, I wanted to reveal three hacks to relieve arthritic pain, and I want to encompass the physical and mental strategies to overcome this. If you don't know what arthritis is, it is something that a hundred percent of us will actually get. In fact, Everybody over the age of 30 have confirmed arthritis in some area of their body. And they've done large thousands of people at the epidemiological studies where they evaluate people that are either symptomatic or Non symptomatic, meaning they either have pain or don't have any pain at all, and yet they still have arthritis. So when it comes to the arthritic side of things, you have to realize that the mental aspects of if you have knee arthritis, let's say if you were running, for example, and you confirm that you had knee arthritis, that might Thank you. That might instinctively cause a lot of fear and anxiety in you, and you may actually try to lower the intensity of your running or even avoid running. So I'm going to share with you three specific hacks that I use for myself. And just to let you know, I am also a person that has arthritis. In fact, I confirm that I have a left shoulder labral tear. I also have a left knee meniscus tear. And when I was 21 years of age, I was confirmed to have multi level degeneration in my neck. So I associated the fact that I was having neck pain, but that only confirmed my bias when I got an MRI on my neck and they said, yes, you have a spine of an 80 year old. And so that's something that really instilled a lot of fear in me until I started to educate myself on how to get. past this pain and to start living again. So I know that arthritis can lead to a lot of limitations and disability for people, but I want to tell you in this episode and inspire you that you can still live a very fulfilling life, regain your movement, regain the confidence to move and do the things you love again. All right. So let's get this show on the road. Number one is that arthritis appreciates Movement and stress and people perceive stress as a bad thing. When in fact, there are different types of stress. There are positive stress mechanisms. There's also negative ones, and there's also something called you stress, which is like it's in the middle. It doesn't do any good nor any bad for you. So the positive stress is like exercise, however, exercising in large amounts, or if you don't know how to exercise appropriately, or let's say you're a You're deciding to exercise, but then you're extremely deconditioned and you just started something a new for your New Year's resolution and you over train. So therefore that actually hurts you in the long run. So classically, there's a lot of people out there like different healthcare practitioners that always say the same type of narrative. If you have knee or hip pain, for example, and you're a runner, they'll often always tell you the same narrative, which is. Don't, don't weightlift, don't squat. If you have knee pain, don't run. If you have knee pain, but multiple articles have actually proven this to be false in case. In fact, long term prospective studies have shown that there was an increase. a medial knee compartment cartilage density in trained adults who ran consistently three days per week. So instead of thinking that running is bad for your knees, it is definitely a medium to high load type of exercise on your knees because you're taking a Thousands and thousands of steps and putting a lot of impact because you are jumping onto that knee. But research actually shows that if you do things appropriately and you have the right training stimulus and you're training at the right capacity, you can actually have positive adaptations where even if you had knee cartilage issues and you confirmed that you had knee arthritis. It can actually improve the density of that cartilage, and that's pretty amazing to hear. Another large analysis on over 74, 000 runners by Williams et al in 2013 showed that running significantly reduced osteoarthritis and the chances of you getting a hip replacement, partly due to the fact that running is associated with a lower BMI. But I can also argue that the conjecture behind that is if you can increase the cartilage of your knees, it can definitely improve the cartilage of your hips, for example, or your lower back or other surrounding areas up above because running is an overall total body sport is that it probably can strengthen the columns of your spine and decrease your chances of more severe arthritis in your lower back or other areas of your spine. All right. So arthritis appreciates movement and stress. And this is the last note that I want to tell you about this first fact. When you're thinking about, let's say, if take the classic example of somebody that squats and they can squat to let's say 20 to 30 degrees. Without pain, but anything beyond that. So anything 30 degrees and deeper causes knee pain. That doesn't mean that squatting beyond knee beyond 30 degrees is bad for you, it's just that you might have to decrease the load or find variations where that exercise becomes more accomplishable. For example, if I had somebody hold on to some TRX bands or even hold on to a countertop, that might allow them to go past 30 degrees of movement. And the thing is that if you only move your knees in a certain amount of range of And let's say, for example, your knee A classic knee goes from zero degrees, which is full knee extension and full straightening to let's say 130 to 140 degrees. That's the classic amount of range of motion that you would have. If somebody tells you to only squat to let's say 60 or 90 degrees, or you only strengthen within that range, You might actually predispose yourself to more arthritis. So when your knee, if you think about it, you have your femur, which is your thigh bone, and you also have your tibia, which is your shin bone. And those two bones articulate and connect with each other. If you only take your knee through certain ranges of motion, you're not actually distributing that stress across the entire cartilage within that knee. Then this has been shown that when with the kneecap and how it articulates with the knee is that there is cartilage behind your kneecap and there is also cartilage that lines the femur and the tibia. If you only take your knee through 30, even 60 degrees of motion, and you don't. ever go into a deep squat, you are actually predisposing yourself more to arthritis because you're only causing stress to that specific range, which is that 30 to 60 degree mark. And that is why I always tell people you need to find windows of opportunity to try to squat deeply. And you can relate this to any other area, your lumbar spine. If somebody tells you don't bend over because that causes a herniated disc or don't bend over and lift weights because that you can really hurt yourself. If you don't actually take. Your lumbar spine or any other joint in the body through full range of motion. And you don't strengthen within those ranges. You are definitely predisposing yourself to further arthritis specifically in those areas. And I've seen this time and time again, where somebody has. Arthritis in a just a very small area of their let's say their hip, which are hip is a ball and socket joint. And I've seen it before where the rest of the ball and socket actually becomes more deteriorated because of disuse. You might actually cause stress to a specific area. Let's say you're squatting to 30 degrees. That area that continuously gets that stress may actually improve cartilage density, which I've said before in the running studies. But if you're not taking that ball and socket through full range of motion your body is definitely going to say bye bye. You don't need me anymore. And that cartilage Even though you're not stressing it out, just due to the fact that you're disusing it and muscles will be disused and your muscles might go through more atrophy. You will actually predispose yourself to more arthritis. Okay, so I'm not saying that arthritis is always associated with pain. It's just that you can definitely accelerate. The articular cartilage deterioration, if you don't take your muscles and your joints through full range of motion. Okay. Number one, arthritis appreciates full motion as well as stressing those areas. Okay. So number two is to incorporate a mixture of closed kinetic chain exercise. as well as open kinetic chain exercise. And this will very depend on the individual. And so just to define what these mean, closed kinetic chain is where your hands or your feet or even your knees are fixated to a immovable object. So this could actually be if you're in a plank position and your hands are on the floor, this is a closed chain exercise. For your hands and your shoulders, if you're doing a squat, for example, your feet are on the ground and that is also considered a closed kinetic chain exercise. Also, if you put your hands on the wall and you're doing some wall pushups, even though your hands are on the wall, that doesn't mean that it's not a closed chain exercise. Anytime that your hands or your feet are fixated to an immovable object, then that is a closed chain exercise. So open chain is completely opposite. Open chain is where you are actually moving an object and your limbs are actually moving. So if you are raising a weight up and down with your shoulders and your hands. That's an open chain exercise. If you're lying on your side and you're lifting your feet and your hip up and down off the floor, which is a Pilates leg raise, that is an open chain exercise. Now that you have these definitions let's decide when these exercises should be indicated. So if you're somebody that has very acute pain, you just had a flare up. It is oftentimes that you might want to try open chain exercises. A good example is one of my clients just tore their meniscus two days ago. And this is actually a true story. They just tore their meniscus two days ago. The knee was still swollen. They could hardly limp. Into my clinic. And what I did was you can't really do a lot of squatting because the knee is swollen. It's inflamed. You might need to let things calm down, but what we can do is we can at least raise that leg up and down, keep that leg relatively straight. And that person was able to accomplish at least sideline leg raises. They were able to do certain exercises that were. Basically, we wanted to cause less stress to the knee, but still strengthen areas around it like the lateral thigh and the lateral hip. And I told that person, if you just do this three to five times a day, it's likely that at least you'll feel minutely better. And we also gave them some ankle stretches, some things that where their foot was in the air. And so again, it was a lot of open chain exercises. Long story short, within just a week, that person came in almost limping. almost mildly limping and almost walking pain free. And that person came in barely able to walk. So open chain exercises can be great if a certain joint is intolerant to excessive stress. Sometimes though, let's say if it's a person that I noticed that there is a severe weakness in an area, I may actually want to incorporate more weight bearing right from the get go. Majority of weight bearing exercises are closed chain. So if you're squatting up and down, you're squatting your body weight. So for example, another one of my clients who had shoulder arthritis, but although also had, I noticed that when I was looking at their shoulder blade and how they move their arm in space in an open chain fashion, is that there was some, Discoordination with how the shoulder blade move with the shoulder. So that in those certain cases, I will incorporate more closed chain exercises because closed chain will stimulate the entire shoulder girdle. So even having that person put their hands on the ground in a push up position and simply just tapping their shoulders. So basically doing intermittent single. Arm stability exercises, they were actually able to gain more range of motion and more control of their shoulder simply by adding weight to their hands and to their shoulders. Okay, so when my baby learns to First Walk, a baby learns to first walk by simply putting their feet on the ground in a closed chain manner. And then falling down multiple times, but eventually they learn the coordination to start walking. And the same thing goes that if I notice this coordination, or if I noticed that there is a neuromotor control issue, you may want to put that person in a weight bearing position versus if somebody has a severe flare up of their elbow or their Or some or their shoulder, you may want to incorporate more open kinetic chain exercises first. And yet, this will still vary from person to person. So it honestly does depend. But hopefully those indications make sense to you. So the last thing I want to tell you in terms of number three is to develop And An anti fragile or anti catabolic mindset. And we all know what fragile means. Fragile means that it's broken. It's very prone to injury. And it catabolic basically means breakdown. So developing an anti breakdown mindset or an anti broken mindset is pivotal. For any of my clients who have confirmed arthritis because we know the statistics that 100 percent of people have arthritis over the age of 30. It shouldn't be something that governs your every thought and governs the actions that you do. This means that if you were a former runner and you had no symptoms at all, But somebody tells you that you have knee arthritis or you get an x ray and you have confirmed knee arthritis. That shouldn't play with your mindset in telling you, I shouldn't run because it may worsen the arthritis in that area. Because we told you in the past two tips that I gave to you, that arthritis appreciates full range of motion. It appreciates stress. So when you're thinking about if I have even moderate or severe arthritis, Dr. J. I need to limit my movements. That doesn't mean that you need to limit your movements. You might just need to find the right modifications that will suit your needs and your goals. So if you're trying to run and you have moderate arthritis, this doesn't mean Do something from back in the day in your twenties and try to run five miles right from the get go. It may mean that you need to take a more slow and calculated approach to getting there. Maybe you need to incorporate more open chain exercises to the point where you have stronger prerequisite muscles to support the areas of arthritis. And that's another point that I hit on with my clients too, is if you have knee arthritis. That shouldn't limit you from exercising. Instead, you can still strengthen your ankles, your feet, you can still strengthen your core and your hips, and you can strengthen all these other muscles so that when the knee flare up or the knee pain lessens. You will have stronger muscles. Once you decide to get back on your feet and start running again, relating that to the upper body is I had many of my clients have neck arthritis. So neck arthritis, if they had a severe flare up, I may not want them to do full range of motion of their neck because it may cause a strain, but that doesn't mean I can't strengthen the chest muscles, the shoulder, I can strengthen the trapezius or the muscles that kind of attach closely to the neck. It doesn't make sense that I would just go cold Turkey. Not do any range of motion exercises or not try to stress other areas around the arthritis. Okay. So you can have confirmed arthritis somewhere, but you can still at least at the minimum, try to strengthen other areas around it, which is called regional interdependence. And that's what I mean is that if you have that breakdown type of mindset, like my body is 50 years old. I can't do this. I can't do this. My doctor confirmed that I should not run, or I should not wait. Lift weights, then that's clearly going to decrease your window of function, your mindset, and your psychosocial behavior in itself will limit the physical capacity that you're able to accomplish. And therefore you're going to limit your potential and long term that is going to lead to disuse. That's going to lead to atrophy. That's going to lead to your muscles being less conditioned. And therefore, guess what happens when your exercises, let's say when your hobbies, you're running, you're weightlifting or whatever sport you like to do. Guess what happens when you decide to adopt a fragile mindset or a catabolic mindset is that you might avoid the activities that you love, but eventually it's going to catch up into your day to day activities. Now it's going to be difficult to sit on the toilet because you stop squatting. You stop weightlifting, it's going to be very difficult for you just to walk and go on long hikes because you decided to stop running. If you try to at least take yourself to the point where you're doing some sort of submaximal exercise, where it's pushing the buttons. But it's not overloading the tissues or overloading the joints. You're always trying to find that happy medium where you're stressing yourself out enough. You're stressing the areas of arthritis or around that arthritis, but then understand where that limit is and not overtrain. And that is a very delicate balance because You have to put math into it. You have to have a good sense of what exercises to do. And that is why people honestly hire coaches, higher trainers, higher physical therapists, like myself, to give you a plan of attack so that you're doing things correctly. And I don't mean the sense of like correctly, like this is a wrong exercise. This is a good exercise. What I mean is just having a calculated mathematical plan of attack where you stressing yourself enough. And creating those positive adaptations where then you're slowing down the deterioration of your joints and you're able to do the activities that you want to do, despite arthritis. Okay, so just to recap this, number one is arthritis appreciates movement and stress. Number two, incorporate a mixture of closed kinetic chain as well as open chain kinetic exercises. And that varies dependent on the purpose and the intended goal. And also, number three, lastly, is to develop an anti fragile or an anti catabolic mindset. We might have arthritis, We might have arthritis the rest of our life and it definitely 100 percent of us will worsen 10 years from now. I guarantee your spine, your joints will look different 10 years from now. But does an image or does arthritis determine the limitations? Does that determine what you're going to limit yourself to? Or are you going to develop a more resilient mindset where you are continuously pushing the boundaries without overtraining? So that's what I got for you guys today. If you enjoyed this episode, definitely hit that subscribe or follow button. I release new episodes every morning on Wednesdays. And I'd love it if you can leave a rating in your podcast. So My content will reach more people who could benefit from the tips that I put out. And if there's any feedback about the content that I'm putting out good or bad, or if there's specific things that you want me to cover in future episodes, send a quick text to 415 965 6580 or email me at jason@flexwithdoctorjay.com. You can also direct message me on Tik TOK, Instagram, or even Facebook. I reply to all of my messages and I'll leave you always with these last words of advice. We only have one body, one life, make every action you take be one that makes you a better version of you. Take care.