Dr Todd Thomas: Hey everyone, this is Dr. Todd Thomas, a physical therapist here at San Juan Regional Medical Center. I'm the acute rehab coordinator here and I've been here at the organization for about 20 years. Today, I'm really excited to be able to share with you some thoughts on having healthy joints.

All of us have in our bodies these magical things called joints. Joints are parts of our body that connect bones to one another. It can connect one or two or more bones together. Sometimes joints can be rigid, like the joints in your skull, or movable, like the ones in your fingers, hands, hips, shoulders, elbows. These joints are what allow us to move. And in the world of physical therapy, we like to pride ourselves on being devoted to motion and allowing and helping people be able to move and keep moving throughout their life to have the best possible lifestyle that they can. Keeping your joints healthy allow you to run, walk, jump, play sports, do all the things that you like to do. And so, maintaining their health is going to be of the utmost importance to you throughout your life.

In our joints, there's what we call cartilage. Cartilage covers the end of every bone that work together or that move together with one another. Cartilage is this thick kind of white slippery tissue that helps to absorb pressures there. And it is usually about an eighth of an inch to a quarter of an inch thick, and it can be damaged over time, either through just normal use or through injury.

In our joints, the cartilage is one thing that helps them to move. Also, we have what we call synovium, or synovial fluid, and this fluid, along with the cartilage helps us to be able to move at each one of our joints. The cartilage in our joints doesn't have a blood supply, so the way that it receives nutrition is through movement. And so, lots of times, as the title of this podcast says, we refer to motion as lotion. The way that our joints get the health and nutrients that they need from the synovial fluid and the cartilage gets that is through motion. And so as we move, that synovial fluid or the synovium is able to lubricate the cartilage and allows those joints and bones to move freely next to one another. So, you can see that if you're stiff and still, and we've learned over time that if something is held in the same position for a long period of time, it becomes stiff and it's not able to move.

So today, we're going to talk about how we can help our joints stay healthy and what we can do to allow the maximum benefit for those joints for us throughout our life. Probably, the number one thing that we can do is move. As I mentioned before, motion is lotion. It allows the fluid to provide the nutrients to the cartilage so our joints stay healthy. And so, being physically active is probably one of the most important things that we can do to keep our joints healthy.

Regular activity helps keep the muscles around your joints strong and working the way that they should. And even people that already have arthritis can benefit from regular physical activity, which helps to reduce their disabilities and keeps joints working well. Remember that to stay active, that if you are doing activities that require protective padding or anything, to make sure that you're wearing your helmets or pads if you're doing things that would potentially cause you harm if you were to have a mishap there.

And speaking about physical activity, some of the things that we can do, and the reason that exercise is so helpful in nourishing our cartilage, it keeps our bones strong. Our bones follow what is called Wolff's Law, which is that function determines structure. So, the more stresses that we put on our bones, the stronger they are.

Exercise also keeps us loose and limber, more flexible, so that we can not be injured so easily. And having strong muscles helps us to be able to protect those joints and keep them safe and stable over time and helps prolong the life of our joints.

One of the things that I think is surprising to most people is that your weight has a lot to do with the health of your joints. Having a healthy weight takes less pressure off of your joints. Do you realize that for every pound of body weight that you have, you have four pounds of force that is exerted, specifically in your knees? And so, let's say you're carrying around an extra 20 pounds of weight, that adds up to 80 pounds of extra force in your knees themselves, and realize that your ankles and feet, actually the joints there, have more forces there because they're farther down the chain in your body. And so, maintaining a healthy weight is really, really important in order for you to protect your joints and to have joint health.

Some activities that you can do, if running and some of the higher impact activities bother you, and that's one of the reasons that you don't move and you don't exercise, walking is certainly a good start. You can also ride a bike. Other things that sometimes it just hurts too much to move. And so, getting active in like water aerobics or even cycling, swimming, things like that, where your body's unweighted a little bit, especially in a pool, can help you initiate that movement and get moving, and then allow you to potentially convert that over and that activity over to more land-based activities.

Other things that we can do to help protect our joints is by paying attention to the ways that we do things throughout the day. Your posture has a lot to do with your joint health, especially the joints in your hips, your knees and your spine. So, sitting correctly is helpful. Make sure that you take opportunities throughout the day to change your position. Whether you're watching TV, sitting at your desk at work, or whatever it is, make sure that you take opportunities to get up and move and allow yourself to change positions so that you have that compression and decompression, that movement in those joints to allow them to have the most nutrition that they can.

You know, if you're not allowed to get up and leave and move from your office, then try standing up and taking phone calls there or doing things, but be able to change that position and change those forces on your back and on your spine. You realize that sitting, the forces in your low back, especially in your lumbar. This space, sitting, there is twice the forces, there is twice the body weight. So if you're a 200-pound person and you're sitting in a chair, there's 400 pounds of pressure in the disc spaces of your low back. And so, standing changes that to just your normal body weight. And so, realize that your positioning and how you sit, how you stand, potentially has impact on those joints and allows them to either have more or less stress on them according to what you do.

Lifting correctly is also important for the stresses on your joints. So, if you need to pick something up, remember that you need to use your knees and don't bend at the waist, but bend at your knees, squat down to it, keep whatever object it is close to you as you lift with your legs to allow yourself to have less stress on especially your low back, the joints in your back and on your hips. And then as you come up, lifting carefully, keeping that object close to your body. When you hold objects and when you are lifting or carrying things, realize that pulling them closer to your body has less force on your back than if you hold it out away from your body. Let's say, for example, you go to the fridge and you get a gallon of milk out of the fridge. A gallon of milk is normally 8 to 10 pounds. If you hold that gallon of milk with your arms straight out in front of you, it's 10 times that force in your low back, so it would be 100 pounds of force in your low back. If you hold that gallon of milk right next to you, it's only 10 pounds of force. So, how we do things how we use our postures, how we position ourselves has an impact on the forces on our joints and the pain and potential damage that we have for them.

A couple other things that help us to stay healthy and protect our joints. Remember, number one, just to keep moving. Make sure that when you start activities that you give yourself an opportunity to warm up a little bit, move about. And then after you've warmed up for maybe 10 minutes, you can stretch gently in order to try to lengthen the muscles around there and loosen things up a little bit. If your joints are really stiff, then work on your range of motion slowly and make sure that you're protecting them and doing all that you can to keep them safe.

Part of exercising and an important part of that is making sure that you have a strong core. Your core adds power to your ability to have strength in your legs and in your arms. And so, you've got to make sure that you maintain exercises that strengthen both the abdominal and your back muscles in order to allow you to have the most power and strength your legs and in your arms.

Other things that help to keep your joints healthy. Your diet is a very important part of that. Make sure that you're eating a balanced diet to help you to manage not only your weight, but to have the appropriate nutrients that you need in order for your body to be healthy. Avoiding, as we talked about previously, extra weight will help you to reduce the stress on your joints. Make sure that you are eating plenty of fruits, vegetables, whole grains, and fat-free or low-fat dairy products like milk, cheese and yogurt. All those things are helpful to you. Make sure that you have enough protein in your diet so that you are able to build muscle and maintain that, and that can easily be done through just making sure that you have lean meats, poultry, seafood, beans, eggs, nuts. There's plenty of sources for protein out there, but making sure that you have nutrients and the proper nutrients is another good way for you to maintain health of your joints.

Other ways that you can protect your joints and maintain the health of them, if you do have joint pain, there are so many different things out there to help you reduce that pain. You can use aids. Sometimes you may need to use a cane, or you may need to use a walker even, or you can make splints sometimes for your hands. That can help take some of the stresses off of those joints or they have build up materials for utensils and devices so that there's not so much stress on your hands.

Utilize those resources and the opportunities there to take the pressure off of the joints themselves. And don't be embarrassed to use a cane or a crutch or a walker for a little while if you need to in order to give the rest that you need to those joints to allow them to be able to recover. Realize that if you are not someone who is very active, when you first start that out, it might be a little bit painful. And it's important to learn how to distinguish the difference between, "Yeah, I'm working out and this is a good pain. And my muscles are growing and building," and then knowing the difference between that and actually, "Oh, I'm hurt and I need to have someone take a look at this." If you are uneasy in your ability to be able to determine how to exercise or what you need to do, make sure that you check with a physical therapist or your orthopedic surgeon, your doctor. All of them can be helpful in providing you information there.

Other things, other questions that people usually have about joints and joint health have to do with supplements, and I would encourage all of you, if you're going to try to use supplements to help, I would refer you to your physician and have you check with them, especially in considering whether to take additional supplements of calcium, vitamin D, or even vitamin C. Make sure that you're talking with them and looking at that and assessing your diet in order to have the right amount of nutrients that you need.

Thank you all for joining me today. I hope that you were able to hear and learn a few things that might help you in maintaining your joint health and keeping you moving and active.

Again, remember that motion is lotion. So begin by getting up and moving, doing whatever you can in order to increase the activity in your body and increase that joint health that you have. Have a great one. Take care.