ATHLETICS AND OSTEOARTHRITIS

Athletes, and an increasing number of middle aged and older people who want to participate in athletics, may question whether regular vigoro us physical activity increases their risk of developing osteoarthritis . To answer this, the clinical syndrome of osteoarthritis must be dist inguished from periarticular soft tissue pain associated with activity and from the development of osteophytes. Sports that subject joints t o repetitive high levels of impact and torsional loading increase the risk of articular cartilage degeneration and the resulting clinical sy ndrome of osteoarthritis. However, moderate habitual exercise does not increase the risk of osteoarthritis; selected sports improve strength and mobility in older people and people with mild and moderate osteoa rthritis. People with abnormal joint anatomy or alignment, previous si gnificant joint injury or surgery, joint instability, above-average bo dy weight, disturbances of joint or muscle innervation or inadequate m uscle strength probably have increased risk of osteoarthritis. These p eople and those with early osteoarthritis can benefit from regular phy sical activity, but they should have a careful evaluation of their joi nt structure and function before participation. They should consider m easures that decrease the intensity and frequency of impact and torsio nal loading of joints, including use of sports equipment that decrease s joint impact loading, maintaining or improving muscle strength, tone , and general conditioning so that muscle contractions help protect jo ints from injury and high impact, and decreasing body weight.