To Protect Arthritis-Prone Knees, Dont Overdo Exercise

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    I f youre at risk for osteoarthritis of the knee, light exercise such as walking or bowling can reduce your odds of develop- ing that painful condition. But strenuous exer- cise such as skiing, soccer, running or playing basketball can lead to cartilage damage and start an osteoarthritis cascade, a new study warns. Even if youre not at risk, too much knee bending can damage cartilage.Keegan Hovis, RN, of the University of California-San Francisco, and colleagues compared T2 MRI scans, which can detect early cartilage changes at the molecular level, among 132 at-risk patients and 33 matched controls. The patients at risk for arthritis, ages 45 to 55, were enrolled in the National Institutes of Health (NIH) Osteoar- thritis Initiative. Factors putting them at risk included previous knee injury or surgery, occasional knee symptoms, a family history of total knee replacement and bone spurs on the fngers.Both those at-risk and the controls were classifed by current (not lifelong) exercise level-sedentary, light or moderate/strenuous- and also according to whether they engaged in frequent knee-bending activities. These included heavy lifting with the legs, climbing stairs, kneeling and squatting.Among the at-risk group, those who engaged in light exercise showed the least car- tilage damage at the molecular level, while moderate/strenuous exercisers had the most damage. For the control group, exercise level made no difference in cartilage degeneration. Frequent knee-bending, however, was associated with greater dam- age in both groups: Those at risk for arthritis showed signifcantly more cartilage damage in fve of six areas if they engaged in knee- bending activities on most days; even those not at risk who frequently did knee-bending revealed damage at the molecular level on two of the six measures.The findings are important, co-author Thomas Link, MD, also of UCSF, told attendees at a Radiological Society of North America meeting where the results were presented, be- cause they show early changes to cartilage, which does not regrow. He went on, Once its gone, its gone forever. Thats why its so critical. You have to be very conscientious of your cartilage if you have osteoarthritis risk factors.When you do exercise, please dont do so aggressively, Dr. Link added. Be aware that if you really injure your joints, you initiate an osteoarthritis cascade that will be diffcult to stop. Radiological Society of North America <rsna2010.rsna.org>Arthritis Foundation, (800) 283-7800,<www.arthritis.org>

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