May 22, 2018

Prevention of Orthopaedic Conditions

By Boyd W. Haynes III, MD

Prevention of illness is an important part of our work with the patients we serve.  Many of the mostly common and costly conditions that are seen today can often be prevented, such as adult onset diabetes, hypertension, obesity, heart disease, high cholesterol, etc.  When we ask patients to eat a nutritious balanced diet, maintain a healthy weight and get sufficient aerobic and weight lifting exercise for their hypertension, heart health or diabetes, the same steps can be taken to avert common orthopaedic conditions, such as osteoarthritis (especially in the knees and hips) or osteoporosis.

Recommending a healthful diet can help your patients’ bones and joints in many ways.  A diet, such as the Mediterranean diet, rich in vegetables, olive oil, fresh seafood and low in sugar, has been shown to reduce systemic inflammation, which may aid in the prevention of OA.  Calcium and vitamin D rich foods aid the body in keeping bones strong and dense, warding off osteoporosis.  A multivitamin, tested by an independent lab for quality and purity, may also provide essential vitamins and minerals that may be missing but are necessary for good bone and joint health.

I can’t put enough emphasis on the role that weight-management plays in helping prevent OA of the knees and hips.  Healthy weight maintenance alone would help eliminate many of the joint replacements we must perform due to the wear and tear on joints caused by obesity. Losing weight is also a treatment for OA, and greatly relieves the associated pain and discomfort.  Oddly, it is rarely mentioned to patients as a treatment outside of an orthopaedist’s office.  Instead, physicians tend to recommend anti-inflammatory medications, physical therapy and even surgery, before weight loss.

Exercise is also a very important part of any OA and osteoporosis prevention regimen.  I have a saying that I often tell my patients: “Motion is life.”  I truly believe that staying active and in motion can prevent or ease much of the pain, stiffness and inflammation caused by OA.  I also know that staying active and fit reduces the chance patients have of injury when participating in sports or other activities.  As a sports medicine specialist, I can attest to the difference in performance and resistance to injury my fit and active patients have compared to less fit, less active individuals.

Weight bearing exercise and weight lifting, where the patient must work against gravity, are proven to help prevent osteoporosis or can assist the patient in rebuilding some of the bone density they may have lost.  When bones are “stressed” against gravity, the resulting forces stimulate the bone to remodel.  When the attached ligaments and tendons are stretched, this puts an additional strain on the bone, further intensifying this effect.  Jumping and running are the best exercises for remodeling bone; however, benefits can be seen from any exercise that involves impact with the ground. Weight lifting enhances this effect and is recommended for maximum bone remodeling efficacy.

Dr. Haynes is an orthopaedic surgeon and the Senior Partner at Orthopaedic & Spine Center in Newport News, VA.  He is fellowship trained and Board certified in Sports Medicine and Orthopaedic Surgery.