There is lots of evidence to support the health benefits of general exercise and that generally the more active we are the healthier we are, resulting in improved mental and physical health. Additionally, exercise has also been proven to be beneficial in the management and rehabilitation of conditions such as cancer and cardiovascular disease, amongst others.
But from a muscle and bone health perspective there are many common misconceptions about exercise. For example, many people think that exercise is damaging to joints but in the absence of joint injury there is no evidence to support this idea. The opposite has actually been shown to be true!...exercise has positive benefits for joints.
Another common misconception is that exercise and greater use of joints such as the knee or spine will result in greater wear and tear or degeneration and ultimately injury and pain. There is no evidence to support this theory...absolutely none! Many studies support the theory that activity levels have little or no influence on wear and tear of joints or degeneration within the human body. Lots of studies have shown the positive effect of exercise on a healthy spine, so much so that the more rigorous the prescribed exercise the better the spinal discs or joints were.
Another study by Belavy et al (2017) show that athletes that run have stronger discs than sedentary people and that running strengthens the spinal discs. These studies are not limited to the spine - many show the benefits of exercise on knee and hip joints also.
Exercise & Pain
Furthermore a recent study has shown that those that were more active had better natural pain control when compared to those who moved less, suggesting that exercise also affects your ability to tolerate pain.
Exercise has anti-inflammatory effects that may aid in pain reduction and we know that those who exercise more are less likely to suffer from the effects of chronic pain; although this is dependent on frequency, duration and intensity of the exercise and specialist exercise opinion should always be sought.
Additionally, another recent study shows the benefits of strength training in reducing early mortality and as a management strategy in conditions such as cancer and cardiovascular disease, amongst others. But only a minority of the aging population studied are involved in enough strength training.
So, the evidence suggests that exercise is beneficial to health in a variety of ways (heart, lungs, bone strength, balance etc) and that exercise, if prescribed by evidenced based healthcare professionals, DOES NOT cause wear and tear of joints or injury of any type.
But what sort of exercise should be prescribed and how should this be performed?
There is strong evidence that functional (using the three planes of human movement) aerobic and strengthening exercise programmes, both land- and water-based, are beneficial for improving pain and physical function. Our beliefs drive our expectations and our actions, so the provision of good quality evidence-based information from reputable healthcare professionals is important.
We all want to live longer, and we know EXERCISE WORKS for improvements in musculoskeletal health, cardiovascular health and mental health, amongst others, and that a lack of exercise is associated with chronic pain and a major cause of chronic disease.
A key part of any effective exercise programme is guidance, on-going support to influence participation and behaviour in the most appropriate manner with expert opinion. Exercise prescription and condition management should form part of a multi-disciplinary approach from physiotherapists, dietitians, psychologists, GP and other team members ensuring a quality evidenced based approach to health, resulting in greater benefits to YOU.
At Strive Clinic our physiotherapist practices are based on the latest evidence-based rehabilitation techniques for managing musculoskeletal-related pain/dysfunction and it WORKS!
Take Home Messages
- Exercise, if prescribed correctly, does NOT cause joint degeneration or deterioration of any joints.
- Injuries of the spine, osteoarthritis of the hip or knee require prescribed exercise, NOT rest!
- Treatments should be a combination of active (i.e. evidence-based functional exercise) and passive treatments (i.e. manual therapy or acupuncture).
- No Pain, No Gain – Exercise if prescribed correctly should NOT be painful.
- Exercise for 20 mins per day, if correctly performed and at a reasonable intensity, is as valuable as hours of exercise
Stephen McNally PhD, MSc, BSc (Hons), MISCP is Musculoskeletal Physiotherapist at Strive Clinic Killybegs
Hunter, DJ., Eckstein F. (2009) Exercise and osteoarthritis. J Anat Feb: 214(2), 197-2017. doi: 10.1111/j.1469-7580.2008.01013.x
Kraschnewski JL, Sciamanna CN, Poger JM, Rovniak LS, Lehman EB, Cooper AB, Ballentine NH, Ciccolo JT. (2016) Is strength training associated with mortality benefits? A 15year cohort study of US older adults. Prev Med. Jun;87:121-127. doi: 10.1016/j.ypmed.2016.02.038. Epub 2016 Feb 24.
Naugle KM1, Ohlman T, Naugle KE, Riley ZA, Keith NR. Physical activity behavior predicts endogenous pain modulation in older adults. Pain. 2017 Mar;158(3):383-390. doi: 10.1097/j.pain.0000000000000769.
Running exercise strengthens the intervertebral disc (2017) Daniel L. Belavý1, Matthew J.Quittner, Nicola Ridgers, Yuan Ling, David Connell, & Timo Rantalainen https://www.nature.com/articles/srep45975.pdf