Osteoarthritis in Athletes Versus Nonathletes

Introduction

Joint disorders are observed very commonly in all categories of age groups today. Whether a person is old and aged or an elite-level athlete, joint disorders are inevitable.

What Is a Joint?

A joint is where two bones meet. The shoulder, elbow, knee, and hip are some examples of it, among others. A joint does not involve only bones but also the soft tissues that surround them.

• Bones are hard and dense; the structured framework of collagen and calcium compounds - phosphate and bicarbonate- owing to its strength.

• The ends of the bone are cushioned by a hard, slippery, and flexible tissue called cartilage. It helps reduce friction between the bone surfaces during movement.

• Two bones are connected with the help of ligaments. They keep the joints stable during movement.

• The muscles that lie over the bones are connected to them with the help of tough bands called tendons. These enable the movement of the joints.

All these structures together form the resilient framework known as a joint. When this structure is damaged, it hinders its normal functioning. Joint disorders are multifactorial. Overuse of a joint, injury due to improper movement, chronic damage due to incorrect use, genetic diseases, a sudden accident or trauma - and many more can be various reasons owing to the dysfunctional joint. In this article, one can find relevant information on one of the most common joint disorders - osteoarthritis.

What Is Osteoarthritis?

Osteoarthritis is considered the most common type of arthritis. It is a chronic, degenerative disease that is continually accelerating in its incidence. Although regarded as a joint disease, the most commonly affected region is the articular cartilage at the joint site. The wearing away of the cartilage leads to increased friction between the contacting bone surfaces, which only worsens with time. The elderly are predisposed to osteoarthritis as the degenerating articular cartilage is a sign of aging. However, young athletes and sportspersons have also reported osteoarthritic changes owing to the excessive abuse the joints experience during impact and loading forces, as required by the sport. Repeating the same movements for several months/years ultimately damages the cushioning structure.

What Are the Symptoms of Osteoarthritis?

The symptoms of osteoarthritis in the elderly include:

1. Pain (especially when the joint is moved).

2. Inflamed joint site with increased stiffness of the joint.

3. Reduced mobility in the joint.

4. Loss of stability; feeling unsure of joint’s weight-bearing capacities.

5. Deformed joint structure due to wearing away of its components.

While the symptoms remain more or less similar in young athletes, the threshold of pain is way higher in the youth compared to the elderly. The athlete is either highly tolerant of the pain or negligent to avoid detraining or missing out on competitive opportunities.

How Common Is Osteoarthritis In Athletes?

Athletes are known to engage in various kinds of sports that pose great demands when it comes to movement. Highly explosive sports such as basketball, football, tennis, soccer, and rugby have a prerequisite to have an above-average jumping height, lateral shifts, sudden decelerating, and constantly loading the musculoskeletal system to generate high amounts of power. All these multi-effort movements not only put a load on one’s joints but also cause damage to the joint structure due to insufficient time for the joint to get accustomed to such fast reflexes. Thus, as bizarre as it sounds, young athletes who engage in such high-velocity sports are highly susceptible to developing osteoarthritis in their immediate or near future.

How Is Osteoarthritis Clinically Presented in Athletic Population?

Clinically, unlike the elderly, young athletes do not complain of pain on movement owing to their high threshold for pain and sensitivity. The athlete disregards the mild pain as minor injuries - strains or sprains - commonly encountered during play. However, this pain becomes difficult to ignore as the athlete ages. The stiffness of the joint is another complaint that the athlete might show up with. A stiff joint is the result of osteoarthritic changes in the affected joint. The athlete, for once, may turn a blind eye to pain but cannot disregard a stiff and rigid joint as it greatly hinders the athlete’s mobility and movement during play. Due to the wearing away of joint structure, the bones' cracking or grinding sound can also be heard (also known as the crepitus).

How to Diagnose Osteoarthritis?

Alongside physical examination, the health care provider orders various imaging tests supporting osteoarthritis diagnosis. These tests are common for all age groups. Diagnostic imaging tests, including

• Plain radiography (X-ray).

• Magnetic resonance imaging (MRI scans).

• Computed tomography ( CT scan).

• Laboratory tests.

• Ultrasonography, the use of ultrasound for diagnosing osteoarthritis, is gaining more traction due to its affordability, ease of use, and ability to show the joint from multiple aspects, unlike the radiographic alternates. However, the diagnosis of the disease is highly dependent on the quality of the image as well as the expertise of the technician examining the ultrasound.

What Is the Treatment For Osteoarthritis?

There are many ways to manage osteoarthritis disease. Physical therapy, performed using an exercise regimen that pertains to the specific needs of the athlete, has proven efficacious in recovering and returning to play. Relief from pain and stiffness is the primary goal of rehabilitation. Bracing the affected joint (knee or elbow) with a good-quality brace while playing can reduce the impact of biomechanical forces exerted on the joint.

Other ways to manage the disease include administering Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) that tackle the inflammation and reduce the pain to a great extent. One suffering from immense pain can attain immediate relief upon getting corticosteroid injections into the affected joint. These steroids are known for their anti-inflammatory action and can effectively subside the pain. Surgical intervention involving arthroscopy is the last option. However, it is not recommended for young athletes.

Conclusion

Osteoarthritis is a joint disease that does not go away once acquired. It has to be managed for an entire life by keeping consistent with physical activity that does not exceed the normal limit. Maintaining a proper nutrient-dense diet is important to keep the bones and joints healthy and functional. The athlete desires to attain pre-injury levels of athletic ability, which is impossible as the disease can not be cured. But, with careful management, one can live a long and active life without major restrictions.