Exercise and Osteoarthritis: Not Necessarily an All-or-Nothing Proposition!

Abstract

Often the mind-set at the start of a new calendar cycle — which may take the form of a New Year’s resolution — is to adopt healthy behaviors that promote and sustain good health and reduce the risk of significant morbidity and premature mortality. Three of the leading causes of mortality in modern society are coronary heart disease, cancer, and stroke1,2. A risk reduction strategy for cardiovascular disease includes improving control of known risk factors, for example, ameliorating an unfavorable lipid profile and enhancing control of hypertension and diabetes mellitus3. Similarly, the risk of malignancy is profoundly influenced by unhealthy consumption of tobacco and excessive alcohol4,5,6. Reduced levels of these products are frequent targets of health improvement resolutions to diminish one’s susceptibility to adverse cardiovascular events, incident cancer, and all-cause mortality. Thus the incorporation of regular forms of physical activity into one’s daily and weekly routine is frequently heralded at the beginning of the new year. Exercise has been demonstrated to reduce incident cardiovascular disease, cancer, and overall mortality7,8,9,10,11. However, in the realm of the musculoskeletal system, is the relationship of exercise to arthritis health necessarily and unequivocally beneficial? In this issue of The Journal Fries, et al 12 implore the rheumatology community to advocate strongly for increasing physical activity in society at large as a strategy with clear-cut benefit for the prevention and treatment of osteoarthritis (OA) of the knee. Further, they call into question the accuracy and validity of the findings of a recent Journal article and accompanying editorial, which concluded that vigorous forms of exercise that entail breaking into a sweat actually increase the risk for future knee replacement13, … Address correspondence to Dr. Gelber; E-mail: agelber{at}jhmi.edu