Sports and exercise are an integral part of treating the rheumatology patient. In this slideshow, we summarize studies that address this concept.
In a session at ACR 2018, rheumatologist and sports medicine specialist Andrew Concoff, M.D., spoke of the importance of exercise in arthritis treatment and the value in developing expertise in both rheumatology and sports medicine. In this slideshow, we focus on past and current developments in the use of sports and exercise medicine in rheumatic disease.
Team up sports medicine and rheumatologyhttps://www.acrdailynewslive.org/treating-exercise-induced-injuries-a-necessary-part-of-arthritis-management/Applications of sports and exercise medicine in rheumatologyhttps://academic.oup.com/rheumatology/article/44/2/143/2899340Rheumatologic diseases mimic sports injurieshttps://link.springer.com/article/10.2165%2F00007256-200838110-00003Musculoskeletal spawns chronic diseasehttps://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1151-2How osteoarthritis can be traumatichttps://link.springer.com/chapter/10.1007%2F978-3-319-76735-2_3Sex-based differences in 5 common sports injurieshttps://www.healio.com/orthopedics/sports-medicine/news/online/%7B57a1eb08-f160-4a9d-b2ea-8377803dafa6%7D/sports-medicine-experts-highlight-sex-based-differences-in-common-sports-injuriesJuvenile idiopathic arthritis reduces physical activityhttps://onlinelibrary.wiley.com/doi/abs/10.1002/acr.23795Activity trackers boost physical activityhttps://onlinelibrary.wiley.com/doi/abs/10.1002/acr.23752Exercise elevates arthritis treatmenthttps://www.acrdailynewslive.org/treating-exercise-induced-injuries-a-necessary-part-of-arthritis-management/Exercise education for patients with arthritishttps://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Living-Well-with-Rheumatic-Disease/Exercise-and-Arthritis
Sports medicine and rheumatology. Rheumatologists may view trochanteric pain as a sign of bursitis and treat it with steroid injections when the pain may indicate a tendon problem that could benefit from physical therapy, Dr. Concoff said at ACR 2018. He suggested the need for rheumatologists to differentiate gluteal tendinopathy from trochanteric bursitis. (©AdobeStock_GlisicAlbina)
Applications of sports and exercise medicine in rheumatology. Sports and exercise medicine may be applied in rheumatology in several areas: recognition and management of regional musculoskeletal injuries, applied biomechanics, rehabilitation techniques, specialized exercise prescription and monitoring, monitoring of muscle function and response to therapies, understanding of physiological response to exercise in musculoskeletal disease, and participation in sport with rheumatologic diseases. (©LMProduction,AdobeStock)
Rheumatologic diseases mimic sports injuries. Athletes with injuries related to a specific activity may have systemic pathologies that initially mimic sports-related injuries. In a systematic literature review, numerous athletes who presented with apparent mechanical low back pain, sciatica pain, hip pain, meniscal tear, ankle sprain, or rotator cuff syndrome had manifestations of rheumatologic diseases. Common causes included ankylosing spondylitis, gout, chondrocalcinosis and early rheumatoid arthritis. (©BillionPhotos,AdobeStock)
Chronic disease. In a meta-analysis, the rate of chronic disease (cardiovascular disease, cancer, diabetes, chronic respiratory disease, obesity) was 17% higher in persons who had a musculoskeletal condition (neck or back pain or knee or hip osteoarthritis) than in those who did not. Preventing and treating musculoskeletal conditions and targeting associated chronic disease risk factors in persons with long-standing musculoskeletal conditions may help prevent other chronic diseases. (©Cherries,AdobeStock)
Osteoarthritis can be traumatic. Osteoarthritis can develop after joint trauma affecting all ages, especially athletes and others who engage in high-level physical activity. Traumatic injury often results in joint instability or intra-articular fractures, which lead to post-traumatic osteoarthritis. Several molecular mechanisms are activated, which increases the production and activation of various factors that contribute to disease progression. (©PuwadolJaturawutthichaiShutterstock.com)
Sex-based differences in five common sports injuries. Injuries seen mostly in female athletes: Stress fractures (female athlete triad), anterior cruciate ligament tears, femoroacetabular impingement injuries, and concussions. Those seen mostly in male athletes: shoulder instability injuries. Sports medicine experts said that recognizing sexual dimorphism contributes to effective injury prevention in athletes and customized management for better outcomes.(©AdobeStock_WavebreakMedia)
Juvenile idiopathic arthritis (JIA) reduces physical activity. To objectively measure physical activity in children with JIA, researchers studied their habits in clubâsport, leisureâtime, and schoolâeducational physical activity. Even with low disease activity, they had significantly lower accelerometryâmonitored physical activity levels than healthy controls. They concluded that structured guidance is needed for all patients with JIA in understanding and coping with the consequences of low physical activity. (©AdobeStock_StockDevil)
Activity trackers boost physical activity. The use of wearable activity trackers (WATs) could improve physical activity in patients who have rheumatologic and musculoskeletal diseases. In a systematic review of mostly patients with osteoarthritis, low back pain, or inflammatory arthritis, WATs had a high shortâterm adherence with a significant increase in number of steps and time spent in moderate to vigorous physical activity. A significant increase in pain was found for long interventions. (©RA2Studio _AdobeStock)
Exercise elevates arthritis treatment. Exercise is a major component of effective treatment for patients with arthritis, said Dr. Concoff at ACR 2018. Regular exercise can improve control of a patient’s disease activity as well as the patient’s strength and physical function. Exercise may be used as a treatment for osteoarthritis and as a complement to the medicines used for lupus or rheumatoid arthritis. (©AdobeStock_AntonioDiaz)
Exercise education for patients with arthritis. Arthritis may affect physical activity, making exercise and planned physical activity that much more important, says the ACR. Patients with arthritis who exercise regularly have less pain, more energy, improved sleep, and better day-to-day function. Exercisers should start off slowly with a few, low-intensity exercises. Having several options and locations improves adherence to exercising. Exercise should be a mainstay of treatment for hip and knee osteoarthritis. (©RobertKneschke_AdobeStock)