Health Features

Keep Moving: Bone & Joint Health

Whether you’re feeling stiff or hearing a few extra creaks when you stand up, it’s no secret that our bones and joints change as we get older. But that doesn’t make it any less important to stay active. Even after joint replacement or other orthopedic procedures, exercise needs to remain an important part of your routine.

before surgery
Ryan Knuckles, DPT, clinic manager at CORA Physical Therapy in Ballwin, says weight-bearing exercise and resistance training are important to promoting bone and joint health. “They help with bone formation when you’re growing, and they protect your bones as you age,” he explains. “The stronger your body, the more stable your joints. Motion is lotion. It’s important to keep moving.” He adds that developing a strong core also improves balance and coordination, which reduces the risk of injury.

As you age, it’s important to keep active, but Knuckles says your fitness routine should evolve with your changing needs. One common adjustment is limiting high-impact exercise, especially if you have arthritis. “You don’t typically see older individuals doing a lot of dynamic movement,” he notes. “Walking or the elliptical are great, but I wouldn’t necessarily recommend distance running.”

SSM Health orthopedic surgeon Dr. Gregory Nelson adds that individuals should use discomfort as a gauge for determining their limits. “It’s rare that physical activity will worsen the underlying pathology,” he explains. “It’s important that people identify exercises they can do that don’t leave them in pain afterward. If you have arthritis but are already in good shape, you’ll most likely be fine running or playing basketball.”

Nelson says that 30 minutes of low-impact, aerobic activity four or five times a week is a good goal for people to maintain their bone and joint health. “Senile osteoporisis is the natural softening of bone as we age, but you can slow the process by performing regular weight-bearing exercises,” he notes. “The body is designed to move, but we’ve developed into a very sedentary society, and that creates issues. I tell my patients to use it or lose it.”

low-impact exercises

  • Walking
  • Yoga & stretching
  • Water aerobics
  • Swimming or water walking
  • Cycling

other factors
While physical activity plays an important role in bone and joint health, Nelson notes that there are other lifestyle adjustments you can make to improve your outcomes.

  • Vitamin D: It plays an important role in healthy bones because it helps your body absorb calcium. “Women need to be especially careful of a deficiency,” Nelson says. “Having children and loss of estrogen in later years can accelerate bone density loss.”
  • Smoking: Nicotine is known to cause weak bones, according to Nelson. Alcohol and majriuana can have similar impacts.
  • Diet: SSM Health researchers found that putting patients on a high protein diet before surgery improved their outcomes and reduced the risk of complications. According to Nelson, this may be because many people are undernourished. “Before surgery, people should be making lifestyle changes,” he notes. “These include limiting alcohol, increasing exercise and improving nutrition.”

after surgery 
Recovery from orthopedic surgery often begins before the procedure. Prehabilitation, or prehab, can improve your outcomes, according to Jodi Klott, DPT, clinical manager at CORA Physical Therapy in Creve Coeur. “It works to increase your range of motion prior to surgery, which can really help,” she says. “If you’re already focusing on moving, the likelihood of improved motion and a smoother recovery are increased.”

Nelson notes that a return to physical activity depends on the nature of the procedure. “In the vast majority of elective surgeries, meaning not trauma or a broken limb, the goal is to regain function and preserve the patient’s lifestyle,” he says. “Exercise is part and parcel of the recovery process and goals.” He adds that with joint replacement, the physical rehabilitation process can begin as early as the night of surgery. However, if repair is involved with the procedure, a period of immobilization may be required to protect the limb while it heals.

It’s important not to wait too long to start therapy, Klott says. Taking too much time could make regaining motion and flexibility more difficult due to scar tissue and other factors. “While the body does need to heal and go through its natural responses to having a procedure, physical therapy helps promote motion and decrease pain,” she explains. “It will drive an increase in both function and quality of life.”

According to Klott, physical activity also improves stability and balance, and it’s critical that patients continue exercising after they are done with formal rehabilitation. “If you don’t stretch and stay active, even getting out of a chair can become hard,” Klott says. “We don’t recommend doing these things just to do them. They help with your daily life. Whether it’s walking the dog or playing with the grandkids, it’s important to be able to move your body.”

Nelson says he counsels patients not to think of orthopedic surgery as just a solution to stop pain. “It’s part of a process to transition to a healthier way of living,” he explains. “You also need to think about your diet, weight and physical activity level. If you treat bone and joint surgery like a lifestyle intervention, not only will you likely see better outcomes, but it can help improve your overall health.


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