A joint effort A joint effort (November 11, 2005)

Movement is key to keep your joints jumping

By Dr. Richard Sandor

Q: How much exercise is too much?
A: When it comes to strong, healthy joints, the rule of thumb is "Use it or lose it!"

Exercise your shoulders, elbows, knees and ankles to keep them strong and working well. The more sedentary the joint, the more vulnerable it is to strain and injury. Do what you love doing, but if it hurts, stop.

Everyone should do some sort of exercise. Correct weight training is good, but make sure it is appropriate for you. Those of middle age and older generally benefit from having some guidance, like a trainer, though most adults who have exercised over the years can manage their own fitness routines. After exercise, if you're in pain, you are either overdoing it or doing it incorrectly. Have any serious joint pain diagnosed.

Q: Should I avoid exercising because I have arthritis?
A: Old-school thought was that exercise and arthritis were incompatible, but current research shows that exercise is an essential tool in managing this ailment.

Regular, moderate exercise builds strong muscle around the joints, reduces joint pain and stiffness, and increases flexibility.

Q: Why do my knees pop and crackle?
A: Knee cracking and popping usually sounds worse than it is, particularly if no pain comes with the noise. Most often, it is being caused by the soft tissue in a joint, so you should consider joint exercises to improve the overall strength of the joint. When the muscles are strong, they take more weight off of the joint. If pain accompanies those joint noises, there may be structural damage in the joint, so have that checked out.

Q: My teen plays a lot of sports and sprains her ankle fairly frequently. When should I take her to the doctor?
A: She should be seen by her doctor if she has severe pain and cannot put any weight on the injured joint, if the area over and around the injury is too tender to be touched, if the injured area looks crooked or has bumps not present on the companion joint, if she can't move the joint or it buckles when she uses it, if there is numbness in the area, if there are red streaks spreading out from the injury, or if the same joint has been injured several times before.

With a moderate sprain there is bruising, some pain and swelling, and she will probably have some difficulty putting weight on the affected joint. Severe sprains completely tear or rupture a ligament and cause more significant pain, swelling and bruising. X-rays or MRIs are sometimes needed to assess the injury and eliminate the possibility of a broken bone.

Q: As a weekend warrior, I injured my knee. Am I looking at permanent damage?
A: Knee pain can represent a spectrum of injuries, including knee cap, meniscus, cartilage or various ligaments. If the pain resolves quickly and doesn't recur, the injury is typically mild. If, however, the pain lasts more than a week, or recurs, or there is significant swelling, the injury is potentially more serious. It requires evaluation by a physician, especially before returning to sports, weekends or otherwise.

Q: I'm recovering from a bout of "tennis elbow." When can I go back to playing tennis?
A: "Tennis elbow" is a nickname for tendonitis. The measure for when you can return to play after this kind of elbow strain is similar to those for other musculoskeletal injuries. You need to recuperate to your normal strength, endurance and flexibility, while avoiding re-injuring the joint. Going back on the court too soon and re-injuring your elbow poses the risk of greater or permanent damage.

Get back in the swing of things gradually, temper your training and adjust your performance expectations. Rest it, ice it and ease back into your game.

Richard Sandor, M.D., is an orthopedic and sports medicine specialist based in Camino Medical Group's Orthopedics department in Sunnyvale.

Have a medical question? E-mail it to Cynthia Greaves at greavec@caminomedical.org.

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