As the saying goes, “the legs get older first”, which means that as we age, the human joints, especially the bones of the knee joint, are damaged due to years of wear and tear, and the cartilage at the joint surface is damaged, and the bone and cartilage tissues undergo proliferative changes, forming bone spurs, narrowing the joint cavity gap, and the bone spurs stimulate the surrounding tissues, compressing the nerves and blood vessels, causing joint pain and discomfort. At the same time, the ligaments around the joints relax, resulting in joint instability, and the tissues inside and outside the joints are prone to fibrous adhesions, especially for those who do not like sports, muscle strength also decreases, and the muscle strength and ligament elasticity related to the joints are gradually weakened, so there is weakness in the legs and feet. Lv Liangjing, Department of Rheumatology, Shanghai Renji Hospital Osteoarthritis is also known as osteophytes, bone spurs, degenerative arthritis, age-related arthritis, etc. All these names have some reasonable components, but they are for the same disease, and the current international terminology is “osteoarthritis. The incidence of osteoarthritis increases with age, with a prevalence of 50% in people over the age of 50 and slightly more in women. The main cause of osteoarthritis is the “wear and tear” of joint cartilage. Normal joints are similar to bearings, with arthritic cartilage between the friction surfaces, which is smooth and wear-resistant, so it is flexible and painless when moving around, and can be used for decades without breaking down. So what is articular cartilage? It is the thin white layer of brittle bone that we usually eat when we eat chicken, duck or ribs. After decades of operation of the human body, some of the cartilage in the joints is worn out, cartilage is different from bone, once the cartilage is worn out, it is difficult to regenerate. Without the protection of cartilage, the bones grind against the bones when walking, and the periosteum and the surrounding synovial membrane are rich in nerves, so it is very painful. The development of osteoarthritis is progressive and does not stop, just as people cannot return to their old age. Some activities can accelerate the wear and tear of joints, such as high heels, obesity, stair climbing, etc.; inappropriate exercise can cause even more wear and tear on the joint surfaces. What should I do if I have osteoarthritis? For patients with early to mid-stage osteoarthritis, while maintaining proper weight, adjusting lifestyle, and performing reasonable exercise and muscle strength exercises, different medications can be given for specific conditions to relieve symptoms, delay joint wear, and protect joints. With the advancement of science and technology, research has shown that it is possible to regenerate non-regenerative articular cartilage by promoting the differentiation of our own stem cells. See our previous WeChat (January 19, 2015) for details and results. Diet and exercise tips for patients with osteoarthritis: There are no special contraindications in the diet of patients with osteoarthritis. Pay attention to proper supplementation of protein, calcium, and collagen, such as milk, dairy products, soybeans, soy products, eggs, fish and shrimp, kelp, black fungus, chicken claws, pig’s feet, lamb shanks, and beef knuckles, to prevent osteoporosis. For obese people, it is necessary to control the diet appropriately, pay attention to adjusting the diet structure, reduce calorie intake, and keep the weight within the appropriate range to reduce the pressure and wear and tear on the joints. Life is about exercise. Patients with osteoarthritis need to avoid high-intensity weight-bearing exercise, but also need to have a certain amount of activity. So which exercises are good for osteoarthritis? Which ones are harmful? Beneficial exercises: 1) Joint range of motion exercise: This refers to the daily exercise of moving the joints in various directions and trying to keep the joints as open as possible and moving to the maximum tolerable limit. Daily activities cannot replace joint range of motion exercises. Of course, if there is joint pain and swelling, you need to exercise gently to the extent that the pain can be tolerated. 2) Muscle exercise: Strong, powerful muscles can keep the joints stable and make activities more comfortable. 3) Endurance exercise: Endurance exercise not only benefits the joints, but more importantly, it benefits the heart and lungs, and improves mental status. Among the various endurance exercise programs, walking, water exercise and cycling are the most commonly used. Walking is the ideal exercise for patients with osteoarthritis, and should be encouraged after the disease is in remission; water exercise such as swimming or hot springs is especially good for stiff, painful joints, because the buoyancy of the water can reduce the gravity on the joints, and the warm water can also relax the muscles and reduce pain; cycling, especially the kind of bicycle in the gym, is also a good exercise method that does not put too much pressure on the lower limbs of the joints with too much stress. Exercises that are not good for people with osteoarthritis: High-intensity weight-bearing exercises are not good for the joints, specifically: 1) climbing hills and stairs: climbing hills and stairs puts a lot of pressure on the patella in front of the knee, especially when the pressure of going down hills or stairs is two to three times higher than the pressure of climbing upwards. Therefore, patients with osteoarthritis of the knee should try to avoid climbing hills and stairs. 2) Squatting: Some people with osteoarthritis want to exercise muscle strength and joint mobility by squatting, but in fact, this exercise is similar to climbing hills and stairs, which is also bad for the knee, especially the patella, and will accelerate the wear and tear of patellar cartilage. 3) Carrying heavy objects: Carrying or carrying heavy objects will increase the load on the joints. Most elderly people with osteoarthritis suffer from severe joint wear and tear in their old age because they worked hard for their families and children when they were young. Therefore, we should pay more attention to the symptoms of back and leg pain of the elderly at home, take them to the doctor in time and actively adjust their lifestyles, so that they can spend a happy and comfortable old age after a lifetime of hard work! (Wang Suli Lv Liangjing, from Director Lv Liangjing’s personal WeChat platform number: luliangjing920)