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Sport, osteoarthritis and prosthesis

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Playing a sport you work your joints. These solicitations will they promote wear or otherwise maintenance of cartilage? If you have a prosthetic hip or knee, can you now take the sport you love or, conversely, should you be careful?

Osteoarthritis, what is it?

Osteoarthritis is the wearing away of cartilage. This precious substance covers the bones in joints. Its exceptional mechanical properties allow it to withstand large compression and shear forces while ensuring the smooth rolling and sliding bone pieces.

However, when the constraints on cartilage exceed its capacity, it insidiously erodes. Unlike bone, it does not heal. Rather, studies show it would take 400 years for it to reconstruct!

To reduce the risk of osteoarthritis and its accompanying pain, stiffness and physical disabilities, avoid certain dangerous sports practices for cartilage. Others, however, prove safe or even beneficial to prevent osteoarthritis or participate in treatment.

The movement is essential to life cartilage

The cartilage is not not passed through the blood vessels. Physical activity causes pressure variations in the tissue and for pumping food from vessels passing into the underlying bone. Conversely, experiments have demonstrated the damaging effects of lack of movement. If an animal is immobilized in a position, the point of contact between the two articular surfaces crashed and cartilage eventually die!

A viscous substance lubricates the cartilage is the synovium. With this natural oil, the rapid movement of bone pieces polishes cartilage maintenance and texture. Rather, a slow and supported friction fighter planes and synovial articular surface. The bike illustrates this phenomenon. To preserve his knee is better "grind" than "crush large gear ratio."

The deeper layers of cartilage are stiffened by perpendicular fiber surface. The pressure guide construction and increases its strength. In contrast, shear stresses can disrupt its structure. In practice sports with many obstacles and directions of change can be harmful to the joints. Conversely, physical activities in a straight line, cycling and even distance running show is usually beneficial.

The movement helps the proper functioning of the joint.

You understood, the right amount of physical activity is beneficial shows the texture of cartilage. But sport maintenance also the function of the joint. Stronger muscles, more flexible, more enduring and coordinated ensure a smoother movement of the joints. The bone pieces do not knock. The pressure on the cartilage are better distributed. This precious fabric is used much less. A varied workout, diverse, well chosen and adapted to your health behaves like a true rehabilitation ... fun too!

Sometimes sport cartilage wears!

Studies show that, in certain circumstances, sport promotes osteoarthritis. This is the case of intensive practices with changes in direction. Marathon runners and high-level cyclists do not have more osteoarthritis than sedentary. Gestures too large amplitudes cause erosion of cartilage. The ball striking promotes wear hip footballer. The hypersouplesse natural dancer abyss joints. After a sprain, the relaxation of the ligaments is responsible for micromovements anarchic bone parts that degrade cartilage. Sport increases the risk of osteoarthritis in the event of localized pressure. This is what happens when he misses a meniscus fragment or when the weight distribution is disturbed by shaped legs parentheses () or X.

Sport promotes osteoarthritis

If you practice a discipline intensively with management changes.
If you have any sequelae of sprains or meniscal tears.
If your flexibility is excessive (hypermobility).
If your joints are abnormally shaped
If you are very overweight

Promoting sports osteoarthritis

Football, rugby.
The basketball, handball.
Tennis, squash.
Volleyball, badminton.
Combat sports

Sport fight against osteoarthritis

If practiced in moderation and in a diversified manner.
If done without changing direction.
If done without support body weight in obesity.
If each of trauma is well cared for.

Sports fighting against osteoarthritis

Swimming, water aerobics.
Cycling, rowing
The cardio on devices (except the race on carpet)
The maintenance gymnastics and flexibility.
Strength training good conduct.

Prostheses, it is also to take over the sport!

Your osteoarthritis of the knee or hip becomes painful and embarrassing in everyday life and especially during your sport. The medication, injections, injections of viscous and physical therapy are not enough to relieve you. You decide to ask you a particular prosthesis to resume physical activities to your heart! It's just a motivation because in many cases, you can resume the sport!

Walking, swimming, water aerobics, cardio indoors, road cycling and golf are not only allowed but also recommended. They maintain the strength, flexibility and coordination of the muscles around the joint made. Some activities with risk of falling can be reversed if you know the technique well and if you stay cautious. This is the case of skiing, horseback riding and mountain biking.

Tennis requires quick races and abrupt changes of direction. That promotes wear of the prosthesis. It is therefore to advise use of playing doubles to limit joint stress. In practice, it is often possible to pursue a reasonable practice simple.

However, other disciplines are strongly discouraged. If a small occasional jogging or hiking on flat terrain is often possible, distance running and trekking are cons-indicated. The receipt of each stride and downhill on uneven ground are responsible for aggressive impact on the prosthesis. Football, rugby, handball, basketball are contact sports and pivots. Trauma and joint friction combine to destabilize and use the prosthesis. These disciplines will also be abandoned.

. - 9 février 2011.

Conflicts of interest: the author or authors have no conflicts of interest concerning the data published in this article.


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The Iroman lack of iron, the other sports too!


Iron is essential to your health and performance. It is a central component of hemoglobin. The latter is contained in red blood cells and gives it color. It is the iron that captures oxygen when blood passes through the lungs. It carries the precious gas to muscles. When they arrived, it drops its cargo which then allows the burning of energy substances and muscle contraction.

When you run or when you jump, your heels hit the ground and the fat pad of the foot of the plant is crushed. It is through many blood vessels. These red blood cells burst and release their hemoglobin. Iron is released into the blood and pass into urine.

Muscle contains a twin sister of hemoglobin, myoglobin. The latter also contains a lot of iron which sets some oxygen. This small local reserve allows starting the contraction before the blood vessels do not provide the necessary complement. When you experience aches, your muscle membranes are victims of micro-fissures. Myoglobin and iron leaves the muscle and gaining the blood. The precious metal is eliminated in the urine.

When you make an effort, the majority of blood flow is directed towards your muscles. There remains very little to the digestive tract and the bladder wall. These organs suffer from lack of oxygen and are shaken with every stride. Small areas are damaged and start to bleed. Red blood cells and iron are lost in the feces and in urine.

You enter the assiduous why athletes often lack iron, especially if they do not take care to concoct "menus and recipes" adapted. Sports are even more concerned since all these iron losses are added the massive elimination of blood during menstruation!

That is why it is good to occasionally perform a blood test to assess the stock in body iron. This levy is necessary when it comes to review a state of fatigue. It unnecessary to dose iron in the blood because the body is able to keep within the limits of normal while the reserves are at their lowest! It is necessary to measure levels of "serum ferritin" because this structure is the storage form of iron.

The bone is strengthened or crack in contact sports


Each sports movement constitutes a solicitation for the bone structure. At each reception process, the tibia runner undergoes vibratory impacts. Unrolling not, the hiker twists slightly small bone in his foot. Even the body-builders, powerfully contracting its muscles, pulls on his bone.

Each strain injures a little bone of sports. Fortunately, during the rest period, the bone trying to rebuild. If time allows, if they bring him the necessary food, it is repaired! It reconstructs even louder than before as if to prepare for new mechanical attacks. This phenomenon is called by coaches cycle decompensation / overcompensation. This process has been described in many body organs and functions: muscle, stock energy, hormones, etc. It is a key driver of growth.

Thus, it was shown that the well-trained marathoner had stronger bones than sedentary. Indeed, its more dense bone structure, higher in fiber and calcium. In addition, the microscopic architecture of the bone is perfectly oriented along the axis of mechanical stresses.

Indeed, the chemical structure of the bone is comparable to reinforced concrete. The protein network is the steel rods. Calcium is comparable to concrete mired these metal axes. At the hip and pelvis direction of the bone structure is very characteristic. On a radiograph, it is found that the fibers leave the femur, the thigh bone, tilt in, come from hip to withstand the weight of the body resting on the hips. The lines of force from the right leg and left leg meet in the middle of the basin and support each other in the manner of the nave of a church.

Physical activity associated with a sufficiently high protein diet, vitamin D and calcium is a great engine of bone construction. This cocktail is particularly useful to hinge periods of life. During growth, it is necessary to eat 4-5 dairy products every day to build strong bones. It should also move: it is essential to practice a sport requiring the running and jumping at least 3 times a week for 30 minutes. In the absence of impact, bones harden less. It has been shown that a young competitive swimmer had lower bone density than sedentary because he was deprived of gravity during those long hours of pool training. In addition, bone densification stops 25 years. At this age you have made up your bone capital for life!

In adulthood, sport reinforces very hard bone and the amount of calcium necessary for the maintenance of bone is still debated. In case of fracture, the rest of the broken area needed a few weeks to allow to "ensnare" the broken area. In addition, gradually increasing mechanical stress are indispensable to "mechanize" the callus. Again, they help to guide the fabric of the bone in the center of the constraints to prepare him for his mission. An increase in calcium intake in consolidation period is proposed by some doctors without that interest has been really shown.

After menopause, the bone structure is gradually degraded to make the brittle bones is osteoporosis. Ladies, remember, your resistance to hip fracture depends on your diet and your sport for 25 years! If physical activity after menopause can no longer denser bones, reduces the loss of bone tissue. So it is advisable to go see jumping around or jog. It is also good to make the soft gym to maintain bone strength to strength. To make the most of this stimulation, it is again necessary to take 4-5 dairy products daily. It should also go out every day to enjoy the sun and make the vitamin D essential for the absorption and calcium binding. Fresh coordinating sports such as Thai Chi or "balance workshops" have proven effective in reducing the risk of falls and fractures.

If the sporting activity is excessive, the micro-cracks caused by impacts on the bones fail to consolidate over the rest. Rather, these lesions worsen in the next workout. Finally the splits right through bone, it breaks without any violent trauma. It is the stress fracture. In a postmenopausal woman, it was demonstrated that 6 hours of sport load per week may be sufficient to break insidiously bones. Among younger adults, this type of injury is favored by dietary deficiencies and hormonal disorders. Lack of calcium, vitamin D and protein alters the rebuild bone victim of microcracks in the exercise. Insufficiency sex hormones reduces the stimulation microscopic chemical plants be responsible for the synthesis of bone tissue. Functional changes occur when the deep depletion of the body. That kind of burnout is most often diagnosed in women because it causes menstrual irregularities and a cessation of menses. The victim is found in a state of "early menopause". In humans this hormone suffering is more insidious but it exists and its effects on bone density are comparable. The sports overwork cocktail, dietary deficiencies and disappearance of rules typically found in young women anorexic. Faced with a stress fracture, the sports physician must remain vigilant. It should not simply treat a "bone". It has an obligation to support a whole person, he is responsible for seeking overtraining or behavioral disorders.

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By Dr. Nicolas Lefevre

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