Osteoarthritis and CyclingOld- age, ageing, wear- and - tear are important factors that impact on the skeletal axial system of man. Cyclists in the veteran and senior age- groups also suffer the consequences of OA. Discomfort is experienced in the neck, thoracic and lumbar vertebral areas. Involvement of one on both knee joints is very common after the age of 50- years. Soft- tissue around the joints are also affected to a degree. Cycling four times a week is very hard on the ageing body above the age of 50- years. Recovery is slow and more rest is needed. A bad back or knee are often disabling, cessation of cycling, partially or permanently is the usual outcome. "Rheumatism" often accompanies OA resulting in a feeling of tiredness or asthenia in the afternoon. OA is a seperate entity from RA, but may accompany it.
How does OA restrict the activity of the cyclist?
What goes wrong in osteoarthritis?
Osteoarthritis, commonly affects weight bearing joints and is characterized
by degenerative changes in the articular hialine cartilage. Factors that
contribute to this disorder include occupational strain, genetic factors, old
joint fractures, hormonal factors, obesity, rugby injuries, altered joint
alignment, wear- and- tear of increasing age with repeated trauma or irritation.
It is a progressive disease in which the articular cartilages gradually soften
and disintegrate. Pain and restriction of joint movement is the result and
follows on often- repeated slight trauma of the cartilage. The onset is slow and
insidious but may fluctuate. An early symptom is joint stiffness experienced
after rest and disappearence on movement. A soft creaking (crepitus) can be felt
or heard. Pain and swelling follow.
Cycling problems with OA
Cycling advice for golden oldies
For the golden oldy,OA in a knee or the back is not good news. Severity of involvement will determine the outcome
Warm up and down
Don't push yourself to the limits. Use a heart- rate monitor
Be careful with the use of pain- killers. Cycling may, however be impossible without them. Pills have side- effects and may affect the liver and kidneys. Paracetamol in pharmacological dosis is usually prescribed (0.5 gm- 1 gram) 6 hourly. For cycling, this agent is mostly ineffective, but safe.
NSAIDS are frequently needed and abused. The result can be progression of the disease (abuse of indomethacin), oliguria, bleeding stomach ulcers, heartburn, reflux and renal failure. There is a wide choice of products (ibuprofen is frequently prescribed). The efficency of the products is currently much the same. A combination of NSAIDS is to be discouraged. Long- term treatment is detrimental. Reasses the situation after 3 weeks of treatment. Avoid narcotic analgesics- rather stop cycling than going over to this drastic step. The new Cox- 2 inhibitors are available in the RSA. Side- effects are refuted to be less- this has advantages. Compared to older drugs, Cox- 2 inhibitors, have not been shown to be more effective. They are a good alternative to the conventional NSAIDS but are very expensive.
Stretching and local rubs, are important. A knee- guard may bring temporary relief. A back brace is of benefit for a sore upper back.
Consider a visit to a physiotherapist, rheumatologist, chiropracter or orthpaedic surgeon.
Avoid unnecessary invasive testing and operations. In some cases, a joint
washout may be of value- consult an orthopaedic surgeon and obtain a second
Frequently Prescribed NSAIDS AND DRAWBACKS
Drug Side- effects