Osteoarthritis and the Personal Trainer

The average age when someone is diagnosed with osteoarthritis is 50 years old. Pain often starts before then, but joint pain followed by easing of pain with rest and recovery makes most of us figure it’s nothing to see the doctor about. It’s not usually until pain continues through those rest periods that we see the doctor. By then we’ve hit stage 3 or 4.


Normal foot

At stage 3 you’ve lost significant cartilage between bones, require movement changes and likely pain meds. At stage 4, you experience bone-on-bone and you may need a new joint. At these stages, you’ll feel a lot of pain and risk accelerated degeneration if you don’t move in ways that are specifically accommodating to YOUR body. Quit plyometrics (jumping and impact), quit high intensity, limit repetitive motions which means finding highly-varied activities, no running, and even limited walking.

I’m talking about myself. Your friendly neighborhood trainer has stage 3 osteoarthritis in both feet, midfoot and toes.

It seems everyone of us has a joint or two or three we must be careful with. Modifying exercises on the fly and designing work outs to provide full body work outs that account for specific limitations is a basic skill for trainers. I do it every day. But there are a few limitations that truly challenge a strength training routine.

The most difficult limitations are with clients who have weak or limited range in both wrists. The other is feet. Ankles, knees, parts of the spine, hips, shoulders, neck — all these joints limit certain exercises but still allow for basic movements and full body work. You can still challenge cardiofitness as well as muscles to improve. Without using both wrists or feet, however, many body weight and external weight exercises are off the table.

But not all.

Keep Moving or Die

I’ve said it before: strength training IS aerobic training.

Most clients prefer lifting as a challenge to their heart rate rather than moving fast. Maybe you can’t run or walk long distance or even row, but strength training will, indeed, get your heart rate up — if you can maintain enough intensity, enough actual weight through the range of motion. When your wrists are weak or painful, you’re relinquishing body weight exercises like push ups and pull ups as well as external weighted exercises like bench press and bent rows. When your feet are weak or painful, you’re doing seated exercises which limit the challenge to core stabilization and limit the aerobic challenge.

Due to toe and midfoot pain, I’ve had to quit doing push ups & planks, no burpees, no clean & press, no box jumps, no jump ropes, no running, no bending my toes at all. I can’t even walk more than 2 miles. I can still manage back squats, overhead presses, and deadlifts, but the pain is there due to how toes are used for balance. In time, these exercises will be gone from my repertoire, too.

Do you know how hard it is to give up push ups and burpees? Not to mention cleans, which is my favorite core exercise and makes me feel like beast when I rip that bar from the ground. When I did.

Do you wonder why I’m whining to you?

Damaged anything will limit you, make you reconsider what’s safe and effective. Each of us has something, and each of us will have to adapt. Sitting down and quitting is not an option. I’ve seen it in family and in clients: when you stop moving, when mobility goes, so does life.

  • Can you get a challenging work out that improves cardiofitness and lean muscle mass when you can’t jump, run, and must limit even walking?
  • What happens to upper body when you can’t lift a heavy weight or push/pull your body from the floor?
  • And the most frustrating question: what happens to your core when you can’t do standing weight-bearing exercise to any meaningful degree?

Let’s find out.



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