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Issue 140 ~ 8th December 2023

Hello,  

Like so many medical conditions, we tend to not take much interest in them until they happen to us. I hadn’t thought about arthritis until in 2015 I went to see a specialist about my very painful feet. When he showed me my X-rays, the results were a real shock.

I had always been pretty active but probably not worn the most appropriate footwear when I started teaching aerobics in the late ‘70s. Plus, I had worn high heels constantly since my teenage years because, at barely 5’ 2”, I needed those extra three-inch heels! Now it was all catching up with me – with bells on!

Over the following few years, my arthritis became more and more painful and the high heels had to go, with cushioned trainers becoming my everyday mode of footwear. Thankfully, they came into high fashion – particularly after the pandemic!

Osteoarthritis can occur at any age, even in children, but it is most likely to raise its ugly head as we age, with it most often developing in folks in their mid-40s or older, and it can occur in our knees, hips, hands and spine as well as in our feet and ankles.

There is not a cure for osteoarthritis but we can take painkillers which help, and in severe cases, we can have very painful joints fused which can dramatically reduce pain but it will, of course, inevitably reduce the flexibility of that joint.

When we launched our website in 2021, I was keen to bring in experts in various fields who could help us to grow older healthily and understand how we could manage some of the inevitable consequences of ageing. So, we filmed videos on the painful condition of Arthritis with a Consultant Orthopaedic Surgeon Mr Maneesh Bhatia and neuro-physiotherapist JD Hylton, to learn how best to avoid and manage this condition if we fall victim to it.

The one message that comes across loud and clear from our experts is to keep our weight down and to keep moving! We must learn not to be put off from activity because our feet hurt. Of course, it hurts when I first step out of bed in the morning. My feet hurt at various times of the day – especially when I have been sitting for a while – but the only solution to keeping on top of it is to get moving again otherwise my joints will become even stiffer. But there is a balance.

Personally, I could not go on a five-mile hike because I would be in agony, however, I can do 10,000 steps in a day without any issue (which amounts to five miles) except it has been achieved in smaller distances over a period of 24 hours. I recognise what I can and what I can’t do.

At weekends Mike and I often sit and ‘binge-watch’ a series on TV but after every episode I need to move about and get my joints moving. If I don't, I suffer more pain.

So, what about pain relief? My GP prescribes me two x 500mg paracetamol four times a day, every day. It works wonders but I have learned that I must take it regularly and consistently for it to truly work. It needs to get into my system and then it is remarkably effective for a condition like arthritis. I also take supplements including green-lipped mussel, turmeric and rosehip to help me cope and mostly, I carry on a pretty normal life.

There are times, though, when despite regularly taking my paracetamol, my feet are really painful so I thought I would take just one 200mg Ibuprofen just to help, but when I mentioned it to my GP he said that I definitely should not take Ibuprofen at all and said ‘for someone of your years it could put you at risk of stroke, heart attack and blood clots’! Well, that was a shock but I must stress that this was personal advice for me from my doctor and you should consult your own GP if you have any concerns about this.

I had already heard that Ibuprofen could give you ulcers and other nasties and how important it was to take it with food as a protection to the stomach, but I hadn’t realised it carried so many other potential risks for some people.

This left me with a bit of a conundrum. What action could I take to minimise my pain? Then I remembered Mary’s revelation a few months ago that we don’t have to do 10,000 steps a day to see health benefits. In fact, we can see equivalent benefits from just 7,000 steps or 49,000 steps a week. Now I balance my activity from day to day, so on Mondays when I teach my classes (when I used to go well over 10,000 steps), I cut back on the distance of my early morning walk and I don’t go shopping! Thankfully, no longer are my feet ‘killing me’ on Tuesdays!

In addition, when I want to cut down the distance of my walk, I make sure that I choose a more challenging route that includes at least one uphill section so I still benefit from a good workout. 

As we age there will be things that happen to us that we don’t like very much… memory loss, hearing loss, lack of flexibility and maybe a painful back. But we shouldn’t give in. Let’s try to find the best solution possible to enable us to live as independent a life as we can, for as long as we can.


Learn more about Arthritis, and Rosemary's experiences with the condition in the Health Section of our website.
FASHION TRAINERS

Find out more about Rosemary's love of fashionable but comfortable footwear now that her high heels have been banished to the bin.

Christmas Recipe of the Week

Serves 4
Per serving 265 calories, 3.6g fat
Preparation time: 10 minutes
Setting time: 1 hour

4 fat-free trifle fingers
2 tbsps sweet sherry
4 tsps fruit compote
200g (7oz) fresh strawberries, sliced
1 packet strawberry jelly
1 x 75g packet instant low-fat custard
4 small pots low-fat vanilla-flavoured live yogurt
extra strawberries to decorate

 

  1. Make up the jelly as per the packet instructions and allow to almost set.
  2. Break the trifle sponges into 4 individual trifle dishes, drizzle with sherry and add a teaspoon of fruit compote before covering with sliced strawberries.
  3. When the jelly is almost set whisk with a fork then pour over the strawberries in the dishes, then slice more strawberries on top of the jelly.
  4. Meanwhile, make up the instant custard using boiling water and allow to cool before pouring it onto the second layer of sliced strawberries. Place in the refrigerator.
  5. When completely chilled, cover with the vanilla-flavoured yogurt.
  6. Decorate with fresh strawberries and serve.
In the run-up to Christmas we will be bringing you more seasonal recipes and on 22nd December we will include my full Christmas Dinner guide including Turkey and all the trimmings.
Click here for more recipes

Fun, Facts & Fitness from Mary Morris MSc.


At this time of year quite lot of my conversation with many of those in the older generation is all about their joints. 'Oh, my knees are giving me so much grief at the moment' or 'my hips are not happy!', telling us that their aches and pains are far more noticeable in the colder weather. It makes sense really as warmth generated by the heat of the sun in the summer keeps joints more 'oiled' and therefore less stiff.  

It's not just the weather that can make our joints very stiff. Getting up first thing in the morning and sitting for long periods are times when we notice how stiff those joints are. We then start to notice that simply getting up and moving about relieves so much of that discomfort. This is a clear indication that the more we move the better!

The most common form of arthritis is osteoarthritis, and the older we get the more likely it is we will have some level of ‘OA’. It is the most frequent cause of disability among older adults and comes from wear and tear over many years, with the loss of cartilage in our joints. Cartilage is designed to cushion our joints and helps to absorb any pressure we put on it. Once that is reduced, we end up with bone on bone making everyday activities such as stair climbing and even standing still very painful.
 

Walk, Walk, and Walk some more!

Fortunately, simply taking regular daily walks can help combat these symptoms and positively impact our cartilage. One study found that those who walked for exercise have increased levels of a substance called interleukin in the body which is a chemical that protects cartilage tissue. The same study found that those who walked had lower levels of a protein found in the blood that is known to speed up cartilage breakdown. 

Our knee cartilage also has a very limited blood supply. It depends on the synovial fluid (the ‘oil’) we find in our joints for its nutrition and it is only stimulated by an activity like walking. Walking helps to flood our joints with this 'oily' substance that allows the joint to move more freely. My knees are not the best after more than 50 years of wear and tear as an exercise instructor and when I first set off on a walk I am often concerned for my knees as they feel 'vulnerable', but 10 minutes later I never give them a second thought!

All good news from such a simple activity!
 

Strong Muscles Support Joints

Importantly, walking alone is not enough. Adding regular strength training to our walks guarantees that we are doing all we can to develop and maintain healthy joints. We need to add specific repetitive moves that build strength around the joint structure. This then ensures that the joint is supported by those ligaments and tendons that hold our joints together and can cope with any stresses we may put on it. Below are some of the key body areas where arthritis may be setting in, with some key exercises that will develop strength around that particular joint. 

 

Arthritis in the Knees
The knee is one of the most common joints to be affected by arthritis. Pain, swelling and stiffness from loss of the cartilage can make life very difficult physically. Achieving and maintaining a healthy weight is critical in helping this situation. For every extra 3lbs we may be carrying we are adding 10lb in extra pressure on the knees! Staying active every day is one of the major ways to help ourselves. Ultimately, we may need a total knee replacement or a partial one as Rosemary has experienced recently, but until that day comes we must do the best we can to keep those knees moving!

Best exercises: 
  • Besides regular walking the best strength work is based on leg extensions. Sitting upright on the front third of a sturdy chair, simply lift one leg up to fully extend the knee and hold for a second before lowering slowly. Do 6 - 10 repetitions before changing legs. This ensures the muscles that support the side of the knee are strengthened and the quadriceps at the front of the thigh are well exercised and strong.
     
  • Another great knee strength exercise is to use a resistance Toning Band to take the full knee extension a stage further. Still sitting on the front third of a sturdy chair, bend one knee toward your chest and place the band underneath your foot. Hold the band in each hand taught enough to keep it under your foot. With elbows close to your side, hold the band firmly and extend the bent leg out in front of you against the resistance of the band and in again. Repeat 6 - 10 times before changing legs. This significantly strengthens the muscles supporting the knee. Repeat again with each leg, ideally two or three times a day.
     

Arthritis in the Hips
This is another common area for arthritis with hip replacements being a highly successful strategy to give back our mobility and take away the pain. But until that day comes 'motion is lotion' so let’s work hard to stay as mobile as we can and work to build strength around the joint. If we go into surgery as strong as possible, our recovery will be so much better.

Best exercise:

  • Lie on your side preferably on the floor (or a bed can be used as an alternative). Bend both knees at a 45-degree angle and only lift your top knee up, keeping the feet still connected. Keep the hips stacked on top of each other. Hold for a second then lower slowly. Do 10 times on each side. This ensures that you strengthen the deep hip stabilisers that have such a crucial role in supporting the hip joint.   

 

Arthritis in the Wrists and Hands
The wrist is prone to arthritis because the 8 bones that make up the joint have no muscle or tendon attachments and therefore have very little protection from everyday wear and tear. When I encourage my groups to do press-ups, I know they will moan about their wrists! However, the benefit of a press-up to their upper body strength far outweighs the short-term pain from loading the wrist.

We may notice arthritis in our most used finger joints – that's because they have more wear and tear than our other fingers.  When I wake up every morning, I do a little routine with my hands to wake them up. Go to the website for The Hand Dance to learn a few good moves.

Best exercise:

  • Simply rotating the wrists regularly is all that is needed, and for the fingers do 'creepy crawlies'.  Imagine your fingers like a spider’s legs moving very fast!

 

Arthritis in the Feet
Each foot contains 33 joints, 26 bones and more than 100 muscles, tendons and ligaments so plenty of opportunities for things to go wrong! That loss of cartilage means that the feet can become misshapen and the bones become deformed. This seriously affects joint function and sufferers must endure a lot of pain, particularly as our feet carry all of our weight every time we walk or stand! Wearing the most comfortable, even cushioned, footwear may help you to keep walking and perhaps try to take your walks in shorter periods of time, say 10 or 15 minute blocks instead of 30 minutes.

Best Exercise:

  • Sitting on a chair, lift alternate heels pressing the big toe joint into the floor to maintain movement at the big toe joint and try a Mexican wave with the other toes. The Foot Workout on the website will give you more ideas.

This Week's Fitness Challenge


  1. Make joint movements a priority this week to 'oil' them. Start with rotation of the shoulders, then rotate the upper body for your spine, lift alternate knees for your hips and alternate heel lifts for your ankles and feet. Do The Foot Workout twice this week.
     
  2. On your daily 30+ minute walks this week focus more on your posture so your joints are held in the right place.  Shoulders back and down, looking straight ahead with a good heel/toe action of the feet.
     
  3. Do the Post Walk Stretches after every walk as they take the joints beyond a normal range keeping them more mobile. 
Did you know... 

You can now go on a public tour of Big Ben?
 

With Rosemary and Mary talking about the health benefits of stair climbing in recent weeks, did you know that since the refurbishment and restoration of the famous clock at the Palace of Westminster you can now climb the 334 stairs to stand next to the enormous Big Ben bell as it strikes the hour? (Ear plugs are provided!)

The climb is not for the faint-hearted, although it is broken into three sections with stops along the way while the tour guides explain the history of the world's most famous clock, how it works and how it became a cultural icon of London.

For more information visit 
www.parliament.uk/visiting/visiting-and-tours/big-ben-tour/

And finally...

When we are diagnosed with a ‘new’ bit of our body that isn’t working like it used to, let’s not throw in the towel and put it down to old age. Instead, let’s work hard to prevent further issues if we can (looking at our parents might give us a clue of potential problems) and let’s do the best we can to delay them! We’re not quitters - we’re fighters!

Have a great week.

With love and best wishes,

Rosemary Conley CBE DL

LIVE LONGER | LIVE HEALTHIER | LIVE HAPPIER

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