Sometimes patient’s say it best.

I was talking to a 70-something gentleman today about his arthritic spine and hips.  We were discussing how he could remain functional and pain free now that his acute episode of back pain has resolved.  As we went over sparing strategies, reviewed functional movement patterns, discussed practical exercise, and realistic expectations for his condition…. he interrupted me and said, “So exercise is like massage for the joints“.

“You got it”, I said.  Exercise when performed in reasonable, practical, thoughtful ways is exceptional for general health and control of symptoms like back pain and arthritis.  (Just don’t exercise like a honey badger.) 

Commonly stated benefits from massage:

• increased flexibility/ROM
• reduction in stiffness or rigidity
• increased blood flow, which gives more nutrient delivery for healing & repair
• decreased pain

Reread this list thinking of exercise and joints.  Assuming reasonable exercises and loads were used, would this list still hold true?

This reminds me of hearing Craig Liebenson, DC present and he explained that while we don’t want our patients to be fearful, many of them who are in pain or suffer with disability already are.  If they are fearful, we want them to fear inactivity more than movement.  The caveat here is we must use appropriate movement and appropriate exercise.  To paraphrase, Charlie Weingroff, DPT, “if they’re paying you, you’re an expert, the least you can do is not hurt them”.  Exercise can be like massage for the arthritic joint, just choose exercise wisely and appropriately for the patient and condition at hand.

As my patient left he said, “so if I keep massaging my joints I’ll be fine”.  For the most part, “Yes.”