Joints wear

Osteoarthritis (OA)

Osteoarthritis (OA) is the most common chronic condition of the joints. In OA, cartilage breaks down, causing bones to rub against each other and even break. This joint degeneration condition occurs in athletes through repetitive impact and loading, most often in the knees, but also in other overworked joints. Football, soccer, hockey and rugby players are under the greatest impact damage.

Other than overuse, risk factors are weight, age, and genetics.

Also known as degenerative joint disease or degenerative arthritis, osteoarthritis affect approximately 29 million Americans. It is especially common among the elderly, but professional and recreational athletes are at higher risk as well.

Joint degeneration occurs in athletes through repetitive impact and loading. The greatest impact damage is caused in sports such as football, soccer, hockey and rugby, where direct blunt trauma to joints is common.

Among the general elderly population, knee OA symptoms are found in every other person, hip OA in 25%, and hand OA in 20%. Osteoarthritis risk is higher among individuals who during their lives were athletes that overused specific joint or suffered from previous joint injuries. More than 80% of either soccer or American football players with a history of knee injury developed osteoarthritis 10 to 30 years after competing. Heavy weight athletes, such as linemen football players and sumo wrestlers, are at additional risk.

There is a substantial inherited tendency for osteoarthritis. A genetic variant in the GDF-5 is a risk factor for joint degredation conditions.

Gene: GROWTH/DIFFERENTIATION FACTOR 5 (GDF5)

Genomic coordinates (GRCh38): 20:35,433,346-35,454,745

GDF-5 is a growth factor involved in bone and cartilage formation. It regulates differentiation of chondrocytes, the cells that produce and maintain the cartilage matrix.

A meta analysis of over 11,000 European and Asian individuals reveals the role of GDF5 variants with osteoarthritis susceptibility. TT variant carriers have close to 50% more risk for OA.

OA symptoms are painful local inflammation, swelling, stiffness and problems moving the joint. However, at early stages, young athletes are harder to diagnose since their pain threshold is relatively higher.

To prevent or reduce joint degradation, load over the joint must be reduced. Strengthening muscles around affected joints, as well as improving joint flexibility is recommended. Reducing weight is another way to reduce the load.

Assistive devices such as walking sticks, custom knee braces and shoe wedges may be considered.