Stay in the Game: Joint Health for Active Families

Joint pain is one of the most common reasons people pull back from the activities they love. Dr. James Johnston, Chief of Orthopedics at GBMC and a board-certified surgeon specializing in hip and knee replacements, says the first step toward managing pain well is understanding what's actually causing it. 

Dr. Johnston breaks musculoskeletal pain into three categories. Soft tissue pain (tendinitis, bursitis, or muscle pulls) tends to flare after exercise and typically settles down within 45 minutes of rest. Nerve pain is intense, often radiating, and capable of dominating every part of your day. Think sciatica or a pinched nerve. Joint pain, the kind associated with arthritis or meniscal tears, falls somewhere in between, a deep ache that can linger for days or even weeks after activity. 

Treatment depends on which type of pain is present. Arthritis, in particular, is often misunderstood. Dr. Johnston describes it as a gradual loss of cartilage, which is the cushioning between bones. He uses an analogy of tire tread wearing down over time. Once enough cushion is gone, the bone underneath starts to feel the pressure. 

"Cartilage doesn't have any sensation," he said. "As you lose it, you don't really notice it until you get to the end and the bone underneath starts feeling that pressure." A flare-up from a workout that once would have resolved in a day or two might now linger for weeks. 

The good news is the vast majority of cases respond well to conservative treatment. 

"Eighty to 90 percent of the time, just with anti-inflammatories, rest, activity modification, maybe a little bit of bracing, most people will get back to their normal function," Dr. Johnston said. The goal then becomes preventing the next flare-up.

 For people with arthritis who want to stay active, swap high-impact movement for low-impact alternatives: walking or swimming as opposed to running, chair exercises or yoga as opposed to high-intensity workouts. 

He also points to weight as a major factor. Reducing body weight meaningfully decreases force across the joints and can extend how long people stay active and pain-free. 

Bone health is another area worth attention, especially for older women, who lose muscle mass alongside bone density as they age, which can increase fall risk. 

Dr. Johnston and his team see patients at GBMC by appointment as well as in two walk-in orthopedic clinics available on the main campus and at the GBMC Health Partners Primary Care—Padonia location.