WEBVTT - The Importance of Movement for Osteoarthritis (Abridged Version)

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<v Speaker 1>Hi everyone. I'm Holly Robinson, pete actor, author, advocate, do

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<v Speaker 1>it all mom, and I'm also a caregiver. And this

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<v Speaker 1>is care Walks, a podcast from iHeartRadio and Voltaian Arthritis

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<v Speaker 1>Pain Gel. It's a show for family caregivers who give

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<v Speaker 1>everything to everyone and need to make time for themselves

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<v Speaker 1>through movement. Every episode is designed for you to walk

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<v Speaker 1>as you listen, so just think of me and my

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<v Speaker 1>guests as your weekly walking buddies. We'll hear stories from

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<v Speaker 1>caregivers and gain tips and insights from health experts and

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<v Speaker 1>advocates who know how important it is to take care

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<v Speaker 1>of yourself and manage joint pain due to arthritis that

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<v Speaker 1>often a companies being a caregiver. Together, we'll find community

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<v Speaker 1>ourselves and maybe even alleviate some joint pain in the

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<v Speaker 1>process as we walk together and connect to the best

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<v Speaker 1>parts of being a caregiver. Welcome back to Kara Walks, everyone,

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<v Speaker 1>and thank you for taking time to join us, and

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<v Speaker 1>thank yourself for taking time to make your self care

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<v Speaker 1>a priority. As a reminder, right now you're listening to

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<v Speaker 1>the abridged version of this episode, but if you're looking

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<v Speaker 1>to get a little extra inspiration, don't miss a minute.

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<v Speaker 1>Check out the full length version of this episode in

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<v Speaker 1>your podcast feed. All right, now that's settled, let's dig

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<v Speaker 1>into the episode. Today, we're talking about the importance of

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<v Speaker 1>movement for caregivers living with ostio arthritis to help us

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<v Speaker 1>better understand how joint pain affects caregiving. I will be

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<v Speaker 1>joined by doctor Amanda Nelson, a rheumatologist and associate professor

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<v Speaker 1>at the UNC Thurston Arthritis Research Center. She understands both

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<v Speaker 1>the challenges and the best strategies from managing away from

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<v Speaker 1>her experience working directly with patients, both in clinical care

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<v Speaker 1>and in research. But before we dig in us begin

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<v Speaker 1>our walk. We're going to focus on staying present within

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<v Speaker 1>our bodies and within our movement. Think about the contact

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<v Speaker 1>you're making with the ground. What does that feel like.

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<v Speaker 1>Be sure to relax your shoulders as you walk, pull

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<v Speaker 1>them down from your ears, and breathe in deeply through

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<v Speaker 1>your nose. Feel the sensation of your stomach and your

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<v Speaker 1>chest rising with your breath, and now breathe out through

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<v Speaker 1>your mouth and let everything in your body relax. As

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<v Speaker 1>you breathe, be aware of the air filling in your lungs.

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<v Speaker 1>Can you feel your chest compressing as you slowly release

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<v Speaker 1>the breath. Take a beat to walk through your five senses.

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<v Speaker 1>What do you see around you? What sense are filling

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<v Speaker 1>the air? What do you notice about the way your

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<v Speaker 1>body moves as you set your pace? Now, as you

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<v Speaker 1>settled into your rhythm, I'm going to share my conversation

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<v Speaker 1>with our guest, and together we're going to learn a

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<v Speaker 1>little bit more about how we can all benefit from

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<v Speaker 1>keeping our bodies moving. Today I am joined by doctor Nelson,

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<v Speaker 1>a rheumatologist and Associate professor at the UNC Thurston Arthritis

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<v Speaker 1>Research Center. She understands both the challenges and the best

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<v Speaker 1>strategies for managing oway from her experience working directly with patients,

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<v Speaker 1>both in clinical care and in research. Doctor Nelson, thank

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<v Speaker 1>you so much for joining us on care walks.

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<v Speaker 2>Well, thank you very much. I'm happy to be here.

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<v Speaker 1>I'm happy you're here too. Could you tell us a

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<v Speaker 1>little bit about the work that you do and how

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<v Speaker 1>you have helped joint pain sufferers improve their symptoms.

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<v Speaker 2>Yeah, So, as you mentioned, I'm a rheumatologist and I

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<v Speaker 2>see patients one day a week, and those patients have

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<v Speaker 2>a range of arthritic conditions and a lot of them

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<v Speaker 2>have challenges with mobility. I also do research primarily an osteoarthritis,

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<v Speaker 2>which is the most common form of arthritis, around a

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<v Speaker 2>lot of different aspects, risk factors, disparities, issues of imaging

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<v Speaker 2>and biomarkers, how we might tell people do or don't

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<v Speaker 2>have arthritis, how it might progress, and some novel methodologic

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<v Speaker 2>approaches to try and understand it better for future clinical

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<v Speaker 2>trials and clinical care. The main recommendations around symptomatic improvement

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<v Speaker 2>is exercise, and we have shown in a variety of

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<v Speaker 2>different studies that exercise really does improve pain. Often that's

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<v Speaker 2>not the first thing that happens, so people have to

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<v Speaker 2>work through some initial discomfort. A lot of times, maybe

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<v Speaker 2>they haven't been very active and they have to sort

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<v Speaker 2>of get into the routine and get over some initial

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<v Speaker 2>joint pain. But over time, being regularly active does improve

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<v Speaker 2>the pain and symptoms of arthritis absolutely.

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<v Speaker 1>Some of our listeners might be new to incorporating physical

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<v Speaker 1>activity or movement into their routine, and as we all know,

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<v Speaker 1>I mean I speak for myself, but I think also

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<v Speaker 1>for a lot of other people, just the prospect of

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<v Speaker 1>starting something like that it seems intimidating. So what would

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<v Speaker 1>you say, is the simplest and best way for them

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<v Speaker 1>to get started.

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<v Speaker 2>I think a lot of my patients, and certainly in

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<v Speaker 2>our research studies as well, people are often coming from

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<v Speaker 2>a position of no activity. They're very sedentary. They might

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<v Speaker 2>get up and go to the store, but otherwise, you know,

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<v Speaker 2>on the couch or not engaged in a regular routine.

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<v Speaker 2>And so there's a lot of ways to approach that.

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<v Speaker 2>It depends a lot on where people start. So if

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<v Speaker 2>we're starting from a place of I do nothing but

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<v Speaker 2>sit on the couch, then the first thing we say

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<v Speaker 2>might be, well, during the commercials on the television, we're

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<v Speaker 2>going to stand up and we're going to move around,

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<v Speaker 2>and we're going to do that every single commercial, because

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<v Speaker 2>there's a lot of commercials, and so that can get

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<v Speaker 2>you a long way. If we're from a place of, well,

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<v Speaker 2>I move around in the house, but I don't really

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<v Speaker 2>like to go out and walk, you know, then maybe

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<v Speaker 2>I say you should walk for five minutes a day,

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<v Speaker 2>you know, three days a week. And I work very

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<v Speaker 2>slowly up to a goal of maybe thirty minutes a

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<v Speaker 2>day for three to five days a week. And I

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<v Speaker 2>actually have a walking prescription where I can write this

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<v Speaker 2>out for people and say, look, this is the medicine

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<v Speaker 2>for your arthritis. The medicine for your arthritis is to

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<v Speaker 2>get up and walk. But it's extremely important to meet

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<v Speaker 2>people where they're starting, because if I just start with

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<v Speaker 2>thirty minutes, five days a week, they're going to have

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<v Speaker 2>that exact reaction that I say, there's no way I

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<v Speaker 2>can do that, and I'm not even going to try.

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<v Speaker 2>And so understanding where people are coming from, what their

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<v Speaker 2>barriers are, and really coming up with a plan that's

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<v Speaker 2>going to work for that person, anyone they're caring for,

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<v Speaker 2>you know, working around their schedule. All those things are

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<v Speaker 2>very important to getting people started and also to maintain

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<v Speaker 2>because you know, if they do it once and then

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<v Speaker 2>give up, that doesn't help.

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<v Speaker 1>Okay, let's talk about possible misconceptions about being physically active.

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<v Speaker 1>I can already hear somebody saying, well, woulden movement just

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<v Speaker 1>add wear and tear to my body and potentially make

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<v Speaker 1>joint pain even worse.

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<v Speaker 2>I get that question all the time because it makes sense, right,

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<v Speaker 2>you think, well, if the cartilage is breaking down, then

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<v Speaker 2>what I don't want to do is use the cartilage.

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<v Speaker 2>But it's not quite how it works. So the cartilage

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<v Speaker 2>itself doesn't have its own blood vessels. It doesn't get

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<v Speaker 2>nutrients from the body through the blood like a lot

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<v Speaker 2>of other tissues. And the way that it gets nutrients

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<v Speaker 2>in and waste products out is by compression. So the

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<v Speaker 2>actual loading of the cartilage is how the cartilage stays healthy.

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<v Speaker 2>If people are unloaded, you know, for example, having a

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<v Speaker 2>paralysis event where they really cannot walk, the cartilage degrades

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<v Speaker 2>because it can't get nutrients, and so walking is healthy

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<v Speaker 2>for the cartilage. It actually improves the cartilage function. And

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<v Speaker 2>so it's completely counterintuitive, and I get that, and so

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<v Speaker 2>I'm happy to explain that to folks. But the joint

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<v Speaker 2>wants to be loaded now, it doesn't want to be

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<v Speaker 2>It's not a jackhammer, right, So it's not looking for

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<v Speaker 2>high impact major activity, but it does like some periodic

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<v Speaker 2>loading and unloading, such as we get with walking and

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<v Speaker 2>what else?

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<v Speaker 1>What are some other low impact activities that caregivers with

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<v Speaker 1>joint pain can do besides walking.

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<v Speaker 2>Yeah, so walking certainly the cheapest and easiest we can

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<v Speaker 2>all do it. I have a lot of people who

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<v Speaker 2>benefit greatly from the elliptical system because there's really no

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<v Speaker 2>impact so much as that gliding motion can be very helpful,

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<v Speaker 2>and for people that really have not been moving, have

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<v Speaker 2>a lot of pain, maybe a lot of other comorbid conditions,

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<v Speaker 2>A lot of times water therapy is very helpful, whether

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<v Speaker 2>that's a PT driven aquatherapy program or again like an

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<v Speaker 2>Arthritis Foundation class at a local pool. Often the pool

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<v Speaker 2>is warm, the buoyancy from the water helps to sort

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<v Speaker 2>of take some of that weight off the joints, but

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<v Speaker 2>still they're being loaded in a useful way for the

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<v Speaker 2>physiology of the joint itself. So there's a lot of

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<v Speaker 2>different modalities and it very much again depends on what

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<v Speaker 2>people want. If you're terrified of the water, then I'm

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<v Speaker 2>not going to tell you to do water therapy, but

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<v Speaker 2>that certainly is a great place to start for people

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<v Speaker 2>that have access and enjoy that.

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<v Speaker 1>Can a workout be too minimal to see benefits.

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<v Speaker 2>There's two parts to that. One is any movement is

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<v Speaker 2>better than no movement, and so if you're just getting

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<v Speaker 2>up during the commercials or doing those five minute walks,

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<v Speaker 2>that's way better than the sitting on the couch was

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<v Speaker 2>previous to that. We have to start somewhere, and we

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<v Speaker 2>want to encourage people to start where they are and

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<v Speaker 2>move forward from that point, and any movement is going

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<v Speaker 2>to be of benefit over the longer term. There's still

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<v Speaker 2>some debate about how much we need right So there

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<v Speaker 2>was the ten thousand steps going around for a while,

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<v Speaker 2>and then one of my colleagues did a study that

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<v Speaker 2>showed that maybe six thousand was probably okay for people

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<v Speaker 2>with osteorthritis. There are guidelines out there for how active

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<v Speaker 2>we need to be that can be very daunting if

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<v Speaker 2>we start so, you know, one hundred and fifty minutes

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<v Speaker 2>a week sounds pretty scary, but again it's it's the

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<v Speaker 2>essential piece of just moving. And if that's a very

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<v Speaker 2>small bit at the beginning and we're working up, then

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<v Speaker 2>that's all we can ask anyone to do. We can't

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<v Speaker 2>leap straight to full maximal healthy adult guidelines and go

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<v Speaker 2>from there. That's just not how it is.

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<v Speaker 1>And how do you know when movement pain is pushing

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<v Speaker 1>the limits or overextending?

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<v Speaker 2>So I usually tell people it's okay if you're a

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<v Speaker 2>little sore the next day, that's kind of again to

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<v Speaker 2>be expected if we haven't been doing too much. But

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<v Speaker 2>if it's lasting for a few days or it's really debilitating,

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<v Speaker 2>like I walked yesterday and I'm in bed today. That

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<v Speaker 2>was either too much or there's something else going on.

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<v Speaker 2>If it's a joint pain issue, we shouldn't have red, warm, swollen,

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<v Speaker 2>angry joints, right, So they might be a little bit

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<v Speaker 2>puffy if we were just up and about more, and

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<v Speaker 2>that's okay, that should go away. But if there's you know,

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<v Speaker 2>acute pain, new redness or warmth, something that's never happened before,

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<v Speaker 2>pain in a place that's never happened before, those are

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<v Speaker 2>all things to look out for. But generally what we

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<v Speaker 2>expect is that the joints that hurt might hurt a

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<v Speaker 2>little bit more after the activity, and they might be

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<v Speaker 2>a little sore the next day, and then we should

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<v Speaker 2>be back to where we were going or even feeling

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<v Speaker 2>a little bit better by then. So big changes, though,

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<v Speaker 2>or new things that hadn't happened should be at least evaluated.

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<v Speaker 2>It might be okay still, but we just want somebody

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<v Speaker 2>to take a look and make sure that we're not

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<v Speaker 2>causing a new problem or you know, maybe our gate

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<v Speaker 2>isn't quite right and we're generating some new pain issue

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<v Speaker 2>that we didn't have before. So just being aware of

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<v Speaker 2>our bodies where we started, where we're going, and what

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<v Speaker 2>to expect.

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<v Speaker 1>Well, thank you so much, doctor Amanda Nelson for talking

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<v Speaker 1>to me today on care walks. I love the idea

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<v Speaker 1>of the commercial movement breaks. I think that's a great

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<v Speaker 1>starting place. If you're not in the habit of moving

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<v Speaker 1>just yet, it's important to take it in those little

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<v Speaker 1>by sized pieces, you know, just to get yourself going.

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<v Speaker 1>And I really appreciate having this conversation with you. Thank

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<v Speaker 1>you so much.

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<v Speaker 2>Well, thank you, Holly. It's been fun.

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<v Speaker 1>I want to thank doctor Nelson again for being my

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<v Speaker 1>guest today. I really appreciated our conversation and hope you

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<v Speaker 1>learned as much as I did about finding a movement

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<v Speaker 1>that will help your joint pain and the physical benefits

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<v Speaker 1>of implementing movement as well as what it does for

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<v Speaker 1>our mental health. That's it for today's episode, and don't

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<v Speaker 1>forget to come back next week for another walk with

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<v Speaker 1>our guest actor and caregiver Jenny Garth. We're going to

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<v Speaker 1>talk about her experience as a caregiver for her father

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<v Speaker 1>and how she now prioritizes self care and manages her

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<v Speaker 1>joint pain. And remember, keep walking and don't forget to

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<v Speaker 1>take care of Yourself Too care Walks is produced by

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<v Speaker 1>iHeartRadio in partnership with voltairean arthritis pain Gel, and hosted

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<v Speaker 1>by me Holly Robinson Pete. Our executive producer is Molly Sosha.

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<v Speaker 1>Our head engineer is Matt Stillo. This episode was written

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<v Speaker 1>and produced by Sierra Kaiser, with special thanks to our

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<v Speaker 1>partners at GSK Platform, GSK, Weber Shandwick and Edelman