Speaker 1: Hi everyone. I'm Holly Robinson, pete actor, author, advocate, do
Speaker 1: it all mom, and I'm also a caregiver. And this
Speaker 1: is care Walks, a podcast from iHeartRadio and Voltaian Arthritis
Speaker 1: Pain Gel. It's a show for family caregivers who give
Speaker 1: everything to everyone and need to make time for themselves
Speaker 1: through movement. Every episode is designed for you to walk
Speaker 1: as you listen, so just think of me and my
Speaker 1: guests as your weekly walking buddies. We'll hear stories from
Speaker 1: caregivers and gain tips and insights from health experts and
Speaker 1: advocates who know how important it is to take care
Speaker 1: of yourself and manage joint pain due to arthritis that
Speaker 1: often a companies being a caregiver. Together, we'll find community
Speaker 1: ourselves and maybe even alleviate some joint pain in the
Speaker 1: process as we walk together and connect to the best
Speaker 1: parts of being a caregiver. Welcome back to Kara Walks, everyone,
Speaker 1: and thank you for taking time to join us, and
Speaker 1: thank yourself for taking time to make your self care
Speaker 1: a priority. As a reminder, right now you're listening to
Speaker 1: the abridged version of this episode, but if you're looking
Speaker 1: to get a little extra inspiration, don't miss a minute.
Speaker 1: Check out the full length version of this episode in
Speaker 1: your podcast feed. All right, now that's settled, let's dig
Speaker 1: into the episode. Today, we're talking about the importance of
Speaker 1: movement for caregivers living with ostio arthritis to help us
Speaker 1: better understand how joint pain affects caregiving. I will be
Speaker 1: joined by doctor Amanda Nelson, a rheumatologist and associate professor
Speaker 1: at the UNC Thurston Arthritis Research Center. She understands both
Speaker 1: the challenges and the best strategies from managing away from
Speaker 1: her experience working directly with patients, both in clinical care
Speaker 1: and in research. But before we dig in us begin
Speaker 1: our walk. We're going to focus on staying present within
Speaker 1: our bodies and within our movement. Think about the contact
Speaker 1: you're making with the ground. What does that feel like.
Speaker 1: Be sure to relax your shoulders as you walk, pull
Speaker 1: them down from your ears, and breathe in deeply through
Speaker 1: your nose. Feel the sensation of your stomach and your
Speaker 1: chest rising with your breath, and now breathe out through
Speaker 1: your mouth and let everything in your body relax. As
Speaker 1: you breathe, be aware of the air filling in your lungs.
Speaker 1: Can you feel your chest compressing as you slowly release
Speaker 1: the breath. Take a beat to walk through your five senses.
Speaker 1: What do you see around you? What sense are filling
Speaker 1: the air? What do you notice about the way your
Speaker 1: body moves as you set your pace? Now, as you
Speaker 1: settled into your rhythm, I'm going to share my conversation
Speaker 1: with our guest, and together we're going to learn a
Speaker 1: little bit more about how we can all benefit from
Speaker 1: keeping our bodies moving. Today I am joined by doctor Nelson,
Speaker 1: a rheumatologist and Associate professor at the UNC Thurston Arthritis
Speaker 1: Research Center. She understands both the challenges and the best
Speaker 1: strategies for managing oway from her experience working directly with patients,
Speaker 1: both in clinical care and in research. Doctor Nelson, thank
Speaker 1: you so much for joining us on care walks.
Speaker 2: Well, thank you very much. I'm happy to be here.
Speaker 1: I'm happy you're here too. Could you tell us a
Speaker 1: little bit about the work that you do and how
Speaker 1: you have helped joint pain sufferers improve their symptoms.
Speaker 2: Yeah, So, as you mentioned, I'm a rheumatologist and I
Speaker 2: see patients one day a week, and those patients have
Speaker 2: a range of arthritic conditions and a lot of them
Speaker 2: have challenges with mobility. I also do research primarily an osteoarthritis,
Speaker 2: which is the most common form of arthritis, around a
Speaker 2: lot of different aspects, risk factors, disparities, issues of imaging
Speaker 2: and biomarkers, how we might tell people do or don't
Speaker 2: have arthritis, how it might progress, and some novel methodologic
Speaker 2: approaches to try and understand it better for future clinical
Speaker 2: trials and clinical care. The main recommendations around symptomatic improvement
Speaker 2: is exercise, and we have shown in a variety of
Speaker 2: different studies that exercise really does improve pain. Often that's
Speaker 2: not the first thing that happens, so people have to
Speaker 2: work through some initial discomfort. A lot of times, maybe
Speaker 2: they haven't been very active and they have to sort
Speaker 2: of get into the routine and get over some initial
Speaker 2: joint pain. But over time, being regularly active does improve
Speaker 2: the pain and symptoms of arthritis absolutely.
Speaker 1: Some of our listeners might be new to incorporating physical
Speaker 1: activity or movement into their routine, and as we all know,
Speaker 1: I mean I speak for myself, but I think also
Speaker 1: for a lot of other people, just the prospect of
Speaker 1: starting something like that it seems intimidating. So what would
Speaker 1: you say, is the simplest and best way for them
Speaker 1: to get started.
Speaker 2: I think a lot of my patients, and certainly in
Speaker 2: our research studies as well, people are often coming from
Speaker 2: a position of no activity. They're very sedentary. They might
Speaker 2: get up and go to the store, but otherwise, you know,
Speaker 2: on the couch or not engaged in a regular routine.
Speaker 2: And so there's a lot of ways to approach that.
Speaker 2: It depends a lot on where people start. So if
Speaker 2: we're starting from a place of I do nothing but
Speaker 2: sit on the couch, then the first thing we say
Speaker 2: might be, well, during the commercials on the television, we're
Speaker 2: going to stand up and we're going to move around,
Speaker 2: and we're going to do that every single commercial, because
Speaker 2: there's a lot of commercials, and so that can get
Speaker 2: you a long way. If we're from a place of, well,
Speaker 2: I move around in the house, but I don't really
Speaker 2: like to go out and walk, you know, then maybe
Speaker 2: I say you should walk for five minutes a day,
Speaker 2: you know, three days a week. And I work very
Speaker 2: slowly up to a goal of maybe thirty minutes a
Speaker 2: day for three to five days a week. And I
Speaker 2: actually have a walking prescription where I can write this
Speaker 2: out for people and say, look, this is the medicine
Speaker 2: for your arthritis. The medicine for your arthritis is to
Speaker 2: get up and walk. But it's extremely important to meet
Speaker 2: people where they're starting, because if I just start with
Speaker 2: thirty minutes, five days a week, they're going to have
Speaker 2: that exact reaction that I say, there's no way I
Speaker 2: can do that, and I'm not even going to try.
Speaker 2: And so understanding where people are coming from, what their
Speaker 2: barriers are, and really coming up with a plan that's
Speaker 2: going to work for that person, anyone they're caring for,
Speaker 2: you know, working around their schedule. All those things are
Speaker 2: very important to getting people started and also to maintain
Speaker 2: because you know, if they do it once and then
Speaker 2: give up, that doesn't help.
Speaker 1: Okay, let's talk about possible misconceptions about being physically active.
Speaker 1: I can already hear somebody saying, well, woulden movement just
Speaker 1: add wear and tear to my body and potentially make
Speaker 1: joint pain even worse.
Speaker 2: I get that question all the time because it makes sense, right,
Speaker 2: you think, well, if the cartilage is breaking down, then
Speaker 2: what I don't want to do is use the cartilage.
Speaker 2: But it's not quite how it works. So the cartilage
Speaker 2: itself doesn't have its own blood vessels. It doesn't get
Speaker 2: nutrients from the body through the blood like a lot
Speaker 2: of other tissues. And the way that it gets nutrients
Speaker 2: in and waste products out is by compression. So the
Speaker 2: actual loading of the cartilage is how the cartilage stays healthy.
Speaker 2: If people are unloaded, you know, for example, having a
Speaker 2: paralysis event where they really cannot walk, the cartilage degrades
Speaker 2: because it can't get nutrients, and so walking is healthy
Speaker 2: for the cartilage. It actually improves the cartilage function. And
Speaker 2: so it's completely counterintuitive, and I get that, and so
Speaker 2: I'm happy to explain that to folks. But the joint
Speaker 2: wants to be loaded now, it doesn't want to be
Speaker 2: It's not a jackhammer, right, So it's not looking for
Speaker 2: high impact major activity, but it does like some periodic
Speaker 2: loading and unloading, such as we get with walking and
Speaker 2: what else?
Speaker 1: What are some other low impact activities that caregivers with
Speaker 1: joint pain can do besides walking.
Speaker 2: Yeah, so walking certainly the cheapest and easiest we can
Speaker 2: all do it. I have a lot of people who
Speaker 2: benefit greatly from the elliptical system because there's really no
Speaker 2: impact so much as that gliding motion can be very helpful,
Speaker 2: and for people that really have not been moving, have
Speaker 2: a lot of pain, maybe a lot of other comorbid conditions,
Speaker 2: A lot of times water therapy is very helpful, whether
Speaker 2: that's a PT driven aquatherapy program or again like an
Speaker 2: Arthritis Foundation class at a local pool. Often the pool
Speaker 2: is warm, the buoyancy from the water helps to sort
Speaker 2: of take some of that weight off the joints, but
Speaker 2: still they're being loaded in a useful way for the
Speaker 2: physiology of the joint itself. So there's a lot of
Speaker 2: different modalities and it very much again depends on what
Speaker 2: people want. If you're terrified of the water, then I'm
Speaker 2: not going to tell you to do water therapy, but
Speaker 2: that certainly is a great place to start for people
Speaker 2: that have access and enjoy that.
Speaker 1: Can a workout be too minimal to see benefits.
Speaker 2: There's two parts to that. One is any movement is
Speaker 2: better than no movement, and so if you're just getting
Speaker 2: up during the commercials or doing those five minute walks,
Speaker 2: that's way better than the sitting on the couch was
Speaker 2: previous to that. We have to start somewhere, and we
Speaker 2: want to encourage people to start where they are and
Speaker 2: move forward from that point, and any movement is going
Speaker 2: to be of benefit over the longer term. There's still
Speaker 2: some debate about how much we need right So there
Speaker 2: was the ten thousand steps going around for a while,
Speaker 2: and then one of my colleagues did a study that
Speaker 2: showed that maybe six thousand was probably okay for people
Speaker 2: with osteorthritis. There are guidelines out there for how active
Speaker 2: we need to be that can be very daunting if
Speaker 2: we start so, you know, one hundred and fifty minutes
Speaker 2: a week sounds pretty scary, but again it's it's the
Speaker 2: essential piece of just moving. And if that's a very
Speaker 2: small bit at the beginning and we're working up, then
Speaker 2: that's all we can ask anyone to do. We can't
Speaker 2: leap straight to full maximal healthy adult guidelines and go
Speaker 2: from there. That's just not how it is.
Speaker 1: And how do you know when movement pain is pushing
Speaker 1: the limits or overextending?
Speaker 2: So I usually tell people it's okay if you're a
Speaker 2: little sore the next day, that's kind of again to
Speaker 2: be expected if we haven't been doing too much. But
Speaker 2: if it's lasting for a few days or it's really debilitating,
Speaker 2: like I walked yesterday and I'm in bed today. That
Speaker 2: was either too much or there's something else going on.
Speaker 2: If it's a joint pain issue, we shouldn't have red, warm, swollen,
Speaker 2: angry joints, right, So they might be a little bit
Speaker 2: puffy if we were just up and about more, and
Speaker 2: that's okay, that should go away. But if there's you know,
Speaker 2: acute pain, new redness or warmth, something that's never happened before,
Speaker 2: pain in a place that's never happened before, those are
Speaker 2: all things to look out for. But generally what we
Speaker 2: expect is that the joints that hurt might hurt a
Speaker 2: little bit more after the activity, and they might be
Speaker 2: a little sore the next day, and then we should
Speaker 2: be back to where we were going or even feeling
Speaker 2: a little bit better by then. So big changes, though,
Speaker 2: or new things that hadn't happened should be at least evaluated.
Speaker 2: It might be okay still, but we just want somebody
Speaker 2: to take a look and make sure that we're not
Speaker 2: causing a new problem or you know, maybe our gate
Speaker 2: isn't quite right and we're generating some new pain issue
Speaker 2: that we didn't have before. So just being aware of
Speaker 2: our bodies where we started, where we're going, and what
Speaker 2: to expect.
Speaker 1: Well, thank you so much, doctor Amanda Nelson for talking
Speaker 1: to me today on care walks. I love the idea
Speaker 1: of the commercial movement breaks. I think that's a great
Speaker 1: starting place. If you're not in the habit of moving
Speaker 1: just yet, it's important to take it in those little
Speaker 1: by sized pieces, you know, just to get yourself going.
Speaker 1: And I really appreciate having this conversation with you. Thank
Speaker 1: you so much.
Speaker 2: Well, thank you, Holly. It's been fun.
Speaker 1: I want to thank doctor Nelson again for being my
Speaker 1: guest today. I really appreciated our conversation and hope you
Speaker 1: learned as much as I did about finding a movement
Speaker 1: that will help your joint pain and the physical benefits
Speaker 1: of implementing movement as well as what it does for
Speaker 1: our mental health. That's it for today's episode, and don't
Speaker 1: forget to come back next week for another walk with
Speaker 1: our guest actor and caregiver Jenny Garth. We're going to
Speaker 1: talk about her experience as a caregiver for her father
Speaker 1: and how she now prioritizes self care and manages her
Speaker 1: joint pain. And remember, keep walking and don't forget to
Speaker 1: take care of Yourself Too care Walks is produced by
Speaker 1: iHeartRadio in partnership with voltairean arthritis pain Gel, and hosted
Speaker 1: by me Holly Robinson Pete. Our executive producer is Molly Sosha.
Speaker 1: Our head engineer is Matt Stillo. This episode was written
Speaker 1: and produced by Sierra Kaiser, with special thanks to our
Speaker 1: partners at GSK Platform, GSK, Weber Shandwick and Edelman