It's said nothing is certain except death and taxes. However, orthopedic surgeons point out that life offers a third certainty: arthritis.
"If you live long enough, everyone gets arthritis," says Dr. Richard Meyer, an orthopedic surgeon at Touro Infirmary. "There is no way to prevent it, but you can make it less symptomatic by exercising and keeping your weight down."
Osteoarthritis is a disease of wear and tear: the cartilage tissue, which serves as a cushion between the bones, wears away with time. "If there's previous damage or simply overuse over many years — for example, someone who has jogged or does a lot of squatting or kneeling — the smooth cartilage becomes irregular," says Dr. Robert Quinet, a rheumatologist at Ochsner Medical Center. Meyer likens the process to the rubber on a car's tires wearing down.
In addition to damage or overuse of the joint, genetics and weight are factors in osteoarthritis, also known as degenerative joint disease. People who are overweight are more likely to have osteoarthritis. They're also likely to experience pain because of it when they exercise.
"Some patients have the tendency to avoid (exercise) because of the pain issue," Quinet says. "They don't recognize (exercise) ultimately will be therapeutic."
Bonnie Barbay Griffin, a 64-year-old resident of Picayune, Miss., struggled with pain when she would attempt to work out. "When you have pain like that in your joints, it is excruciating," she says. "I did not like to get out in the street and walk because my leg always bothered me."
However, Griffin admits that for a long time, she used the pain as an excuse not to exercise. Griffin was doubly at risk for the disease: Her mother had osteoarthritis in the knees, and Griffin had struggled with her weight her whole adult life. When Griffin was in her 50s, she began having problems with her knees. Her husband died in 2007, after an eight-year struggle with multiple myeloma, a bone marrow cancer. Griffin's weight increased, which exacerbated her osteoarthritis by placing additional stress on her joints.
"From (his diagnosis) until he passed away, it really wasn't about me, so I ignored what was going on in my body and gained more weight because of the stress," Griffin says. "One year after Daryl died, I realized I couldn't stand the pain. The scale was going higher and higher, and the weight wasn't helping my left knee. It was bone on bone."
Meyer performed a total knee replacement on Griffin in 2008. In 2010, weighing 304 pounds, she applied to be a contestant on NBC's The Biggest Loser. When she was rejected, she went to a Weight Watchers office.
"I lost 50 pounds from August 2010 to February 2011, at which time the producers called and asked if I was still interested," she says.
Though Griffin found out she needed a second knee replacement, she pushed through the pain during the show's grueling eight- to nine-hour workouts. Cortisone injections, a leg brace and post-workout ice treatments helped her last for nine weeks, during which time she lost 77 pounds. When she left, her first phone call was to Meyer to schedule knee replacement surgery.
"My rehab was 100 percent better than the first go-round, because I was 130 pounds lighter [and had more] muscle mass," Griffin says.
Meyer recommends knee replacement surgery for patients whose osteoarthritis is not responding to therapeutic exercise, steroid injections and medications —though he adds all patients should exercise and be at a healthy weight. Knee replacement surgery patients experience smoother recoveries and can participate in physical therapy at higher levels if they are in shape prior to the surgery. For all patients, exercise can be as beneficial as medicine in treating osteoarthritis, Quinet says.
"Exercise is as therapeutic as any drug therapy," Quinet says. "Injections of the knee with cortisol steroids or hyaluronic acid derivatives — the benefits in terms of pain relief and functionability are actually no better than regular exercise."
Exercise reduces weight that stresses the joints and stabilizes the joints by strengthening the muscles around them. Patients who experience pain when exercising can take acetaminophen, naproxen or ibuprofen, Quinet says. They may find some comfort in the fact that, with regular exercise, the soft tissue stiffness will lessen.
"Some of the pain is due to the soft tissue's inactivity," Quinet says. "They have to persist, and eventually the pain will diminish."
Griffin completed a Down syndrome awareness fundraiser walk with her grandson, who has Down syndrome, three weeks after her surgery. She is now walking three to four miles a day in preparation for the Crescent City Classic. It will be her second time participating in the race.
"Neighborhood people come with me. It's going to be awesome," Griffin says. "My story when I was on the show was I didn't have to win, but I did have to complete it. If I finish what I start, that's the most important thing."