Freya Gilmore | Ep #35 | Is Arthritis triggered by Winter?

in england um welcome of the foreign we’re excited to speak to you today it’s nice to be here thank you nice well welcome freya um and as we are right in the winter season with the temperature dropping i don’t know about you all but um i feel like that i feel more my joints so i don’t know if i’m developing early signs of arthritis or maybe not i don’t know but i i did some research i don’t seem to be alone it looks like it’s a common problem but i think that there’s different layers to what arthritis is and so i think we’ll be covering this um during our episode today and so um just there’s around 10 million people suffering from arthritis in the uk so around 15 which is quite a big number um and so to start off maybe we could we could dive deep on what arthritis is yeah definitely so um when people say they’ve got arthritis often it’s just osteoarthritis which is not an autoimmune condition like things like rheumatoid arthritis or lesser known ones like psoriatic arthritis osteoarthritis is more like the wear and tear kind of arthritis so most people will tend to get a little bit at some point but there are things you can do to maybe prevent and yeah to manage rheumatoid arthritis is more under the autoimmune umbrella affects the smaller joints first typically so hands feet neck and it comes with inflammatory episodes so although arthritis literally means joint inflammation some are more inflammatory than others right and is it is it like um something that people develop with time with age um or is it something that people just uh it’s like genetic you know and so after a certain age uh because genetics kick in yes i think um all of these have some sort of genetic element um but there tends to be a trigger um it seems like there’s got to be sort of the right combination of factors um involved before it happens so rheumatoid arthritis will typically affect you sort of around onset might be around late 20s 30s doesn’t often start before 50s and yeah sometimes it seems to follow some sort of traumatic event whether that’s emotional or physical illness anything like that but yeah it seems like it is sort of perfect storm for that onset what i described with you know the winter etc me feeling a bit more my joints is is that like a typical sign or is it just a thing yeah so early stage can be quite sort of generic just sort of general achiness um with conditions that are more inflammatory like rheumatoid arthritis um it’s worse after prolonged rest so first thing in the morning might be particularly bad but also aggravated by excessive exercise so there is that fine line of sort of managing it but sometimes it comes with more sort of general malaise and things like that as well so when your body’s fighting inflammation you do get more sort of general unwellness kind of feelings but again not in every case right um i’m just curious because you’re saying that people who exercise also experience this right and it’s aggravated by that how can someone tell the difference between like their soreness and arthritis can be difficult um i would say if it was sort of your dom’s your delayed onset muscle soreness then you’d have that tenderness in the muscles um if it was more of an arthritic kind of pain it would probably happen sort of once you’ve rested it’ll kick back in so that might be later on that day might be the next morning again could be the same with dom’s um but it wouldn’t be sort of characterized by that same kind of muscle tenderness you might find that there’s more of a kind of heat to the to the area if it’s one that’s quite close to the skin and any link with regards to winter the fact that we might feel our joints a bit more during winter is is that even a thing yeah i mean anecdotally you hear it a lot um and that would go for osteoarthritis as well i’m not sure about the research i don’t think i’ve come across anything that particularly gives you those um seasonal patterns but for all of these conditions they like a certain amount of movement so when it’s cold and dark and wet you’re probably doing that outside maybe that’s where the link comes from so inflammation i hear that inflammation is linked to arthritis right so is there a link between the fact that the temperatures are dropping or the fact that we are moving less that will cause inflammation probably not directly um if you were moving less then yeah the rheumatoid arthritis isn’t going to like that but reduce temperatures i mean if anything if you had an inflammatory problem you might want to put ice on it to cool it down make it a bit more comfortable i mean the inflammation is there for a reason so sometimes i mean speak to your osteopath but yeah it can be soothing to put ice or a cold compress on something inflamed so yeah it kind of goes both ways there doesn’t it hmm interesting it’s it’s a it’s always tricky because i find like different at different points different you get different messaging because sometimes they say if there’s information you put ice but then sometimes there’s no inflammation but that’s there’s pain right so they put heat on it so how do you how do you know the difference like of course you can’t just self-diagnose but you know is there like a rule of thumb we should we should all know and follow yeah it’s a bit of a tricky one um generally i’d say if in doubt use something cool because regardless of what’s going on there’s probably some degree of inflammation if there’s pain whether it’s an inflammatory condition or not um heat is really just good for muscles um and even then if there’s a muscle problem if it’s like a tear micro tear there’s probably going to be inflammation there as well so you can’t go too far wrong with ice um or rather a cool compress but in any case you don’t want to do it for too long so generally i would say five minutes per hour if you’re doing it enough that it’s numbing it it’s probably going to hurt more when the feeling comes back oh wow right okay so this is good information because i think i’ve definitely done that in the past where it’s like no you’re like oh i think this is a good thing you hear about that yeah typical amateur here so right so i guess if if people who have arthritis um i mean i guess you tell the difference between to pull it back to arthritis right uh and not soreness um so if there’s rheumatoid arthritis and then there’s also osteoarthritis that you were mentioning earlier so between the two um are they different in different in symptoms as well um yeah so there are definitely some similarities um the joints affected can be a bit of a giveaway so um like i said the small joints are generally affected first in rheumatoid arthritis so that be the joints of the hands feet neck um whereas osteoarthritis we probably hear more about knees and hips but that said often people will say that oh and my thumb’s a little bit crunchy a little bit sore and that’s just a little bit of arthritis there but smaller joints might even be a little bit easier to manage in osteoarthritis so silver linings um but in terms of symptoms um to be honest they’re both probably a little bit worse after rest but for inflammatory conditions it does take longer to get going in the morning so when we’re trying to screen between rheumatoid or osteoarthritis we’d want to know how long it takes for symptoms to ease up in the morning if it’s more than half an hour then we’re definitely thinking more inflammatory if it’s just sort of stretch a little bit of movement and by the time you’ve got to the bathroom you’re fine then probably less of an inflammatory thing yeah and and so what would be typical treatments for for those so for osteoarthritis i mean to explain the treatment it’s probably easiest to explain the actual pathology so um osteoarthritis is a condition of the cartilage so any joint that’s got cartilage could get osteoarthritis um basically cartilage doesn’t have a great blood supply it’s kind of like a sponge so you need to be squashing it and unsquashing it to let the nutrients flow in and the waste flow out so if you’re not going through the entire range of that joint there’ll be some bits of cartilage that are always squashed and some that are always released so they’re not getting that same kind of cycle of nutrients and waste um when that starts to happen the body might try and protect itself so you might find that your or might not find might just happen without you realizing um that your joints are being held in such a way so for the hip you often lose extension so that’s bringing your leg back um but the body likes to protect itself so you might actually just start leaning forwards still getting that movement but it’s not coming from that joint in the same way and then you only realize when someone says oh you’re looking really really stooped and you think oh oh yeah no i can’t can’t move my hip like that um so the muscles at that point are starting to play a role as well so when someone comes in say using hip arthritis as an example again if someone comes in looking for treatment for that it would be a case of getting that joint moving first and foremost which will mean releasing those muscles that are trying to protect it and sort of just working that movement back in showing the body that it can do it and it’s not too painful and then really important would be the exercises after as well we’ve only got a fraction of the week to see you in clinic um but anything that you can do during the day during the week that’s all going to make such a massive difference um just since you’re talking about treating it right and how to fix it i guess a question i have before we i guess to to utilize that information is other movements or any any type of activities that can actually cause that to be triggered like excessive movements um because i know from my experience or like a freedom like for example a sport like crossfit you know um because it’s high intensity and there’s certain types of movements that are potentially not something that people would do in a daily basis um and that that i’ve been told can cause long term in the long term uh you know arthritis um or like severe inflammation and you don’t know the impact until you know you’re aging um is there something like that that you you can speak on yeah so it’s it’s all kind of specific stuff like i wouldn’t say crossfit as a whole it’s going to give you arthritis although i do see quite a few crossfit injuries but they say that it’s misuse or overuse that would lead to osteoarthritis so if you had sort of a particularly i don’t want to say bad form because i mean particularly things like squatting there’s not really one right form for everyone but if you were using your joint in such a way that it’s particularly demanding on the joint as a whole or it’s not going through the whole range and it’s just sort of repeatedly doing the same thing in one spot of it that’s the sort of thing i’d be worried about but interestingly again it’s moderation so um i saw a stat earlier this week and i didn’t say that saying if you looked at sedentary people sort of your average runner and your ultra marathoner it would be the regular runner who has the lowest incidence of knee osteoarthritis so that kind of underusing or overusing that’s the sort of thing i’d be looking for that’s that’s a that’s a good point and kind of gives you context to how our body works as well right yeah definitely we’re not a car we’re we’re not going to break down it’s it’s not the same kind of thing it’s we are adaptable so i think other studies of again using runners as an example found that the discs in the lower back are kind of healthiest in those average runners again um you respond to the demand that’s put on your body yeah basically everything in moderation isn’t it absolutely and to bring in the so we spoken spoken about osteoarthritis for the treatments what why i’m saying this is but when i prepared for for this uh for this episode one thing that we found is that um a study where it showed uh how there’s potential um ethnic disparities with regards to prevalence to uh ra i’m not gonna try to say it and um and it looks like um so one of the conclusion is that the there’s a greater prevalence for minority groups uh versus white patients in um in the us so this this was done in the us potentially ethnic groups our minority ethnic groups are potentially more prevalent to this have you observed anything in your in your practice that would be a testament to this yeah so annoyingly 99 of my patients are white so trying to spot the patterns myself is pretty much impossible um what i would say is when we’re talking about ethnic differences as well is that sometimes there are sort of ethnic predispositions to conditions and we know that ra has a strong genetic link so potentially that’s a factor there i suppose as well maybe we’re thinking things like what sort of different lifestyles are we talking about is is the average job more demanding is there more likely for that um physical or emotional trauma that might set it off in the first place um so yeah so many different variables in it um i suppose we’re lucky here that at least the access to health care is there for everyone at least the medication side but in terms of management again it’s finding that fine line between doing too much and not doing enough so the same applies to treatment and exercise as well as just what you’re doing day to day um so although i wouldn’t say that austropathy can cure ra in any way we can help manage the symptoms alongside the necessary drugs medications so it would be a case again thinking similarly to osteoarthritis what are the muscles doing what sort of compensation is there um you can look further afield as well like is the neck involved and does that is that made worse by the upper back being particularly stiff like demanding more of the neck that’s already irritated because the upper back’s not moving enough things like that so that’s kind of the osteopathic approach look at the body as a whole but also make sure that the local area is working well in terms of the joints and the muscles um with things like the neck you’ll probably be thinking more about instability in the later stages so the small joints just get a little bit more overloaded and the neck muscles are fine for what they’re meant to do but when you start putting more of a load on them they do struggle so thinking longer term about strengthening that kind of thing as well that makes sense um and would you say that these different type of arthritis are preventable probably not for ra just because of the factors in it um i guess in an ideal world maybe oa would be preventable if you can keep yourself in that range of moving enough moving through the whole joint not doing anything badly i hate to put those labels on it um but yeah i mean if we were all running like 5k every other day or something yeah maybe we’d all have great needs but obviously everyone’s different um that said there are things that you can do to reduce the impact or potentially reduce the risk of developing it in the first place um thinking about whole body health if you’re eating well moving well what do they say food sleep stress and exercise if you’ve got those for under control then you set yourself up for the best it’s such a great summary yeah yeah i mean it’s all about like living that um balanced life beat even as you we were talking earlier the average runner versus you know the marathon runner versus the person who’s not active at all um so if you do get in some exercise would you say daily or every other day yeah i quite like the 10 000 steps i know it’s an arbitrary number but if you’re doing i mean if it’s just a case if you’re gonna walk to the shop instead of drive it and then the next day you do do your exercise and do a run or the next day you swim little and often yeah yeah that’s a good that’s a good indicator and reminder actually of what we should be doing not should be but you know what is i guess ideal yeah it’s a good starting point um great so as our normal close-off that we do um we have a rapid-fire round of questions so our first question is what is the worst health advice you’ve ever received in your life well having had a baby in the last 18 months has been some pretty awful advice there oh really tell us oh honestly i won’t even the six week check was an absolute disaster i’m not even gonna go there um maybe more more topical would be in regards to back pain just rest it no don’t don’t just rest it right give it a little bit of rest but again the more you can move it within a reasonable amount the better you’re going to be there’s a reason that gps don’t prescribe bed rest now so if you’ve got back pain move it if you’ve got arthritis move it just don’t go doing the ultra marathons yeah because i was like moving but how ten thousand steps exactly exactly um and um our next question is if you had one habit uh to promote what would it be that’s a tough one can i say movement again i’m a bit of a one-try record today movement over hydration and there’s the two things that could be it could be of use yeah no i’d say movement’s good you can’t go too too far wrong with you 10 000 exactly steps but yeah a good variety of stuff as well if you were doing like a swim a week and a 5k a week and then just sort of walking about in the meantime then yeah that probably be ideal to be honest and not too unrealistic either she says doing neither of these things and a final question is if you were to put a song or a soundtrack to your life what would it be i was thinking about this one this is impossible it got me thinking about my um 2020 wrapped but we don’t want to go there there’s only one wrapped stone 21. yeah no we don’t want to go there because that wasn’t a great soundtrack but i would say um every year apart from this year the one artist that keeps coming back is banks so any of her stuff play that and it’ll probably suit me at any okay time that’s a good answer well thank you so much freya for your time and and your insight and for being on our show no worries thank you for having me