Love Your Joints, Live Your Life

Released July 7, 2026 

PODCAST OPEN: Thank you for tuning in to the Live Yes! With Arthritis podcast, produced as a public service by the Arthritis Foundation. You may have arthritis, but arthritis doesn’t have you. Here, you’ll get information, insights and tips you can trust — featuring volunteer hosts and guest experts who live with arthritis every day and have experience with the challenges it can bring. Their unique perspectives may help you — wherever you are in your arthritis journey. The Arthritis Foundation is committed to helping you live your best life through our wide-ranging programs, resources and services. Our podcast is made possible in part by the generous financial contributions of people like you. (MUSIC BRIDGE) This episode of the Live Yes! With Arthritis podcast is brought to you in part by Amgen. 

Trina Wilcox: Welcome to the Live Yes! With Arthritis podcast. My name's Trina Wilcox, your host for this episode. It doesn't take too much to aggravate joint pain, inflammation, whether you live with osteoarthritis or an inflammatory form like rheumatoid arthritis or ankylosing spondylitis. Knowing the best ways to protect your joints and maintain joint health is critical to living well with the disease. So today we're talking with Dr. Fabrisia Ambrosio about strategies to protect your joints and to keep them as healthy as possible, even with arthritis. Welcome, Dr. Ambrosio. 

Dr. Fabrisia Ambrosio: Thank you, Trina. I am looking forward to this conversation. 

Trina Wilcox: Me, too. Tell me a little bit about yourself and what makes you an expert in this field. 

Dr. Fabrisia Ambrosio: Well, I will start with where I am now. I am currently director of the Discovery Center for Musculoskeletal Recovery at the Schoen Adams Research Institute, Spaulding Rehabilitation Hospital and Harvard Medical School. We are really focusing on age-related diseases and conditions that affect musculoskeletal health. And one of the primary areas that we are very interested in is osteoarthritis, or this gradual and progressive degradation of the integrity of the joint. This actually builds from my background and my training. I am a physical therapist. I received a master's of physical therapy from Drexel University. I also have a master of science in physiology endocrinology. 

My doctoral work was primarily focused on biomechanics. I was very interested in understanding how body position affects likelihood for injury and how body position can provoke degeneration of joints and all the other tissues. And so really then I moved on to looking at a more basic and fundamental level. All of this to say that my background is all the way from cellular to whole body. 

Trina Wilcox: You know it all, so let's get into it. (laughs) Some people might already know this, but could you tell us the difference between a physical therapist, physiotherapist and occupational therapist? 

Dr. Fabrisia Ambrosio: Sure thing. Physical therapist and physiotherapist, those are actually synonymous. Really the difference between the two represents more regional differences than anything. Different countries will have a tendency to use more physiotherapy versus physical therapy, but really they mean the same thing. Oftentimes, when you think about physical therapy, that really is a profession that is dedicated to restoration of normal, healthy movement, whether this be a focus on performance or, more commonly, it's a recovering after an injury or disease. I think between physical therapy and occupational therapy, in common we have this focus on restoration of function. Occupational therapy, there is a lot of emphasis on really thinking about daily activities and things that are a part of our everyday lives and working to develop strategies and recovery techniques that can promote participation in these daily activities. So really, I think the difference is a little bit about focus. 

Trina Wilcox: There's an impression that PTs will work with lower body and OTs upper. Is that a misconception? 

Dr. Fabrisia Ambrosio: That really comes from this idea that physical therapists oftentimes will focus a lot on gait and walking ability and strategies to restore normal walking. I tend not to think about it as lower versus upper extremity, mostly because, I mean, there are some physical therapists that are specialists in hand function and get specialized training. Also there are certified hand occupational therapists. But I think there’s a lot of overlap, and I think the two fields are extremely complementary. 

Trina Wilcox: Tell me what it exactly means to protect your joint when we're talking about cartilage protection, synovial health and biomechanics. Can you break all of that down? 

Dr. Fabrisia Ambrosio: Sure. Well, I'll do my best. (laughs) In thinking about joint protection, maybe I'll start with what joint protection is not. 

Trina Wilcox: OK. 

Dr. Fabrisia Ambrosio: Because I think when people first hear that word, maybe there is an inclination to say, "Don't use my joint." And, you know, you can imagine somebody, for example, who has a bad elbow, that they just want to kind of hold it in and protect it and not move it. I think that's not what we mean by joint protection. What I really think about when I think about joint protection is at a very broad sense: It is leveraging one's agency, leveraging one's proactive approach to how they manage in this case arthritis in the various forms. 

I think the number one strategy is education, being aware of the different approaches and the different ways to protect and take care of your joints, especially if there is some indication that osteoarthritis or other types of arthritis are starting to set in. How can we ensure that we minimize disease progression? And that involves a lot of things. It involves slowing down sometimes and giving yourself more rest breaks. It can involve physical activity, pain management strategies, it’s pretty broad, but I think from the highest level, it really is kind of taking a proactive approach. 

Trina Wilcox: OK. When it comes to moving and you're used to doing something, but then osteo sets in, or maybe, you know, you have a flare, what are some movement modifications that people can be doing to protect those joints? 

Dr. Fabrisia Ambrosio: A lot of modifications will be very person specific. So, I think key is identifying those movements that seem to provoke pain. And in particular, we're thinking about pain during the activity. We're also thinking about how long pain persists after an activity. And so, oftentimes it's things like prolonged kneeling that can be very bad and kind of lingers. There are other things, such as different body positions, for example, positioning while you're sitting. If you're sitting at a very low chair, that can be very painful after sitting for a long period of time, particularly in a low chair, then standing up; that can also really aggravate joints. Thinking about large joints in particular, there are oftentimes very repetitive activities. So, for individuals who may have osteoarthritis of smaller joints — for example, in the hands — repetitive activities, high intensity activities can also provoke that pain and exacerbate a flare-up. 

Trina Wilcox: So, are there certain things that we should be doing to protect the big ones versus small then? 

Dr. Fabrisia Ambrosio: When you think about big joints, oftentimes the strategies that we think about are really trying to unload those joints. Oftentimes the large joints are the ones that are bearing more weight, thinking about the hip, thinking about the knee. And so there, a lot of times what we try to focus in on is: How can we unload those joints, whether that be by losing weight or even just modifying positions to kind of give our larger joints a break. With smaller joints, that tends to be trying to minimize repetition and forces that are concentrated on those smaller joints. For example, if you think about a can opener, a manual can opener, that can be very, very painful, that repetitive high force of the smaller joints. So, those are things that we kind of think about, big versus small. 

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Trina Wilcox: I feel like, when we're talking about protecting joints, the first thing that comes to our mind is being active and moving, but I have on more than one occasion woken up and, with sleep, like a joint's been held in an awkward position. So, are there things we can do to protect our joints as we sleep so we get that restorative sleep we desperately need? 

Dr. Fabrisia Ambrosio: Absolutely. And it's so critical. I am really blown away by the importance of sleep for overall health and how it just affects a multitude of different diseases. How can we really ensure the most restorative sleep possible? And for sure, without a doubt, positioning is going to be important. This is really being very deliberate and intentional in thinking about the body positions that will be most comfortable according to different pain levels. It changes so much from person to person. But I do recommend being very aware, paying attention to those positions that seem to be more comfortable for your joints, alleviating pain, alleviating stress. And, you know, a person is their own best  determiner of what position that is. 

Trina Wilcox: What would you recommend? Like, I guess pillows have been a helpful way for me to offload some of those joints, or like, feet on top of each other, you know, and giving that space to relax, but not impound them where they're hurting the next day, things like that. 

Dr. Fabrisia Ambrosio: If somebody is sleeping on their back, sometimes just putting a pillow underneath their knee alleviates some of that pressure and feels really comfortable. If people tend to be side sleepers, sometimes a pillow in between the knees also helps. So, definitely taking that time to try different things and see what works best and how a person feels best waking up in the morning. 

Trina Wilcox: What about joint splints and braces? When should those be used? 

Dr. Fabrisia Ambrosio: I think the evidence shows that, for some people, they can be effective. People are so different in their presentation of symptoms, so it's hard to say one thing will work for everybody. And so, that's oftentimes a limitation in being able to definitively say with a research study: “This is the way to go.” But when you think about splints and braces, a lot of times those have been shown to potentially be effective in terms of decreasing pain. I have seen minimal adverse effects of having these braces if people can tolerate them OK, and they feel like they're sufficiently comfortable, oftentimes they can help to decrease pain. Same thing with different compression sleeves. I think these tools can be effective for pain. I don't know of too much evidence that suggests that it's actually improving cartilage health. 

Trina Wilcox: Now with the compression sleeves, is there a time limit on how long someone should wear one of those? 

Dr. Fabrisia Ambrosio: I don't really have any, off the top of my head, any guidelines in terms of how long and what, if there's a maximum. I mean, of course, skin irritability: You want to make sure that there's no problems with blood flow to the area. 

Trina Wilcox: OK. So, we all get into our routines. Are there any habits or lifestyle factors that can make a difference either for better or worse? 

Dr. Fabrisia Ambrosio: There are things that are out of our control. Of course, age is the number one risk factor for osteoarthritis. And we know that osteoarthritis increases significantly with increasing age. Genetics can also play a factor. Of course, those we don't really have control over. What we do have control over are these lifestyle choices. And that really includes things like diet. Managing overweight and obesity, we know that that makes a big difference in joint health. It's been suggested that even a 5% decrease in body weight can really make an important impact in preserving joint health. Exercise perhaps is the most widely researched area, and I think consistently the benefits of exercise on joint health have been demonstrated. Aerobic exercise in particular seems to be very effective, but also things like weight training and strengthening. Strengthening the muscles around joints is very effective for managing pain and helping promote activity and even range of motion. 

Tai chi for kind of this neuromuscular control, that has also been shown to be helpful, also increasing balance. Similarly with yoga. So, there's a number of different ways I think that we can engage in trying to promote joint health. And I think a key is for individuals to find those activities that they enjoy, that they really look forward to, because that is going to be what really promotes adherence in sticking with it. Because this is not the kind of thing that you complete a four-week protocol, you know. You do exercises and then you can call it a day. This really is a lifestyle modification that should become a way of life. 

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Trina Wilcox: Now with the importance that you just expressed with exercise, I know that swimming always comes up. And a lot of folks don't have access to a pool. So, what are some of the other measures they can take? I know you mentioned tai chi with gentle movement there. What else? 

Dr. Fabrisia Ambrosio: It really is broad. Even walking, if walking is comfortable and doesn't promote that pain, that can be very effective. Maybe you find a friend and it can be also something that you socialize while you're doing it. It's true that the pool can be good, but that is by far and away not the only way to get exercise. 

Trina Wilcox: What are some of the tasks that you've seen that people tend to have the most difficulty with as a result of joint pain or limited mobility? 

Dr. Fabrisia Ambrosio: It really depends on the severity of the arthritis. Going up and down stairs can be very painful for people. There are ways to modify that. So, for example, the default is to go one leg over the other, but there are ways to even modify that. Here's a little trick that the physical therapists teach their patients. If there's one knee that's more painful, essentially what you want to do is: When you're going up the stairs, you should lead with the knee that is less painful. That knee that is going first and leading upward is really the one that is bearing all the weight. Kind of taking the step one step at a time can make a big difference. Now, when you're coming downstairs, it's actually the opposite, because it is the leg that is on the step, that remains on the step behind, as the person is going downstairs, that is actually bearing all the weight. So, essentially, you want to start going downstairs with the leg that is most painful. So, it's a little tricks to try and minimize the pain. 

Trina Wilcox: What about specialty devices that folks can use with tasks? I mean, some household items can really get the best of us. (laughs) 

Dr. Fabrisia Ambrosio: I mentioned very briefly this idea of low chairs. Those are things that can be extraordinarily painful and really provoke pain because the knee is really bent at such an extreme angle. And so, even just thinking about things like higher chairs or even stools where the hip is less bent and the knee is less bent, that can oftentimes help. Gadgets in the kitchen, using gadgets, maybe electric can openers can help. One of the things that I really focused in on when I was working on my PhD was this idea that, when participating in activities, we should really implement strategies that allow us to be as engaged as possible. There's a time for doing exercise, there's a time for participating in this physical activity, but when it comes to things that we need to get done, trying to maximize the environment so that we can get those activities done with the least pain is really what we want to be thinking about. 

Trina Wilcox: With all of this protecting of the joints, will that actually prevent or delay osteoarthritis or inflammatory arthritis? 

Dr. Fabrisia Ambrosio: This will not reverse some of the declines that we've seen, but certainly by protecting the joints and taking some of these strategies, for example, to unload joints and decrease forces about those joints, it has been shown that that can potentially decrease the rate at which the disease progresses. And so, I think it is very much worthwhile to invest in implementing some of these strategies. 

Trina Wilcox: All right. What else should patients know about joint protection, maintaining our joint health? Anything else that you've seen that we're not thinking of? 

Dr. Fabrisia Ambrosio: Being your own advocate and reading about the literature and really getting involved. I mean, listening to these kind of podcasts dedicated to sharing what the research shows I think is really important. An area that is very important and of great interest for our laboratory is really thinking about how osteoarthritis really affects individuals differently according to their sex. I mentioned that age is the number one risk factor, but osteoarthritis is also much more severe and much more prevalent in older female individuals. We really start to see kind of the separation in incidences in males versus females around the time of menopause. And so, it does seem like there is this tight relationship between menopause onset and osteoarthritis specifically. This is something, you know, definitely would be worthwhile to consult with a prescribing physician. But even thinking about strategies like hormone replacement. In some of our basic science studies, we have seen that estrogen and progesterone may be very valuable for preservation of that cartilage integrity. So, something to think about. 

Trina Wilcox: Yes. 

Dr. Fabrisia Ambrosio: I think we need a lot more research though. 

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Trina Wilcox: We asked social media followers: What’s one simple thing that you wish you had started sooner to protect your joints? We’ve got some answers here. I’ll read some of these and you kind of follow up and let me know your thoughts on the response. 

Dr. Fabrisia Ambrosio: Great. 

Trina Wilcox: Carol Henry Lee said, "Resting. I didn't stop to rest until my 60s and it's really helped." (laughs) 

Dr. Fabrisia Ambrosio: Carol, I couldn't agree more. Pacing is an important strategy. Sometimes it is so easy to kind of get caught up, to really focus on all of the things that we need to do, without giving ourselves the time to take breaks in between. Taking those breaks, giving your body that rest to kind of recover after different activities, is a great suggestion. 

Trina Wilcox: Barry Bouvet said, "Wearing a weighted vest. My pain is too severe now, and my legs are getting weaker." 

Dr. Fabrisia Ambrosio: When I think about wearing a weighted vest, I do think about the research that kind of talks about strength training. And I think there is definitely a place for strength training and maintaining, for example, muscle mass to protect joints. Particularly that's the case with large joints. Treating individuals with arthritis in the clinic, I always found that resistance training was very effective in helping to decrease some pain. But I think Barry's comment about pain being too severe and that being more challenging is a great reminder to really listen to our bodies, because that pain is telling us something. Really being aware of kind of the limits of one's own abilities and trying to maybe think about alternative ways of getting in that physical activity if, for example, what was working well, like this weighted vest in Barry's case, is no longer working because of the pain, trying to think about alternatives. 

Trina Wilcox: Yeah. And the great thing about those vests, you can usually add weight or take away. 

Dr. Fabrisia Ambrosio: Great point. 

Trina Wilcox: And so, if you're not able to lift the weights because maybe your hands are weak and you put the vest on and you can adjust there. Or maybe even ankle weights to take the load off your back. So, I'm glad that there are those alternatives and that they're thinking ahead. 

Dr. Fabrisia Ambrosio: That's a great point. 

Trina Wilcox: Tracy Sayers Trombeta said, "Stop eating sugar and processed foods." 

Dr. Fabrisia Ambrosio: There's the whole aspect of trying to be thoughtful about weight loss and minimizing overweight, no obesity. We know that that helps joints. But also I think Tracy here is speaking to the quality of the diet. It's not just about eating very little, but it's also about eating very thoughtfully and eating those diets that are rich in the foods and the nutrients that we know to be so important for joints and really all of our systems. 

Trina Wilcox: Kathy Aires said, "Doing research on the subject." 

Dr. Fabrisia Ambrosio: I think individuals definitely have that need to understand where research is. Again, being very proactive about strategies that can help minimize pain, stiffness, and maximize physical activity. Right now, a lot of what we know about osteoarthritis is we have some good strategies to minimize pain and minimize our symptoms. I would love to see more research on the subject so that we can really start to think about disease-modifying strategies, strategies that can actually help to restore cartilage after it's been degraded. 

Trina Wilcox: That'd be great. 

Dr. Fabrisia Ambrosio: That's some work that we have ahead of us. 

Trina Wilcox: And lastly, Kim Diverse Few said, "Lose weight." Which you briefly touched on already. 

Dr. Fabrisia Ambrosio: That's right. I totally agree, Kim. 

Trina Wilcox: Finally, we like to wrap up each episode with our top three takeaways from our discussion. So, I'll let you go first. What were your takeaways from our discussion today? 

Dr. Fabrisia Ambrosio: I think one of the things as a researcher who does research specifically in the biology of aging, one of the things that I often go back to, because I think it's so encouraging, is that so much of our aging process and our experience are things that we can take under our own control. This isn't the kind of thing that we always have to think of as something that happens to us, that it's an inevitable decline. There are a lot of strategies that we have talked about today that kind of speak to the ability to really intervene and maximize activity levels. And of those, this idea of diet and how diet is important. Exercise without a doubt is going to be beneficial for our joints and, again, for just overall whole body wellness, even for mood. So, it's really worth finding an activity, exercise programs, that you love, so that you stick with it. Those are my main takeaways. 

Trina Wilcox: Good. Mine would be the diet and exercise, modification, modification, modification. I know that it can be frustrating, but when you're able to find a way to do stuff, the stuff you love, it's a game changer. And even once you change something, you might have to change it again. But keep at it. It can get frustrating, but it's worth it to give you a better life, better movement. And then also, like our listeners said, education, research, keep learning and understanding what's happening around us. Because hopefully it will be able to benefit us all sooner than later. 

Dr. Fabrisia Ambrosio: You said it, Trina. (laughs) 

Trina Wilcox: Great. Thank you so much. Because all the folks that are listening are part of the conversation, we want to hear from you. Please email your thoughts and suggestions to [email protected] and find more information and resources to help your arthritis journey at arthritis.org. Thanks so much. 

Dr. Fabrisia Ambrosio: Thank you. 

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