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Treating Arthritis Pain With Exercise Overview
No matter how much your arthritis seems to trip you up, you can take steps to maintain control over your life and your daily activities. One essential step is exercising. Making proper exercise a part of your daily routine helps keep your bones and muscles strong and helps you stay flexible, giving you the physical tools you need to stay in control.Proper movement of the joints during a carefully planned exercise program helps prevent the loss of calcium from bones, which can make bones brittle and fragile. It helps prevent loss of muscle tone that can make you weak and injury-prone. And it helps nourish cartilage, the tough elastic tissue that covers the ends of bones and helps cushion and protect. In this article, we will help you create an exercise routine that will work with your arthritis over the course of the following sections:
- Exercises to Keep Your Joints Healthy
While exercise is important when you have arthritis, any sort of physical exertion will be nearly impossible if your joints are too weak to support it. On this page, we will offer some tips for strengthening your joints before you hit the gym. Whether you a stretching before taking a walk or after a long car trip, we will show you how to prepare your body for exercise and keep your joints nourished. - How to Plan an Arthritis Exercise Program
As hard as it is to plan and stick to an exercise regimen, it is much more difficult for a person suffering from arthritis. When joint pain begins to flare up, simply walking down the hall might seem like an insurmountable task. In this section, we will show you how to set realistic goals that will keep you focused and excited about your arthritis exercise program. We will also tell you what type of exercise clothing is best for arthritis patients. - Range of Motion Exercises for Arthritis
As the pain and stiffness of arthritis advances, most patients will find that they have lost a great deal of their flexibility. Also, long periods of inactivity can also make your joints stiff and cut down on your range of motion. In this section, we will show you some simple range of motion exercises for your entire body that can help you reclaim some of the flexibility you have lost to arthritis. - Strengthening Exercises for Arthritis
If you are feeling healthy enough, the best thing you can do to support your joints and relieve some of the pain of arthritis is to strengthen and condition the muscles around them. Of course, with a condition like arthritis, any strengthening regimen must be approached with caution. On this page, we will show you how to safely build the muscles in your neck, back, shoulders, knees, and abdominals. We will also offer some exercise alternatives like aqua-aerobics.
Exercises to Keep Your Joints Healthy
For the person with arthritis, proper exercise is essential. Individuals with chronically painful joints often keep the joints immobile for long periods because they feel better that way. However, if the joints stay immobile or bent for too long, they may become stiff, causing further loss of movement that could eventually lead to deformity.That doesn't mean you have to -- or should -- go out and run a marathon. There are varying levels of exercise intensity, and everyone can exercise at one of these levels. Indeed, the most vital type of activity for every person with arthritis is a mild form of exercise called range of motion, or ROM. ROM exercises involve moving the joints through the full range of movement that the joints allow. You may even be able to do some gentle ROM exercises when your joints are painful or hot (called a "flare"), although you will need to check with your doctor first (some doctors recommend rest during flares). Once the flare has resolved, you should resume a regular exercise routine, including ROM and strengthening exercises, tailored to your abilities.
 ©2006 Publications International, Ltd. Sometimes massaging an aching joint can temporarily relieve the pain. |
Feed Your Joints
Moving your joints is the only way to nourish and lubricate them. Although keeping an arthritic joint in a stationary position may temporarily prevent pain, this extended lack of movement can produce greater pain and stiffness in the long run. In severe cases of lack of joint movement, contractures may develop. Contractures refer to shortening of the muscles and shrinking of the connective tissue. Over time, the joint's ability to function is reduced.
Gentle range-of-motion exercise as well as other types of more vigorous exercise can help nourish the joints and prevent stiffness and pain. These should be performed regularly. In addition, try the following:
- Stretch frequently. Even during rest breaks, gently flex or stretch your joints occasionally or change your position slightly to prevent stiffness.
- Massage your joints. Massage can help soothe a painful area, and you'll be moving other joints as you do so.
- If you'll be travelling by airplane, bus, or train or if you'll be sitting at a sporting event, concert, or movie, try to get an aisle seat. This will give you more room to stretch your legs frequently while seated. It will also make it easier for you to get up and move around once in a while.
- During long car trips, take advantage of rest stops to stretch and move around. If you're the passenger, do range-of-motion exercises for your fingers, lower legs, and neck while on the road.
- Avoid clenching objects for extended periods. If holding a pen is painful, try a computer or typewriter. Instead of holding a newspaper or book in your hands while reading, try laying it flat on a table or using a book stand. Instead of carrying a purse or briefcase with a handle, choose one with a shoulder strap.
This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.
How to Plan an Arthritis Exercise Program
To garner the benefits of exercise, you need to exercise on a regular basis. Sometimes, however, it can be a challenge to stay motivated, especially when you're feeling a bit stiff or fatigued. The following tips can help you plan a program that fits into your daily lifestyle and keeps you interested.- Remind yourself that exercise is something you can do to help yourself. While improvement may be slow, the results are well worth the effort. If you exercise properly, you can decrease your pain and stiffness, improve your ability to perform everyday tasks, increase your energy level, and even help lessen stress and depression.
- Don't get discouraged if you break your routine. We all have life events and distractions that take us away from even the best laid plans. If you falter from your schedule, just get back to it.
- Choose an activity you like. Exercise should be enjoyable, not torture. If you try one activity and find you don't like it, give another a try. Options include walking, cycling, aquatic exercise, and swimming.
- Blend exercise with socializing. Walk with a friend or in a group so you can encourage and support each other.
©2006 Publications International, Ltd.
If you can exercise with a friend it might help you stick to your exercise program. - Keep an exercise diary to help you set goals and track progress.
- Start slowly and be realistic about your progress.
- Look for an exercise class designed for individuals with arthritis that focuses on strengthening while avoiding movements that may be harmful to arthritic joints.
- When planning your routine, choose an activity and schedule that you can realistically incorporate into your life. If you enjoy water exercise but have to travel an hour each way to get to the pool, consider whether you'll honestly be willing and able to travel that distance regularly. If not, consider an activity closer to home.
Your workout will be more pleasant if you are dressed for the occasion. Choose comfortable clothes that you can get into and out of without assistance, especially if you have difficulty dressing and will be exercising at a health club. Most clubs don't provide assistance with such activities. If you have decreased function in your hands, look for tops that are large enough to get into easily and pants that slide easily over your hips. Try layering clothing, so you can slip off layers as you warm up.
Pay special attention to your shoes. Many forms of arthritis affect the feet, and foot problems are very individual. Select a shoe with a wide toe area that prevents rubbing and pressure. Many shoes are now available with Velcro closures that can be loosened if your feet swell. Look for a shoe with good cushioning and arch support. And try to air out your shoes between workouts, since dampness can lessen a shoe's support.
Now that you are ready to exercise, we will get started by learning some simple stretches. In the next section, we will learn about range of motion exercises.
This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.
Range of Motion Exercises for Arthritis
Many individuals with arthritis experience gel phenomenon, or morning stiffness. It is more common in rheumatoid arthritis but is seen in other forms of arthritis as well. The cause of this symptom is not really known, but it is thought to be related to inactivity, such as during sleep. During prolonged periods of inactivity, fluid is thought to leak out into the tissues, causing swelling and pain. The swelling, in turn, causes stiffness and pain when you attempt to move the affected joint. The swelling and pain usually dissipate during the course of the day, as movement pumps fluid out of the surrounding tissue and into the veins.There are strategies you can use that may lessen the discomfort associated with morning stiffness. These include using an electric blanket and wearing stretch gloves on your hands at night to keep your joints warm and to help prevent inflammation. Another valuable strategy is to perform range-of-motion (ROM) exercises.
 ©2006 Publications International, Ltd. Simple range of motion exercises can greatly increase your flexibility and joint health. |
ROM exercises can be done on selected joints prior to getting out of bed. For example, you might put your knee joints through their fullest range possible before getting up and putting weight on them. In addition, you may be able to use ROM exercises to keep up flexibility during a flare (an episode in which the joints are hot and painful), although you will have to discuss this with your doctor first. ROM exercises can also be done before more vigorous exercise, to help warm up your joints, and after exercise, to help you cool down gradually.
Keep in mind, however, that ROM exercises should not replace your regular exercise program. These exercises are not meant to strengthen the muscles that support the joints, nor are they designed to do much for muscle endurance. ROM exercises should be done in conjunction with a program of more vigorous exercise that has been tailored to your specific needs.
When performing ROM exercises, keep these thoughts in mind:
- Begin slowly. Start with five to ten repetitions, if you can, and gradually increase that number.
- Don't push a joint to the point of pain. If you are experiencing pain, you may have extended your range too far.
- Remember to breathe regularly as you do the exercises. Do not hold your breath.
Wrist and Fingers
Always be sure to exercise both hands. You may find it helpful to use a table to support your hands and arms during the exercises.
- Relax your fingers, and bend your wrist back and forth as far as possible.
- Rest your forearm and hand, palm down, flat on a tabletop. Lift each finger as high as it will go. Also lift the thumb. Then, with your fingers together, lift your entire hand while keeping your forearm on the table.
- Open and close your hand, make a fist, then release.
- With your hand wide open, touch the tip of each finger to the tip of your thumb. Spread the fingers wide for extended range.
- Place your hand palm down on a table, with your thumb extended to the side. One by one, slide each finger over to your thumb until all your fingers are together.
These exercises can be done while sitting or standing. Remember never to hyperextend the neck directly backward as this puts undue pressure on the cervical spine (upper neck vertebrae).
- Turn your head slowly and look over your right shoulder, then over your left shoulder.
- Tilt your head to the left, moving the left ear to the left shoulder; repeat to the right. Don't be alarmed if you hear a cracking sound; it is likely the sound made by the normal movement of bone against bone, known as crepitus.
- Lying on your back, with your arms at your sides, bend your elbows and try to move your upper arms away from your body until they are at right angles to it.
- Keep your arms on the bed throughout the exercise.
- Lying on your back and keeping your upper arms resting on the bed, bend your elbows at right angles so that your forearms are perpendicular to your body.
- Once in this position, rotate your forearms so that you are alternately looking at the palms and backs of your hands.
- Stand with your hands on your hips and your feet shoulder-width apart.
- Turn your head and shoulders to the right and then to the left. Keep your hips facing forward throughout.
- Sit on the floor with your legs stretched out in front of you.
- Roll your legs inward so that your feet point toward each other.
- Then roll your legs outward so that your feet point away from each other.
- Lie on the floor faceup, with your legs extended.
- Bring one knee up toward your chest and then back down to the floor. Do four repetitions, then switch legs.
- Sit on the floor with your legs extended in front of you.
- Trace circles in the air with your toes, first clockwise, then counterclockwise. Be sure to rotate your ankles gently. Do several repetitions.
- Sit on the floor, with your legs extended in front of you.
- Flex and extend your toes. If your toes are too stiff, use your hands to gently bend the toes up and down.
This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.
Strengthening Exercises for Arthritis
Strong, properly conditioned muscles not only look good, they are essential to supporting and protecting the joints. In particular, strong muscles serve to support the back and spine to help prevent back injuries.Your regular exercise program will gradually help to strengthen your muscles. However, additional strengthening exercises can be done independent of other forms of active exercise. You may even want to combine your strengthening exercises with your gentle ROM routine.
Usually, strengthening exercises should be done at least once a day but no more than twice daily to avoid fatigue and stress to the muscles and joints. Of course, you need to consider your individual tolerance when determining how often to exercise.
The time of day you select is strictly up to you, but you'll get the best results if you do strengthening exercises when you are not fatigued. This type of exercise may be easier or more comfortable to perform after a warm shower. Some people prefer doing their strengthening exercises before retiring for the evening to promote restful sleep. Whatever time of day you choose, the important point is to do these exercises, as well as your ROM exercises, regularly. They should become as much a part of your daily routine as brushing your teeth.
As you perform your strengthening routine, keep these guidelines in mind:
- Spend a few minutes warming up and stretching to loosen tight muscles and limber up stiff joints before beginning.
- Do your exercises in a logical order beginning with the upper body and progressing to the lower body.
- Perform the movements slowly and smoothly, precisely, and correctly. Distractions such television may cause loss of concentration and improper technique in performing exercises.
- Begin with no more than five repetitions and gradually increase the number of repetitions as your tolerance builds.
- Change the number of repetitions you do according to the way you feel on any particular day. Listen to your body. If you're having a bad day, don't push yourself.
- Breathe normally. Holding your breath during exercise may cause you to fatigue more rapidly.
Shoulders
- Raise one arm over your head and reach back with your hand as if you were trying to scratch an itch on your back.
- Bend the other arm behind your back and reach upward, trying to touch the fingers of the other hand. Repeat using opposite arms. This is a good exercise for both strength and flexibility of the shoulder.
 ©2006 Publications International, Ltd. Keeping your forearms on the floor, lift your head and shoulders. |
- Lie flat on your back on a mat or cushioned floor. (Use a sturdy chair if necessary to lower yourself to the floor.) Pull one knee to your chest and hold for ten seconds; then extend that leg and repeat the movement with the opposite leg. This will stretch the back and prepare it for the following strengthening exercise.
- Lie on your stomach. Keeping your forearms on the floor, lift your head and shoulders off the floor, placing the weight on your forearms. Hold for ten seconds, then release and repeat.
- Lie on your back with your knees bent and your feet flat on the floor.
- Slowly raise your head and shoulders off the floor, hold for ten seconds, then release. Be sure to keep your lower back on the floor throughout the exercise. Support your neck with one hand if you have arthritis in the neck region.
- While sitting in a firm, sturdy, hard-backed chair, straighten your leg by tightening the thigh muscles.
- Point your toes straight out in front of you, then up toward the ceiling, working up gradually to ten repetitions, then relax and repeat. Do the same with the other leg.
- Remain seated in the chair, and raise both feet slightly off the ground.
- Rotate your ankles to the right and then to the left.
Aquatics, or water exercise, has long been accepted as an exercise of choice for people with arthritis. Therapeutic water workouts feature a series of specially designed exercises that promote joint flexibility, muscle strength, and relaxation. The buoyancy the water provides allows joints to move through their full range of motion with less stress.
 ©2006 Publications International, Ltd. Aquatic exercise will allow you to workout without putting too much pressure or strain on your joints. |
- Look for a class sanctioned by the Arthritis Foundation, which has developed a program taught in many locations across the country. To be sanctioned, the instructor must have completed special training. If you can't find a sanctioned class, be sure the class you're considering is taught by a qualified instructor who either is a physical or occupational therapist or has some form of certification in water exercise.
- Get your doctor's approval before participating.
- Look for a pool that maintains a water temperature of 84 degrees Fahrenheit (pools for lap swimmers are usually in the 80 to 83 degree range), since you may find cooler water uncomfortable.
- If getting into and out of a pool is tough for you, look for a "therapeutic" pool. Some fitness centers feature pools with ramps or steps with railings leading into the pool and water at only midchest level to promote balance.
- Protect your feet. Regular aquacizing can be irritating to the soles of the feet. Protective nonslip rubber-soled shoes are available at sporting goods stores in a variety of price ranges. These specially designed shoes protect the feet and provide traction in and around the pool.
- If you use a cane or walker in the pool area, make sure rubber-tipped ends are functional and intact to prevent slippage.
- If you wear a swimsuit coverup, make sure it's not touching the floor, so it doesn't trip you up.
- If you want to use the whirlpool at the fitness center, do so only after your water exercise class. The very warm water of the whirlpool may induce fatigue and increase heart rate, potentially depleting your physical resources for exercise.
Although exercise plays an important role in the management of arthritis, doing too much can be as bad as doing too little. When you begin your exercise program, you will probably experience some normal discomfort and soreness. You may even be a little more tired than normal at first. However, it's important to recognize the difference between normal soreness and fatigue and overdoing it. How do you do that?
Try following the two-hour pain rule: If you have pain or discomfort in your joints for as long as two hours after you've finished your workout, you're probably overdoing it and may need to modify your program. In addition, be careful not to overuse a joint once it begins to feel better, since this can lead to damage.
The throbbing joint pain of arthritis may make exercise sound impossible, but skipping the gym may cause more pain in the long run. As long as you are safe and careful, exercise can control and even relieve some of your arthritis pains.
©Publications International, Ltd.
ABOUT THE AUTHOR:
Diana L. Anderson, Ph.D., is the author of 50 Ways to Cope with Arthritis and a past First-Vice President of the Association of Rheumatology Professionals. She is the President, CEO and founder of D. L. Anderson International, Inc., parent company to subsidiary D. Anderson & Company, a patient recruitment and retention provider and is recognized internationally as an expert in her field. For more information, visit her website at www.dandersoncompany.com.
ABOUT THE CONSULTANTS:
Eric Gall, M.D., is a professor and chairman of the Department of Medicine, professor of microbiology and immunology, and chief of the Division of Rheumatology at the Chicago Medical School of Rosalind Franklin University of Medicine & Science. He is a master of the American College of Rheumatology and the American College of Physicians and former president of the Association of Rheumatology Health Professionals. He has a long-time interest in multidisciplinary care of arthritis and is active in both the national and local chapters of the Arthritis Foundation.
Paul Katz, M.D., is Professor and Vice Chairman, Department of Medicine and Chief of the Division of Rheumatology, Immunology and Allergy, at Georgetown University Medical Center. Dr. Katz serves on the Council on Education of the American College of Rheumatology and is a member of the Government Affairs Committee of the Arthritis Foundation.
This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.