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.
The following are examples of strengthening exercises. Keep in mind that a physical therapist who is knowledgeable about the exercise needs and special concerns of people with arthritis can help you establish an individualized strengthening program.

Shoulders
  1. Raise one arm over your head and reach back with your hand as if you were trying to scratch an itch on your back.

  2. 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.
Back

Keeping your forearms on the floor, lift your head and shoulders.
©2006 Publications International, Ltd.
Keeping your forearms on the floor,
lift your head and shoulders.

  1. 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.

  2. 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.
Abdominals
  1. Lie on your back with your knees bent and your feet flat on the floor.

  2. 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.
Knees
  1. While sitting in a firm, sturdy, hard-backed chair, straighten your leg by tightening the thigh muscles.

  2. 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.
Ankles
  1. Remain seated in the chair, and raise both feet slightly off the ground.

  2. Rotate your ankles to the right and then to the left.
Try Aquatic Exercise

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.

Aquatic exercise will allow you to workout without putting too much pressure or strain on your joints.
©2006 Publications International, Ltd.
Aquatic exercise will allow you to
workout without putting too much
pressure or strain on your joints.

Those who have difficulty walking for exercise usually can aquacize, because there's less stress on the back, hips, knees, and feet in the water. For most classes, you don't need to know how to swim (check before you sign up). Here are some tips for selecting and participating in a water exercise class:
  • 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.
Follow the "Two-Hour Pain Rule"

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.