Exercises to Improve Joint Function in People Suffering from Arthritis
Osteoarthritis (OA) is a musculoskeletal non-systemic disorder characterised by the progressive degeneration of articular cartilage and its underlying bone. Before the age of 50, men have a larger incidence of OA than women; however, beyond the age of 50, women have a higher frequency.
Arthritis and Exercise
COMPREHENDING ARTHRITIS
The definition of arthritis is “joint inflammation” (arth = joint; itis = inflammation). It refers to about 100 distinct disorders that affect the joints and surrounding tissues.
Muscles and tendons are found in the joints. Some types of arthritis, such as rheumatoid arthritis and lupus, can also cause damage to the skin and internal organs.
Approximately 70 million Americans suffer from arthritis or a similar illness. People with arthritis experience numerous obstacles as a result of the condition, but the good news is that there are numerous methods to overcome these challenges.
overcome such obstacles and live a fulfilled life.
EXERCISE, WHAT CAN IT DO FOR ME?
Exercise is beneficial to practically everyone. For many years, persons with arthritis were advised not to exercise since it would harm their joints. Doctors and therapists now understand that patients with arthritis can improve their health and fitness by exercising safely.
Exercise is especially important if you have arthritis or a similar illness. Exercise is important because it can help with the following:
• Maintain joint flexibility;
• maintain the strength of the muscles surrounding your joints;
• avoid additional bone and cartilage degradation
• enhance your capacity to do daily tasks; and
• increase your general health and fitness by doing the following:
- providing you with greater energy
- promoting better sleep
- Maintaining a healthy weight
- strengthening your heart
- lessening depression
- boosting your self-esteem and overall well-being.
Regular exercise, together with medicine, rest, and other aspects of your treatment plan, can help keep your joints in functioning order so you can continue your normal activities. It may also assist to avoid further joint injury.
What Could Happen If I Don’t Work Out?
Because you have arthritis, it is critical that your muscles remain as strong as possible. The stronger the muscles and tissue surrounding your joints, the better they will be able to support and protect those joints, even if they are weak and injured due to arthritis. If you don’t exercise, your muscles shrink and weaken. Weight-bearing workouts also help to maintain bone strength and prevent osteoporosis and bone fractures.
Many persons with arthritis keep painful joints bent because it is more comfortable at first. If your joints remain in the same position for an extended period of time without movement, you may lose the capacity to straighten them out.
Exercise keeps your joints mobile, allowing you to perform your daily chores as independently as possible.
Exercise has the ability to alter your mood. You may experience depression if you are in pain. If you are depressed, you may not want to move or exercise. However, if you do not exercise, you may experience increased discomfort and despair. Regular exercise, according to research, is an excellent way to feel better and move more comfortably.
How Do I Decide What’s Best?
Everyone can benefit from an exercise programme. The optimal programme for you will be determined by the type of arthritis you have, which joints are afflicted, and the intensity of involvement.
Your treatment plan may also change depending on how active your arthritis is. Your doctor and a physical therapist can advise you on the ideal workout programme for you.
Even if your arthritis has produced foot, knee, or hip abnormalities, you can still exercise. Your doctor and physical therapist can work with you to create a programme that allows you to exercise your leg muscles without aggravating these joints.
Who Can Assist Me in Beginning an Exercise Programme?
Two categories of health professionals are uniquely qualified to work with you to maximise the benefits of a customised fitness programme.
Physical therapists can demonstrate specific range-of-motion and strength exercises to help maintain your joints flexible and your bones and muscles strong. They can also instruct you on suitable exercise practises, safety considerations, and other requirements.
Occupational therapists can teach you how to perform routine tasks in a way that does not put additional strain on your joints. Splints and other assistive devices can also be provided by occupational therapists to help you exercise more comfortably and reduce pain.
Is There a Risk to Exercising?
The most prevalent risk of exercising is that it will aggravate your arthritis by overworking your joints or muscles. This can happen if you exercise for too long or too hard, especially if you are just starting out.
Keep in mind that exercise is simply one component of your treatment plan. Your programme should also include the following components:
• appropriate medical diagnosis;
• arthritis information;
• making proper use of your joints;
• energy conservation;
• pharmaceuticals;
• appropriate nutrition;
• relaxation and rest;
• splints (in some cases);
• using heat or cold therapies; and
• surgery (in some cases).
THE MAIN EXERCISE TYPES
A balanced exercise programme that includes various types of exercise is generally beneficial to those with arthritis. Range-of-motion, strengthening, and endurance activities are the three basic types of exercise that should be included in your fitness programme.
Exercising Your Range of Motion
Range-of-motion (ROM) exercises minimise stiffness and help keep your joints flexible, which can help you carry out your regular tasks. The “range of motion” refers to how far your joints can move in different directions. Pages 9-12 of this pamphlet contain examples of ROM exercises. If your joints are really painful and swollen, move them through their range of motion carefully. These exercises are most effective when performed in a non-weight-bearing position, such as reclining on your bed or couch. You should strive to execute these exercises on a daily basis. Before you begin, do a quick check of your joints from head to toe to see which ones are stiff. Exercise the stiffest joints first. Do at
Every day, do at least one set of three to ten repetitions.
Exercises to Build Muscle
These workouts are advantageous because they aid in the maintenance or increase of muscle strength. Strong muscles aid in the stability and protection of your joints. Isometric workouts are preferred over isotonic exercises by those with arthritis. Every alternate day, perform these exercises.
EXERCISES IN ISOMETRIC SIZE
You contract your muscles but do not move your joints throughout these workouts. These workouts allow you to strengthen your muscles without having to move uncomfortable joints. Isometric workouts include quadriceps sets, which involve tightening the big muscle in the front of your leg. Another example of an isometric exercise is shown in the figure below.
This exercise strengthens the muscles that allow your knee to bend and straighten. Sit on a straight-backed chair and cross your ankles. Your legs can be almost straight or as bent as you desire. With your back leg, push forward, and your front leg, press backward. Hold this stance and count out loud for six to ten seconds while exerting even pressure on your legs. Relax before switching leg positions and repeating.
EXERCISES IN ISOTONIC FORM
You move your joints in these workouts to build your muscles through resistance. Gravity, a resistance band, or a light barbell or cuff weight can all provide resistance to movements. (Start with one or two pounds of weight.)
In addition, water exercises can help build muscles since the water gives both support and resistance to your motions.
This workout helps to develop your thigh muscles. Sit in a chair with your feet slightly apart on the floor. Raise one foot till your leg is as straight as possible. Hold this stance for six to ten seconds while counting aloud. For each leg, perform two sets of three to ten repetitions. Lower your foot gently to the floor. Relax. Rep with the other leg.
Strengthening exercises for those with arthritis must be properly tailored. Knowing which muscles to strengthen and how to perform the exercise without overstressing the joints are critical components of a successful fitness programme. Your physical therapist, occupational therapist, and/or doctor can make some suggestions.
Exercises for Endurance
Once you’re comfortable with strengthening and ROM exercises, add endurance workouts gradually. Start with exercising for five minutes three times a day for a total of 15 minutes that day. Try gradually increasing the endurance component of your workout programme to a total of 30 minutes per day, most days of the week.
Endurance exercises benefit your heart because they strengthen it. They improve the efficiency of your lungs and increase your stamina, allowing you to operate for longer periods of time without tiring as rapidly. Endurance workouts can also help you sleep better, lose weight, and feel better in general.
Walking and water activities are two of the most useful endurance exercises for people with arthritis.
WALKING
Walking is preferable than running for persons with arthritis since it puts less strain on your joints. It does not require any specific talents and is affordable. You will, however, require a nice pair of supportive walking shoes. You can stroll practically anywhere and at any time. If you have significant hip, knee, ankle, or foot problems, consult your doctor; walking may not be appropriate for you, or you may prefer to undertake this activity in a pool.
EXERCISE IN WATER
Swimming and water exercise are especially beneficial for tight, achy joints. Warm water (between 83o and 88o F) aids in muscular relaxation and pain relief. Water supports your body, reducing tension on your hips, knees, feet, and spine. Warm-water exercises can be performed while standing in shoulder- or chest-high water, or while sitting in shallow water. Use an inflatable tube or floating vest to keep you afloat while exercising in deeper water.
BICYCLING
Cycling, particularly on an indoor, stationary bicycle, is an excellent way to increase your fitness. When the pedal is at its lowest position, adjust the seat height such that your knee maintains a modest bent. Don’t add so much resistance that you can’t pedal.
If you have knee difficulties, begin exercising on a stationary bicycle slowly and with little or no resistance.
HOW SHOULD I BEGIN?
Before commencing any form of exercise programme, consult with your health-care team. If you haven’t been exercising regularly or have pain, stiffness, or weakness that interferes with your everyday tasks, begin your fitness programme with only ROM and strengthening exercises.
WHEN SHOULD I WORKOUT?
Experiment with different times of day to see what works best for you. Some people find that doing gentle ROM exercises before bed helps them loosen up for the day’s activities; others feel that doing gentle ROM exercises before bed helps them wake up less stiff. It may be beneficial to undertake a few short bouts of ROM exercises throughout the day. A good rule of thumb is to workout during the day when you have less pain and stiffness and when you have enough time.
Don’t conduct intense workouts right after eating or right before going to bed. Allow at least two hours after eating.
Regular exercise is essential. Do ROM exercises every day and strength and endurance workouts every other day. If you skip a day, simply resume where you left off. If you miss a few days, you may have to restart at a lower level.
EXERCISE TIPS FOR BETTER RESULTS
Prior to Exercise
USE HEAT OR COOL TREATMENTS
Apply heat or cold to the area where you will be exercising. If your joints are heated, red, or swollen, you should use ice before exercising. If your joints are uncomfortable and stiff but not warm or swollen, you should consider applying heat to them before exercising. Heat relaxes your joints and muscles, relieving pain. Some people find that being cold relieves pain and swelling. There are numerous ways to deliver heat or cold. You could try the following methods:
• having a warm (not hot) shower before working out;
• putting a heating pad, hot pack, or heat lamp on the hurting spot;
• relaxing in a hot tub; and/or
• wrap a bag of ice or frozen veggies in a towel and place it on the aching spot. (Gel packs, which are widely available at pharmacies, can be stored in the freezer between uses and are convenient.)
Make certain that the heat or cold is applied correctly. Heat treatments should be calming and comfortable rather than hot. Apply heat for approximately 20 minutes. Cold should be used for 10 to 15 minutes at a time.
WARMING UP
It is critical to warm up for five to fifteen minutes before performing ROM, endurance, or strengthening exercises. This reduces the risk of injury by assisting your body in preparing for and recovering from activity.
Walk gently while swinging your arms to warm up before beginning ROM exercises. Begin with a few easy repetitions in mid-range and work your way up to full range of motion.
Warm up for endurance activities by walking slowly or doing a slow version of the activity you intend to do, then stretching gently. (To achieve a moderate stretch of the muscles and tissues surrounding the joint, simply go to the end of your range of motion, hold for five seconds, and relax.) Increase gradually until you reach your endurance speed.
Walk slowly while practising arm swings to warm up for strengthening workouts. Then, stretch the muscles you want to strengthen gradually.
DRESS IN COMFORTABLE CLOTHES AND SHOES.
Clothing should be loose and comfy to allow for effortless movement. Layering your clothing will assist you in adapting to changes in temperature and activity level. Your shoes should be supportive, and the soles should be constructed of a non-slip, shock-absorbing material. Wearing shock-absorbing insoles can also make your workout more comfortable.
During the Exercise
DON’T BE RUSHED
Exercise at a steady, comfortable speed that allows you to talk to someone without being out of breath. Exercising at this speed allows your muscles to relax between repetitions.
It is best to do each exercise slowly and completely than to do several repetitions at a fast pace for range of motion and flexibility. As you get into condition, you can gradually increase the amount of repetitions.
BREATHE WHILE EXERCISING
Don’t get your hopes up. Breathe out (exhale) when performing the exercise and in (inhale) while relaxing between repetitions. Counting out loud will help you breathe deeply and frequently during the workout.
BE ON THE LOOKOUT FOR “WARNING SIGNS”
If you experience chest tightness, severe shortness of breath, or feel dizzy, faint, or sick to your stomach, stop exercising immediately. If you experience any of these symptoms, call your doctor right away.
If you have muscle soreness or a cramp, rub and stretch the muscle gently. Continue exercising with moderate, easy motions once the pain has subsided. It is normal to experience mild to moderate joint discomfort after activity for a short period of time. If you experience an increase in pain, warmth, or swelling after exercise that lasts more than a couple of hours, you probably strained your joints and should exercise less the next time.
BE AWARE OF YOUR BODY’S SIGNALS
During the first few weeks of your workout programme, you may notice that your heart rate increases, your breathing rate increases, and your muscles feel strained. You may be more weary at night, but you will wake up feeling rejuvenated in the morning. These are normal exercise reactions that indicate your body is responding to your new activities and getting in shape.
DO NOT TRY TO DO TOO MUCH TOO FAST.
Starting to exercise should be a gradual process that takes several weeks or more. If you have joint pain that lasts two hours after exercising, or if your soreness, stiffness, or weariness is greater the next day, you’ve done too much. According to the Two-Hour Pain Rule, if you experience greater arthritic pain (as opposed to sore muscles from exercise) two hours after you exercise, you’ve probably done too much and should cut back a little.
But don’t stop working out. Not exercising can aggravate your arthritis. Reduce the number of times you do each exercise the next time, or do them more softly. If this does not work, consult with your therapist about modifying the workout. A decent rule of thumb is to quit exercising if you experience sharp discomfort or greater pain than normal. Pain serves as a warning sign when something is amiss.
Following Exercise
SLOW DOWN
It is critical to cool down after exercise to lower your risk of injury. Simply repeat the activities you did to warm up to cool down. Cool down for five to fifteen minutes to allow your heart rate and breathing to return to normal. Gentle stretches at the end help keep muscles from becoming overly painful.
HOW DO I CONTINUE?
Maintain a positive attitude towards yourself and your fitness routine. Remember that exercise can help you lessen pain and maintain most of your everyday activities. But keep in mind that there will be days when you don’t feel like doing anything. Do a little less activity on these days.
The following are the keys to sticking to your fitness routine:
• Make fitness a part of your daily routine.
• Maintain the habit by getting some exercise on days when you aren’t inspired. Make an effort because breaking the pattern can reduce the benefits of exercise.
• Pay attention to your body’s cues. Know when to reduce or adjust your workout routine.
There are numerous reasons why we should not exercise. Here are some frequent issues you may encounter and solutions to them. “I haven’t worked out in a long time.” What if I’m unable to complete the task?” It’s natural to be nervous about doing something you haven’t done in a long time. To overcome such feelings, avoid viewing exercise as a competition with others. Instead, concentrate on your own strengths and do your best. Consider yourself fortunate. Each accomplishment, no matter how minor, will assist to boost your self-esteem and confidence.
“I’m not in good shape. It will take too long to see benefits.” Setting goals can often help to address and manage long-term issues. You can utilise the same measures to ensure the success of your exercise programme:
• Determine what you want to achieve (your long-term aim).
• Determine the steps required to achieve this aim. Make a list of your possibilities, then pick one or two to work on.
• Create short-term plans to assist you get there the possibilities you’ve chosen. These plans specify specific actions you can realistically anticipate to complete in a short period of time. These acts should be something you want to accomplish, something you believe you can do, and something that contributes to your long-term goal. Make a fitness agreement with yourself. (See sample.) Keep a diary of what you intend to do, how much you intend to do, when you intend to do it, and how frequently you intend to do it. Place your strategy somewhere you’ll see it every day.
• Follow through on your plan. Keep track of your progress and any issues that arise. In addition, ask your family and friends for input on how you’re doing.
• At the end of each week, review the outcomes of your short-term plans.
• If something does not appear to be working, change your plans. If your issues persist, get assistance from others.
“It hurts.” Having some discomfort or soreness when starting an exercise programme is natural. Always remember to warm up and cool down before and after exercising to help relax your muscles and decrease soreness. Also, keep in mind that exercising to strengthen muscles and joints might help minimise arthritis discomfort.
Keep the Two-Hour Pain Rule in mind.
Reduce the quantity of workouts you do on days when your joints are more uncomfortable and inflamed. Talk to your doctor or therapist if you see a significant change in your ability. If you only have one or two swollen or painful joints, you can modify your activities to put less strain on those joints. If your knee hurts, for example, instead of walking, try water workouts or a stationary bicycle with no resistance.
“It’s boring.” Perform workouts that you enjoy. Inquire with your therapist about new workouts that can help to spice up your routine. While exercising, listen to your favourite music. Exercise with a group of friends or family members. If you stroll or ride your bike, go to a park or another nice location.
“I don’t have enough time.” Stick to a fitness routine. Several brief intervals of exercise are just as beneficial as one extended time. Making time for physical activity should not be a chore. Consider your exercise time to be personal time.
“The weather’s bad.” If you normally exercise in a group and are unable to attend your class, conduct your exercises at home. Have a backup plan for indoor exercises if you swim or stroll. If the weather is too awful to stroll outside, go for a walk inside a retail mall.
“I don’t like to exercise alone.” Enlist the help of friends or family members to exercise with you, or enrol in an exercise class.
“It’s too much work.” Perhaps your fitness programme is overly ambitious. Perhaps you’re attempting to do too much. Relax! Exercising for fun is the best way to stay motivated.
“I lose interest and forget about it.” If you’re having difficulty sticking to your programme, consider the factors that can influence your attitude. What motivated you to begin the programme? Are these arguments still valid? Keep track of what you do, and at the end of each day, cross off the exercises you completed.
“My joints are not bothering me anymore.”
Exercise has most likely played a significant role in this.
Instead of giving up, try some new workouts.
or activities that will spice up your schedule.
Consult your doctor before beginning.
any fitness programme.
THE HEAD TURNS
• Maintain a straight face.
• Turn your head to gaze behind your shoulder.
• Hold the position for three seconds.
• Go back to the beginning.
• Repeat on the opposite side.
CIRCLES ON THE SHOULDERS
• Slowly move your shoulders in a circular motion.
REACH OF THE FORWARD ARM
• Extend your arms in front of you, palms facing each other.
• Raise one or both arms forward and as high as possible (if necessary, one arm can assist the other).
• Lower gradually.
RUB AND PAT ON THE BACK
• Raise one arm to pat yourself on the back.
• Reach the other arm behind the lower back.
• Bring your hands together.
• Hold the position for three seconds.
• Switch arm positions.
BEND AND TURN THE ELBOW
• Place your fingers on your shoulders, palms facing you.
• Extend your elbows out to the side, palms down.
WRIST BENDING
• Stand with your elbows tucked to your sides.
• Raise your wrists.
• Hold the position for three seconds.
• Lower your wrists.
• Hold the position for three seconds.
FINGER CURLING
• Keep your hand flat and your fingers straight.
• Make a loose fist by softly bending each joint.
• Hold the position for three seconds.
• Straighten your fingers once more.
KEEL LIFT
• Sit up straight.
• Raise one knee three or four inches off the chair.
• Hold for three seconds before lowering.
• Repeat with the opposite knee (you can aid this by elevating with your hands under your thigh).
LIFT AND BEND YOUR LEGS
• Maintain a straight posture.
• Bend knee and place heel beneath chair.
• Hold the position for three seconds.
• Extend your front knee.
• Hold the position for three seconds.
CIRCLES OF THE ANKLE
• Sit up straight with one foot in front of you.
• In and outward rotation of the foot’s sole.
• Make a large, leisurely circle with your foot.
• Switch directions.
** Please consult your doctor before performing any of these exercises or methods. This information is not meant to replace the advice of trained medical professionals.