Exercising with arthritis: Improve your joint pain and stiffness

As you consider starting an exercise program, understand what's within your limits and what level of exercise is likely to give you results.

Exercise is critical for people with arthritis. It increases strength and flexibility, reduces joint pain and helps combat fatigue. Of course, when stiff and painful joints are already bogging you down, the thought of walking around the block or swimming a few laps might make you cringe.

You don't need to run a marathon or swim the pace of an Olympic competitor to help reduce the symptoms of your arthritis. Even moderate exercise can ease your pain and help you maintain a healthy weight. When arthritis threatens to immobilize you, exercise keeps you moving. Not convinced? Read on.

Why exercise is vital

Exercise can help you improve your health and fitness without hurting your joints. Along with your current treatment program, exercise can:

• Strengthen the muscles around your joints
• Help you maintain bone strength
• Give you more strength and energy to get through the day
• Make it easier to get a good night's sleep
• Help you control your weight
• Make you feel better about yourself and improve your sense of well-being

Though you might think exercise will aggravate your joint pain and stiffness, that's not the case. Lack of exercise actually can make your joints even more painful and stiff. That's because keeping your muscles and surrounding tissue strong is crucial to maintaining support for your bones. Not exercising weakens those supporting muscles, making your bones more prone to breaking.

Check with your doctor first

Talk to your doctor about how exercise can fit into your current treatment plan. What types of exercises are best for you depends on your type of arthritis and which joints are involved. Your doctor or a physical therapist can work with you to find the best exercise plan to give you the most benefit with the least aggravation of your joint pain.

Exercises for arthritis

Your doctor or physical therapist can recommend types of exercises best for you, which might include:

Range-of-motion exercises
These types of exercises relieve stiffness and increase your ability to move your joints through their full range of motion. Range-of-motion exercises involve moving your joints through their normal range of movement, such as raising your arms over your head or rolling your shoulders forward and backward. These exercises can be done daily or at least every other day.

Strengthening exercises
These exercises help you build strong muscles that help support and protect your joints. Weight training is an example of a strengthening exercise that can help you maintain your current muscle strength or increase it. Do your strengthening exercises every other day — but take an extra day off if your joints are painful or if you notice any swelling.

Aerobic exercise
Aerobic or endurance exercises help with your overall fitness. They can improve your cardiovascular health, help you control your weight and give you more stamina. That way you'll have more energy to get through your day. Examples of aerobic exercises that are easier on your joints include walking, riding a bike and swimming. Try to work your way up to 20 to 30 minutes of aerobic exercise three times a week. You can split up that time into 10-minute blocks if that's easier on your joints.

Other activities
Any movement, no matter how small, can help. If a particular workout or activity appeals to you, don't hesitate to ask your doctor whether it's right for you. Your doctor might give you the OK to try gentle forms of yoga and tai chi. Be sure to tell your instructor about your condition and avoid positions or movements that can cause pain.

Tips to protect your joints

Start slowly to ease your joints into exercise if you haven't been active for a while. If you push yourself too hard, you can overwork your muscles. This aggravates your joint pain.

Consider these tips as you get started:

• Apply heat to the joints you'll be working before you exercise. Heat can relax your joints and muscles and relieve any pain you have before you begin. Heat treatments — warm towels, hot packs or a shower — should be warm, not painfully hot, and should be applied for about 20 minutes.
• Move your joints gently at first to warm up. You might begin with range-of-motion exercises for five to 10 minutes before you move on to strengthening or aerobic exercises.
• Exercise with slow and easy movements. If you start noticing pain, take a break. Sharp pain and pain that is stronger than your usual joint pain might indicate something is wrong. Slow down if you notice inflammation or redness in your joints.
• Ice your joints after exercising. This can reduce swelling and pain. Use a cold pack on your joints for 10 to 15 minutes.

Trust your instincts and don't exert more energy than you think your joints can handle. Take it easy and slowly work your exercise length and intensity up as you progress.

Don't overdo it

You might notice some pain after you exercise if you haven't been active for a while. In general, if your pain lasts longer than an hour after you exercise, you were probably exercising too strenuously. Talk to your doctor about what pain is normal and what pain is a sign of something more serious.

Tell your doctor if your exercise causes:

• Persistent fatigue or increased weakness
• Reduced range of motion in your joints
• Joint swelling
• Continuing pain

If you have rheumatoid arthritis, whether you should exercise during general or local flares is up to you and your doctor. Consider working through your joint flares by doing only range-of-motion exercises, just to keep your body moving.

Exercise programs for people with arthritis

Check with your doctor about exercise programs in your area for people with arthritis. Hospitals and clinics sometimes offer special programs, as do local health clubs.

The Arthritis Foundation conducts exercise programs for people with arthritis in many parts of the United States. Programs include exercise classes — in water and on land — and walking groups. Contact your local branch for more information.

2006-08-18

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