Exercise and arthritis

Trainer Lorilee recently came on The Midday Show, with some exercise tips for those dealing with arthritis. Enjoy!


Exercise and Arthritis

If you have arthritis, exercise is essential. For anyone, exercise increases energy levels, helps develop a better sleep pattern, helps with weight control, maintains a healthy heart, increases bone and muscle strength, decreases depression and fatigue, serves to improve self-esteem and self-confidence.

Exercise is important for healthy joints. Moving your joints daily helps keep them fully mobile. Strengthening the surrounding muscles helps support the joints. Also, joint movement transports nutrients and waste products to and from the cartilage, the material which protects and cushions the ends of the bones.

Exercise And Arthritis - Types of Exercise
There are different types of exercise and it's important for you to understand why each is important.

Range-of-motion Exercises
Range-of-motion exercises are gentle stretching exercises that aim to move each joint through their normal maximum range of motion. These exercises need to be done daily to help keep joints fully mobile and prevent stiffness and deformities.
Range-of-motion exercises are important for arthritis patients who -- because of intense or chronic pain -- shy away from moving their joints through their full range. Some people believe that normal daily activities take joints through their full range of motion but this is not the case. Normal daily activities, such as housework, dressing, bathing, and cooking are not a substitute for range-of-motion exercises.

Strengthening Exercises
Strengthening exercises help increase muscle strength. Strong muscles help support the joints -- making the joints more stable and helping you move more easily and with less pain. The two types of strengthening exercises are isometric and isotonic.
Isometric exercises involve tightening the muscles, without moving the joints. These exercises are especially useful when joint motion is impaired.
Isotonic exercises involve strengthening the muscles by moving the joints.

Endurance Exercises
Endurance exercises are physical activities that bring your heart rate up to your optimal target level for at least 20 to 30 minutes. Your target heart rate is computed based on age and physical condition. By raising the heart rate, endurance exercises improve cardiovascular fitness. Endurance exercises should be performed at least three times a week to build on their effectiveness.

Many arthritis patients who regularly perform endurance exercises find they are able to increase physical strength, develop a better mental attitude, and improve arthritis symptoms.

Not all arthritis patients are able to perform endurance exercises however. For example, patients with long-term rheumatoid arthritis who have severe joint damage and functional limitations may be unable to do this type of activity. Endurance exercises for arthritis patients need to be chosen carefully to avoid joint injury.

Exercise Choices
You should always discuss exercise plans and goals with your doctor before starting a routine or program. There may be exercises that are off-limits because they could cause injury or further joint damage, espeically when joints are swollen and inflamed. The amount and form of exercise recommended for each individual will vary depending on type of arthritis, joints involved, levels of inflammation, stability of joints, joint replacements, or other physical limitations.

Exercise Guidelines
To obtain the maximum benefit from an exercise program:
-Be consistent. Exercise should be performed daily. In order to see results and obtain full benefits from exercise, it cannot be done sporadically.
-Build up gradually. The best exercise program is one which begins at a low intensity and builds up gradually as symptoms permit. Too much exercise, especially initially, can worsen symptoms.
-Exercise when symptoms are least distressing. The best time to exercise is when pain and stiffness are at a minimum. Some people with arthritis prefer exercising after morning stiffness subsides. Others dislike afternoon exercise sessions because they grow more tired as the day progresses. It's a matter of personal preference.
-Do not overdo. Many strengthening and range-of-motion exercise programs suggest performing the exercises in sets of three to 10 repetitions, with each set repeated one to four times. No set number works for everyone. The number of repetitions is dependent on how well you feel. Too much activity, especially during a flare, can aggravate or worsen symptoms.
-Listen to body signals. A certain amount of discomfort during exercise is acceptable and expected. If pain lasts two hours or more after exercise, the body is signaling that the exercise session was too strenuous. Fewer repetitions should be performed until symptoms subside.
-If the joint feels hot, avoid exercise. Exercise can worsen swollen, tender, or warm joints. Modify your activity until arthritis symptoms are once again under control.
-Set realistic goals. Begin the exercise program with reasonable goals and the determination to gradually increase over time. -Too much, too soon can be harmful.
-Smooth, steady rhythm. Exercising and breathing should be coordinated. Avoid bouncing or jerky motions which can add stress to joints. Exercise in a smooth, steady rhythm and relax between repetitions.
-Alternate rest with activity. While activity is important in maintaining healthy joints, so is getting the appropriate amount of rest.

How Often Should People With Arthritis Exercise?
-Range-of-motion exercises can be done daily and should be done at least every other day.
-Strengthening exercises should be done every other day unless you have severe pain or swelling in your joints.
-Endurance exercises should be done for 20 to 30 minutes three times a week unless you have severe pain or swelling in your joints. According to the American College of Rheumatology, 20- to 30-minute exercise routines can be performed in increments of 10 minutes over the course of a day.

Exercises to Avoid if You Have Rheumatoid Arthritis
In general, you should be careful about activities that put a lot of stress on a joint, or are "high-impact," such as jogging, especially on paved roads, or heavy weight lifting.