Exercises for arthritis
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
Click here: Second Opinion Arthritis Treatment Kit
An important part of arthritis treatment is instructing the patient in a good exercise program. The proper exercise can mean the difference between a patient doing well and doing poorly.
Exercise is essential for people with arthritis. Exercise increases energy levels, helps develop a better sleep pattern, helps with weight control, maintains a healthy heart, increases bone and muscle strength and flexibility, reduces depression and fatigue, and helps to improve self-esteem and self-confidence.
There are three major types of exercise:
• Stretching- which includes range-of-motion
For people with arthritis, exercise is especially beneficial for the joints. Moving the joints daily helps to keep them fully mobile. Added joint support is achieved by strengthening the surrounding muscles. Joint mobility is improved by stretching ligaments and tendons to keep them supple. Also, joint movement transports nutrients and waste products to and from the cartilage, the material which protects the ends of the bones.
Range-of motion exercises are gentle stretching exercises which move each joint as far as possible in all directions. These exercises need to be done daily to help keep joints fully mobile and prevent stiffness and deformities. Range of motion (ROM) exercises are especially important for rheumatoid arthritis patients who have inflammatory pain. They tend not to want to move painful joints. It is thought by many people 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 ROM exercises. Stretching properly can also reduce the chance of injury.
Strengthening exercises help increase muscle strength. Strong muscles help to support the joints, making the joints more stable, and helping a person 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. In contrast, isotonic exercises involve strengthening the muscles by moving the joints.
There are a number of ways to help improve strength. These include machines or free weights. Any weight training should be done under the supervision of a knowledgeable therapist.
Strength training has the added benefit of helping prevent or improve osteoporosis.
Endurance or “cardio” exercises are physical activities that bring your heart rate up to your optimal target level for at least twenty to thirty minutes. This is the aerobic component. The target heart rate is computed based on age and physical condition. These exercises improve cardiovascular fitness. These exercises should be performed at least three times a week to enhance effectiveness. Many arthritis patients who do endurance exercises increase their physical strength, develop a better mental attitude, and even an improvement in arthritis symptoms. Not all arthritis patients are able to perform endurance exercises however. Patients with long-term rheumatoid arthritis and left with functional limitations will be unable to do this type of activity. Endurance exercises for arthritis patients need to be chosen carefully to avoid joint injury. Those exercises which are no impact or low impact are preferred. This form of exercise helps promote increased blood flow to the joints.
Walking, water exercises or swimming, and bicycling are the best choices of endurance exercises for people with arthritis. These are good choices because they put less stress on the joints. For example, the warm water of water exercising helps to relax muscles and decrease pain. The water should be between 83 and 90 degrees. The water helps support the body while the joints are moved through the full range-of-motion. The buoyancy of the water places less stress on the hips, knees, and spine.
Other forms of exercise such as t’ai chi or yoga also are beneficial.
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