Exercises for person with osteoarthritis

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.

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Multiple studies have shown that exercise is one of the best treatments for osteoarthritis.

Exercise can improve mood and outlook, decrease pain, increase flexibility, improve blood flow, help with cardiac health, maintain weight, and promote general physical fitness. Exercise is also inexpensive and, if done properly, has few negative side effects. The amount and form of exercise will depend on which joints are involved, how stable the joints are, and whether a joint replacement has already been done.

Two types of exercise are important in osteoarthritis management. The first type, therapeutic exercises, keep joints flexible and functioning. The other type, aerobic conditioning exercises, improve strength and fitness, and control weight. Patients should learn how to exercise correctly, because exercising incorrectly can cause injury.

Exercises that will help a person with osteoarthritis include:

• Aerobic exercise that builds cardiovascular endurance, such as walking, biking, or swimming.

• Strength exercise, such as lifting weights. These can also be performed with exercise bands, inexpensive devices that provide resistance.

• Range-of-motion (flexibility) exercise, such as stretching or joint-specific exercises. These keep joints limber.

• Agility exercises. These help with balance and coordination.

Most people with osteoarthritis exercise best when their pain is least severe. Start with an adequate warmup and stretching and begin exercising slowly. Resting frequently ensures a good workout. It also reduces the risk of injury. Stretching afterwards is also crucial to protect against injury.

Many people enjoy sports or other activities in their exercise program. Good activities include swimming and aquatic exercise, walking, running, biking, cross-country skiing, and using exercise machines and exercise videotapes.

People with osteoarthritis should check with their doctor or physical therapist before starting an exercise program. Pain medications and applying ice after exercising may make exercising easier.

The following information comes from the American College of Rheumatology

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.

What Type of Strengthening Program Is Best?

This varies depending on personal preference, the type of arthritis involved, and how active the inflammation is. Strengthening one's muscles can help take the burden off painful joints. Strength training can be done with small free weights, exercise machines, isometrics, elastic bands, and resistive water exercises. Correct positioning is critical, because if done incorrectly, strengthening exercises can cause muscle tears, more pain, and more joint swelling.

Are There Different Exercises for People With Different Types of Arthritis?

There are many types of arthritis. Experienced doctors, physical therapists, and occupational therapists can recommend exercises that are particularly helpful for a specific type of arthritis. Doctors and therapists also know specific exercises for particularly painful joints. There may be exercises that are off-limits for people with a particular type of arthritis or when joints are swollen and inflamed. People with arthritis should discuss their exercise plans with a doctor.

How Much Exercise Is Too Much?

Most experts agree that if exercise causes pain that lasts for more than 1 hour, it is too strenuous. People with arthritis should work with their physical therapist or doctor to adjust their exercise program when they notice any of the following signs of strenuous exercise:

• Unusual or persistent fatigue
• Increased weakness
• Decreased range of motion
• Increased joint swelling
• Continuing pain (pain that lasts more than 1 hour after exercising)

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