MDAdvice.com - Arthritis Informative Material: Questions and Answers About Arthritis and Exercise

This fact sheet answers general questions about arthritis and exercise. The amount and form of exercise recommended for each individual will vary depending on which joints are involved, the amount of inflammation, how stable the joints are, and whether a joint replacement procedure has been done. A skilled physician who is knowledgeable about the medical and rehabilitation needs of people with arthritis, working with a physical therapist also familiar with the needs of people with arthritis, can design an exercise plan for each patient.

What Is Arthritis?

Arthritis is a general term that refers to many rheumatic diseases that can cause pain, stiffness, and swelling in joints and other connective tissues. These diseases can affect supporting structures such as muscles, tendons, and ligaments and may also affect other parts of the body. Some common types of arthritis are osteoarthritis, rheumatoid arthritis,systemic lupus erythematosus,gout,juvenile rheumatoid arthritis,ankylosing spondylitis, and psoriatic arthritis.Osteoarthritis is the most common.

Should People With Arthritis Exercise?

Yes. Studies have shown that exercise helps people with arthritis in many ways. Exercise reduces joint pain and stiffness and increases flexibility, muscle strength, and endurance. It also helps with weight reduction and contributes to an improved sense of well-being.

How Does Exercise Fit Into a Treatment Plan for People With Arthritis?

Exercise is one part of a comprehensive arthritis treatment plan. Treatment plans also may include rest and relaxation, proper diet, medication, and instruction about proper use of joints and ways to conserve energy (that is, not waste motion) as well as the use of pain relief methods.

What Types of Exercise Are Most Suitable for Someone With Arthritis?

How Does a Person With Arthritis Start an Exercise Program?

People with arthritis should discuss exercise options with their doctors. Most doctors recommend exercise for their patients. Many people with arthritis begin with easy, range-of-motion exercises and low-impact aerobics. People with arthritis can participate in a variety of, but not all, sports and exercise programs. The doctor will know which, if any, sports are off-limits.

The doctor may have suggestions about how to get started or may refer the patient to a physical therapist. It is best to find a physical therapist who has experience working with people who have arthritis. The therapist will design an appropriate home exercise program and teach clients about pain-relief methods, proper body mechanics (placement of the body for a given task, such as lifting a heavy box), joint protection, and conserving energy.

Step Up to Exercise: How To Get Started

Discuss exercise plans with your doctor.
Start with supervision from a physical therapist or qualified athletic trainer.
Apply heat to sore joints (optional; many people with arthritis start their exercise program this way).
Stretch and warm up with range-of-motion exercises.
Start strengthening exercises slowly with small weights (a 1 or 2 pound weight can make a big difference).
Progress slowly.
Use cold packs after exercising (optional; many people with arthritis complete their exercise routine this way).
Add aerobic exercise.
Consider appropriate recreational exercise (after doing range-of-motion, strengthening, and aerobic exercise). Fewer injuries to arthritic joints occur during recreational exercise if it is preceded by range-of-motion, strengthening, and aerobic exercise that gets your body in the best condition possible.
Ease off if joints become painful, inflamed, or red and work with your doctor to find the cause and eliminate it.
Choose the exercise program you enjoy most and make it a habit.

What Are Some Pain Relief Methods?

There are known methods to stop pain for short periods of time. This temporary relief can make it easier for people who have arthritis to exercise. The doctor or physical therapist can suggest a method that is best for each patient. The following methods have worked for many people:

How Often Should People With Arthritis Exercise?

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 smallfree 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 theirexercise plans with a doctor. Doctors who treat people with arthritis include rheumatologists, general practitioners, family doctors, internists, and rehabilitation specialists (physiatrists).

How Much Exercise Is Too Much?

Most experts agree that if exercise causes pain that lasts for more than 1 hour, it is too much. 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 too much exercise:

Should Someone With Rheumatoid Arthritis Continue To Exercise During a General Flare? How About During a Local Joint Flare?

It is appropriate to put joints gently through their full range of motion once a day, with periods of rest, during acute systemic flares or local joint flares. Patients can talk to their doctor about how much rest is best duringgeneral or joint flares.

Are Researchers Studying Exercise and Arthritis?

Researchers are comparing the development of musculoskeletal disabilities, including arthritis, in long-distance runners and nonrunners. Preliminary results show that running does not increase the likelihood of developing osteoarthritis.

Researchers also are looking at the effects of muscle strength on the development of osteoarthritis. Other researchers continue to look for and find benefits from exercise to patients with rheumatoid arthritis, spondyloarthropathies, systemic lupus erythematosus, and polymyositis.

Where Can People Find More Information on Arthritis and Exercise?

This is the major voluntary organization devoted to arthritis. The Foundation publishes a free pamphlet on exercise and arthritis and a monthly magazine for members that provides up-to-date information on all forms of arthritis. Local chapters organize exercise programs for people who have arthritis, including People with Arthritis Can Exercise (PACE) and an aquatic exercise program held in swimming pools. The Foundation also can provide physician and clinic referrals.

This center sells PACE exercise videotapes at two levels, basic and advanced. Each videotape is approximately 30 minutes long and includes a warm-up section, a gentle or moderate exercise routine, and a rhythmic movement sequence to help improve endurance. The videotapes are available for $19.50 per tape, plus shipping charges.

This nonprofit, voluntary organization helps people who have ankylosing spondylitis and related conditions. SAA sells books, posters, videotapes, and audiotapes about exercises for people who have arthritis of the spine.

This association provides referrals to physical therapists who have experience designing exercise programs for people with arthritis. The organization also provides exercise guidelines developed by the American College of Rheumatology.

Acknowledgments

The NIAMS gratefully acknowledges the assistance of Jeanne Hicks, M.D., and Naomi Lynn Gerber, M.D., both of the Rehabilitation Medicine Department, and Stanley R. Pillemer, M.D., Office of the Director, NIAMS, at the National Institutes of Health, in the preparation and review of this fact sheet.

The National Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse (NAMSIC) is a public service sponsored by the NIAMS that provides health information and information sources. The NIAMS, a part of the National Institutes of Health (NIH), leads the Federal medical research effort in arthritis and musculoskeletal and skin diseases. The NIAMS sponsors research and research training throughout the United States as well as on the NIH campus in Bethesda, MD, and disseminates health and research information.