Why Exercise Is Essential for Arthritis

Exercise is important for everyone, but if you have arthritis, it is considered essential. Exercise helps you:

• increase your energy level
• develop a better sleep pattern
• control your weight
• maintain a healthy heart
• increase bone and muscle strength
• decrease depression and fatigue
• improve self-esteem and self-confidence

Exercise is important for healthy joints. Moving your joints daily helps to preserve or improve range of motion. Strengthening the surrounding muscles helps to 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.

Types of Exercise

There are different types of exercise and it is important to understand why each is necessary.

Range-of-Motion Exercises

Range-of-motion exercises are primarily gentle stretching movements which 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 to prevent stiffness and deformities.

Range-of-motion exercises are important for people with arthritis who, because of intense or chronic pain, shy away from moving their joints through their full range. Some people believe that normal daily activities sufficiently 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 to 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 people with arthritis who regularly perform endurance exercises find that they:

• increase physical strength
• develop a better mental attitude
• improve arthritis symptoms

Not all arthritis patients are able to perform endurance exercises, however. For example, people 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 healthcare provider before starting a routine or program. There may be exercises that are off-limits because they could cause injury or further joint damage, especially when joints are swollen and inflamed. The amount and form of exercise recommended for each individual will vary depending on:

• the type of arthritis
• joints involved
• levels of inflammation
• stability of joints
• presence of joint replacements
• physical limitations

Here are some exercise options that tend to work well for people with arthritis:

• Walking can be an excellent exercise choice. Walking helps build strength and maintain joint flexibility, aids in bone health, and reduces the risk of osteoporosis.
• Tai Chi is a gentle martial arts exercise with origins in ancient China. While performing fluid and flowing circular movements, you can relax, maintain mobility, and improve range of motion.
• Yoga can provide pain relief, relax stiff muscles, and ease sore joints. With controlled movements, pressures, stretches and deep breathing relaxation, yoga can improve range of motion. Use caution when disease activity is flaring and avoid excess torque or pressure on the joints.
• Warm water exercise is an excellent way to build up strength, ease stiff joints, and relax sore muscles. The water helps support the body while the joints are moved through their full range of motion.
• Bicycling/cycling, both indoor and outdoor, may provide a good low impact exercise option. Cycling as an exercise can be either freestanding or stationary. Cycling equipment can be adjusted and adapted for many physical limitations.
• Running/jogging may still be a good exercise option if you run on softer surfaces. Walking or more gentle forms of exercise may be a better option, though, if you already have arthritis in your lower extremities. Contrary to popular belief, running does not cause osteoarthritis in people who have with normal, uninjured knees.

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. But, consult your healthcare provider to determine your ideal, individual program.
• Build up gradually. The best exercise program is one that 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. There is no set number that 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.

Therapeutic Exercises

Therapeutic exercises are exercises that are recommended by a healthcare provider, physical therapist, or occupational therapist with a specific goal in mind. Health professionals can help you design a fitness program that meets your individual needs.