FITNESS TRAINING: ARTICLES

Exercise and Arthritis
By John Hoeber, MS, RD

For quite some time there was debate about whether or not individuals with osteoarthritis (OA) should or shouldn't exercise. Today the answer is a resounding “yes.” The Arthritis Foundation, sports medicine physicians and other researchers all agree that proper exercise will help control the pain and other symptoms of osteoarthritis. Cardiovascular, flexibility and strengthening exercises can ease the pain of OA. In fact, exercise may be the most effective treatment available for OA.

Exercise is proven to improve general health and mood, reduce disability and fatigue, and to favorably modify risk factors in the progression of OA. Other benefits for people with arthritis include:

· regular motion and weight bearing nourishes cartilage and bone and strengthens joints
· physical activity decreases feelings of depression and improves sleep and mood
· physical activity strengthens muscles around joints to protect them and absorb shock
· strong muscles improve posture and reduce weight-bearing stress on joints
· physical activity decreases pain and stiffness
· strong bones reduce the risk of osteoporosis and injury
· exercise improves balance, coordination and range of motion to make movements easier
· exercise improves the daily energy level
· physical activity promotes general health.

Exercise makes obvious sense because it's opposite, inactivity, leads to decreased ability, increased pain, and more inactivity. Breaking the cycle is vital but difficult because increasing activity with OA involves a certain amount of discomfort. It’s also difficult because our natural tendency, supported by years of medical advice, tells us to rest painful joints.

When beginning an exercise program, joint protection is very important. Workouts should begin with cardiovascular exercise of 10 minutes or more to physically warm up the body. A goal of 30 minutes either continuous or interspersed throughout the day is ideal for health maintenance. On days when the disease flares in one or a few joints, try different activities so the exercise habit is maintained, but joints are protected.

A number of moderately intense stretches should be done daily. Stretches increase the range of motion in a joint and can help reduce problems caused by imbalances in muscle tightness. Be careful not to overstretch lax joints; When joint pain and swelling follow activity, they should be treated as an "overuse" injury, with ice and rest.

Strengthening the muscles around the joint will add support and can ease pain by taking pressure off painful areas. Often, as muscles weaken, we depend on joints for support, such as locking the knees to stay standing. Unlocking the knees while standing for long periods takes conscious correcting, and requires a certain amount of muscle endurance. The benefit is that forces on the knee, hips, and spine will be different and could result in easing of pain. For these kinds of improvements, a strength training routine should focus on improving posture and the structural support of the body (muscles attached to the hips and spine including the gluteus, hip flexors, abdominals, and back muscles).

Specific exercises for affected joints should begin with limited movements and even isometric (no movement) exercises. For example: For OA in the knee try starting with straight leg lifts to strengthen the muscles around the joint without actually bending it. The overall strength training program should also include exercises that challenge balance as this will increase stability in the joints.

Many people with OA find that exercise provides a way back to a normal active life. It is a challenge that requires almost daily diligence as if training for an athletic event. Exercise can help us do better at our event, do more vigorous endeavors, have less pain, and more enjoyment.