Do you find that ordinary daily tasks are causing pain or
discomfort in your joints? You might be among the ever-increasing population
affected by arthritis.
Arthritis is a group of inflammatory conditions that result in decreased
cartilage, joint damage, restricted movement, limited functional capacity, and
pain. While there are over 100 different types of arthritis, we will focus on
the most common form, osteoarthritis. Other prevalent types of arthritis
include rheumatoid arthritis and ankylosing spondylitis.
Arthritis is the most prevalent medical condition for people over
the age of 65. It’s the leading cause of disability in later life, affecting
both physical and psychosocial function. The pain and fatigue that many
experience with arthritis are associated with psychological distress and depression.
But here’s the good news! The negative effects of arthritis can
be significantly reduced with exercise. This article will explore how arthritis
affects your body and how exercise can help you live with arthritis.
Osteoarthritis
Osteoarthritis is the most prevalent type of arthritis. This
disease causes a gradual degradation of the cartilage and the underlying bone
in the joints. This damage causes the bone to thicken and the joint to become
narrowed, inflamed, and weakened.
Osteoarthritis most commonly affects the hands, feet, spine, hips
and knees. Symptoms usually present as chronic joint pain, stiffness, crepitus
(that ‘grinding’ feeling), swelling, and even the formation of bony growths or
spurs at the joint edges.
This combination of symptoms can lead to significant impairments
to functional activity, with the increased fatigue and energy cost of daily
activities contributing to many people who suffer from osteoarthritis being
physically inactive.
Other Types of Arthritis
Rheumatoid arthritis is a chronic autoimmune disease that causes
inflammation and deformation. Mainly of the fingers, hands, wrists, elbows,
shoulders and knees.
This form of arthritis can lead to muscle loss, increased trunk
adiposity (fat gain in the stomach), and increases the risk of many co-morbid
conditions such as type 2 diabetes and cardiovascular disease.
Ankylosing spondylitis is another chronic inflammatory condition
that primarily affects the spine and sacroiliac joint at the back of the
pelvis. Inflammation causes bony growths to form around these joints,
eventually leading to fusion of the segments of the lower spine. The result:
low back pain and immobility.
There are many other forms of arthritis, however these are the
most common.
How Exercise Can Help with Arthritis
Some of the main physical ailments caused by arthritis are a loss
of aerobic capacity, muscular strength, endurance, and joint range of motion.
Thankfully, these can all be greatly improved with appropriate exercises.
Moreover, the damaged cartilage in joints with arthritis are
avascular, meaning they do not receive their own blood supply. This means that
they depend on appropriate joint loading and movement to receive nutrition and
to maintain physiological function.
The exercise program you should implement will be based on the
state of your arthritis. For example, the joints affected, the stage of the
disease, and other medical conditions such as hypertension or previous
surgeries will all contribute to deciding which level of exercise will be best
for your situation.
The main aims of an exercise regimen for arthritis will be to
restore your ability to perform all the tasks of daily living, increase you
body composition with sufficient muscle mass, and reduced body fat.
Types of Exercises for Arthritis
Exercise for arthritis can be broken down into three key areas:
flexibility, muscular strength, and cardiovascular endurance.
Stretching Exercises for Improved Flexibility and Range of
Motion
When you suffer from arthritis, inflammation, and damage to the
surfaces and tissues of your joints, it can make previously effortless
activities, such as getting dressed or drinking a glass of water, difficult and
painful.
Eventually, this damage can decrease your range of motion and
make everyday tasks nearly impossible. In turn, not moving your joints because
of pain or swelling makes them even more stiff! This is where we bring in range
of motion and stretching exercises to maintain and improve a healthy freedom of
movement for your joints.
These exercises will lubricate and provide nutrition to your
arthritic joints, keeping the muscles and tissues around the joints lengthened
and elastic. Range of motion exercises should be performed daily for the
maximum benefit.
You can try these exercises in the morning if you experience
stiffness, in a warm shower if you find the humidity helps to relieve soreness,
or even break these exercises up throughout the day to have several small
sessions to keep you moving.
Hands & Wrists: Open Up, Close Down
For this exercise, hang your hands off the edge of your knees, or
the edge of a table, with palms facing down. As you extend your wrists upward,
open your fingers slowly until your hands and fingers are stretched up and
outwards, pointing up to the sky.
Next, slowly start to curl your fingers in, knuckle by knuckle,
as you flex your wrist back down to the starting position; this should end with
your wrists hanging down and your hands closed into fists.
This exercise can be performed 10 to 15 times, and can be followed
by some gentle wrist circles or palm ups / palm downs.
Elbows & Knees: Flexion, Extension
For elbow range of motion, simply stand with your arms by your
sides, palms facing forwards. Bend your elbows to flex your arms upwards,
trying to touch your shoulders if possible without pain. Slowly extend your
arms back down to the starting position and repeat for 10 – 15 repetitions.
For knees, the principle is similar. Stand while holding onto a
table or wall for balance. Flex one knee, lifting your heel towards your
buttocks, then slowly lower your leg back down. You can perform 10 – 15
repetitions before changing sides, or you can alternate between left and right.
Resistance Exercises to Maintain Muscular Strength With
Arthritis
As we mentioned, arthritis can make movement painful. When this
happens, people move less. This infrequent use of one’s muscles results in
muscle atrophy, wastage, and weakness. This makes the appropriate exercise
critical to restoring and maintaining our muscle strength to be able to perform
all of the necessary daily tasks.
Muscle contractions can be performed while the muscle is in a
fixed position or while lengthening and shortening. These are called isometric
and isotonic contractions, respectively. Isometric exercises are beneficial if
your arthritic joint is particularly inflamed or painful on movement. Isotonic
movements are more transferable to functional movements like carrying and
lifting objects.
The following exercises can be performed after a warm up of range
of motion exercises for 5 – 10 repetitions, or if no pain or inflammation are
present, up to 15 repetitions. Resistance training 2 – 3 days per week will be
sufficient to gain the strength benefits for the muscles supporting your
arthritis.
Wall Sit
To strengthen the lower limb muscles that support your hips,
knees and ankles, try this exercise. Simply start by standing with your back to
the wall, with the feet shoulder width apart and one step away from the wall.
Slide your back slowly down the wall until your hips and knees are both at 90
degrees. Start by holding 10-30 seconds, 1-5 times, building your tolerance.
Wall Push
This exercise will strengthen the muscles that flex the shoulders
and extend the elbows. Stand facing a wall with your hands placed on the wall,
at chest height, shoulder width apart. Have your feet 1 – 2 feet away from the
wall; the further away your feet, the harder the challenge. Next, bend your
elbows, allowing your nose and chest to come towards the wall until your elbows
are bent 90 degrees. Finally, push away from the wall until your arms extend
back to the starting position.
Band Row
For this exercise you will require a resistance band, which you
can purchase from a sporting goods store or from a physical therapist. This
move is great for strengthening the upper back muscles which keep your posture
upright, as well as strengthening your elbow flexors, important muscles for
lifting and carrying.
To perform this exercise, tie the band around a fixed point such
as a door handle or sturdy table leg. Holding one end of the band in each hand,
sit or stand facing the anchor point, with your arms fully extended. Then
simply pull or ‘row’ your hands towards your chest, feeling the resistance of
the band against your back muscles. Straighten your arms back to the starting
point and repeat.
Cardiovascular Exercise for Stamina and Performance
Improving your cardiovascular fitness is critical for allowing you
to perform daily tasks and leisure time activities with vigor and confidence.
The great thing is that this exercise doesn’t have to be intensive! An
accumulation of just 30 minutes a day – even in small 10 minute increments here
and there, of moderate aerobic activity can significantly improve your health,
fitness, and quality of life with arthritis.
Cardiovascular exercise has many benefits for arthritis patients,
including maintaining a healthy body weight, strengthening the heart, improving
circulation, increasing energy, lowering blood pressure, and reducing stress, just
to name a few! This form of exercise can be performed while weight bearing, or
without weight bearing if you experience pain.
It is important to mention that cardiovascular exercise is also
an important part of warming up before any exercise session for those with
arthritis. This helps ease the joints into movement and a simple five minutes
of walking and some gentle range of motion moves like the ones described in this
article will be sufficient.
Walking for Arthritis
Walking is arguably the best form of exercise for arthritis, as
it is highly flexible, requires no special skills or equipment, and can be done
almost anywhere. Walking gives the joints of the lower limb some healthy weight
bearing which they need to stay lubricated and strong.
Start by walking moderately, using a simple rate of perceived
exertion, or RPE, to monitor your intensity level. The recommendation for those
with arthritis is an exertion from 3 – 6 out of 10. Initially bouts as short as
10 minutes are great, but try to work your way up to 30 – 45 minutes on most
days of the week.
Aquatic Exercise for Painful Joints
If walking or other weight bearing activities are painful for
you, you might consider exercising in the water. Warm water can feel great for
sore joints, and the buoyancy of the water decreases the load on your body.
Aquatic exercise can involve different exercises using water as
resistance, light swimming or even just walking at chest level in the water to
increase your heart rate. Do be careful not to overexert yourself, as the
relief of being in the water can lure some into overdoing it. Again, aim for 30
minutes, even alternating this form of movement with others such as walking.
Getting Started
Of course, these are just a few examples of exercises for common
areas of arthritic pain. There are many other exercises for arthritis, such as
passive assisted stretching where a therapist can help you stretch further than
you can by yourself, or pin-loaded resistance machines which make strengthening
exercises safe and effective. Please consider consulting with an accredited
professional if you would like further help with your arthritis exercise plan.