Arthritis and exercise
If you have osteoarthritis, it need not limit your mobility—at least not if you exercise and keep moving. Half of the adults with OA report that they don’t participate in any physical activity. Thus, the muscles grow weaker and the joints become more painful.
Many people with osteoarthritis can maintain flexibility, and even restore it to some degree, through a well-designed exercise program that is implemented gradually and followed regularly. There’s evidence that people with knee osteoarthritis can improve their physical functioning by walking at least 3,000 steps a day, gradually increasing to at least 6,000 steps a day.
Specialists have devised scores of exercises to stretch muscles or strengthen important joints. Exercise may cause you some pain at first, but the discomfort should diminish.
The exercises illustrated here are a way to begin, and fall into two categories.
Range-of-motion exercises relieve stiffness, restore flexibility, and help with joint movement. If you haven’t yet lost your full range of motion, an exercise like the shoulder stretch can help prevent such loss as well as help minimize joint stiffness. Tai chi, the gentlest form of martial arts training, offers an excellent range-of-motion exercise.
Strengthening exercises are particularly important because weak muscles add to joint problems. People with lower extremity osteoarthritis in particular may benefit from doing strength training that targets the thigh muscles (quadriceps). Many studies have found that strength training can relieve knee pain, improve strength, and boost physical functioning. With isometric exercise, you contract the muscle without moving the joint. Isotonic exercises, using bands, weights, or machines, require you to move the joints and can result in greater strength gains. Water workouts, free weights, or weight machines can be useful.
Aerobic exercise is also beneficial. Continuous movement for 10 minutes or longer, such as walking, swimming, and cycling (at low pedal resistance, over level surfaces at first) can definitely reduce pain and improve physical functioning. Rowing, water walking, aqua aerobics, and ballroom or other low-impact dancing are also excellent choices.
Generally, it’s wise to avoid high-impact activities like tennis, aerobic dance, or running, which can overload sore joints.
Before you start
Exercises must be individualized, depending on the joints involved and the degree of pain. Your doctor or physical therapist will help you develop an exercise program that focuses on your most painful joints and takes into consideration your overall level of fitness. Whatever exercises you do, there are some general rules.
Start gradually and never overdo it. Follow the instructions of your doctor or physical therapist. There will probably be some pain or discomfort, but stop a particular exercise if there’s unusual or severe pain. Cut back if necessary, but don’t stop exercising entirely.
Always warm up first. Walk in place for a few minutes. Gently massaging stiff joints may help, as may heat (a warm bath or shower, or an infrared lamp). Wear a sweat suit, or leg or arm warmers.
Vary your exercises, so that you work different muscle groups. Don’t rely on one long, strenuous (and painful) session a week. Begin with as few as three repetitions of an exercise. Over the course of several weeks try to work up to 10 repetitions, or as many repetitions as your doctor recommends.
Gentle exercises to try
Gentle exercise should be a daily routine. And it’s a long-term project—you shouldn’t stop for more than a few days. Note: Remember, unless you know you are healthy and have only mild osteoarthritis, talk to your doctor before attempting any of these exercises.
Shoulder stretch. Reach one palm over shoulder and place back of other hand on lower back. Slide hands toward each other, trying to touch fingertips (many people can’t reach that far). Alternate arms.
Leg strengthener. Stand in front of chair. Slowly bend at hips and knees as if to sit down, but don’t go all the way down to the seat. Lower your hips as far as you can without sitting. Keep your upper body upright. Then slowly straighten up.
Arm curl. Hold one end of an elastic band in fist, palm up, the other end securely under arch of foot. Start with arm extended downward (but elbow not locked). Slowly curl forearm toward shoulder, keeping elbow close to side. Then lower slowly; repeat. Switch arms.