What types of exercise are most suitable for someone with arthritis?

• Range of motion exercises (eg. Hydrotherapy) help maintain normal joint movement and relieve stiffness. This type of exercise helps to maintain or increase flexibility.
• Strengthening exercises (eg. weight training) help to keep of increase muscle strength. Strong muscles help to support and protect joints affected by arthritis.
• Aerobic or endurance exercises (eg. bike riding) improve cardiovascular fitness and help to control weight and improve overall function. Weight control can be important to people who have arthritis, because extra weight puts pressure on many joints. Some studies have shown that aerobic exercie can reduce inflammation in some joints.

How does a person with arthritis start and exercise program?

People with arthritis should discuss exercise options with their doctors and other health care providers. 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. Your doctor will know which, if any, sports are off limits.

Step up to Exercise: How to get started.

• Discuss your exercise plans with your doctor
• Start with supervision from a physiotherapist or qualified fitness instructor
• Apply heat to sore joints
• Stretch and warm up with gentle range of motion exercises
• Start strengthening exercises slowly with small weights
• Progress slowly
• Use cold packs for 20 minutes after exercising if you feel you may have irritated the joint
• Add aerobic exercise
• Consider appropriate recreational exercise
• Ease off if joints become painful, inflamed or red. Work with your Doctor to find the cause and eliminate it.

Should people with arthritis exercise?

Yes. Studies have shown that exercise helps 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, no wasted movements), as well as the use of pain relief methods.

What are some pain relief methods?

• Moist heat supplied by warm towels, hot packs, a bath or shower can be used at home for 15-20 minutes three times a day to relieve symptoms. A physiotherapist can use methods to deliver deeper heat to non-inflamed joints. Heat is often used around joints to relax tight tendons and muscles prior to stretching exercise.
• Cold supplies via a bag of ice or frozen vegetables wrapped in a towel helps to slow pain and reduce swelling when used for 15-20 minutes at a time. It is often used for acutely inflamed joints. People with poor circulation should check with their doctor before using this method.
• Hydrotherapy (water therapy) can decrease pain and stiffness. Exercising in a pool can be easier than on land as the water takes significant weight and loading from the joints as you exercise. Community centres, YMCA'a and some physiotherapists have water exercise classes developed for people with arthritis. Some people also find relief in the heat and movement provided by the pool.
• Mobilisation therapies including traction (gentle, steady pulling), massage and manipulation. When done by a trained professional these methods can help control pain and increase joint motion and muscle and tendon flexibility.
• Relaxation therapy also helps to reduce pain. Patients can learn to release the tension in their muscles to releive the pain.
• Acupuncture is a traditional Chinese method of pain relief.

How often should people with arthritis exercise?

• Range of motion exercises can be done daily and should be done at least every other day.
• Strengthening exercises also can be done daily and should be done at least every other day, unless you have severe pain or swelling in your joints.
• Endurance exercises should be done for 20-30 minutes three times a week, unless you have severe pain or swelling in your joints.

How much exercise is too much?

Whilst it is ok to feel working pain whilst exercising, it should settle as you back off. If you feel unusual pain or if you experience continued pain (pain that lasts more than an hour after exercising) then you are most likely to be over doing it. If the pain persists, you should discuss it with your health practitioner.

What happens if you don't exercise?

If your joints hurt, you may not feel like exercising. But without exercise, your joints can become even more stiff and painful. This happens because exercise actually keeps your bones, muscles and joints healthy.

Whilst rest is important, especially during flare ups, lack of physical activity is associated withincreased weakness, joint stiffness, reduced range of motion, fatigue and deconditioning.

There needs to be a balance between physical activity and rest. Also, exercise needs to be directed at the entire body and not just the joints that are affected by arthritis.

Thus, while improvements in fitness require strenuous and continuous activity on a regular basis, health benefits can be enjoyed by accumulating moderate intensity activities throughout the day.

Additional evidence of the value of moderate intensity exercise comes from recent investigations that have shown that activity need not be undertaken in a single bout to be beneficial. For instance, the benefits from three 10 minute walks or one 30 minute walk are similar. Studies also suggest that moderate intensity activity may improve pain, reduce disability, improve fitness and enhance psychological well being.

Tips for exercising

• Begin slowly and progress gradually
• Avoid rapid or repetitive movements of affected areas
• Adapt physical activity to the needs of the individual
• If you don't think you should be doing it, you probably shouldn't
• When starting out with a new activity, halve what you think you can reasonalbly acheive. Remember it is not often until after completing an activity that you will feel the effects. By then it is too late and you may be sore. Rather have a "taste test" and if you recover well gradually increase the amount you perform. This will ensure an easier progression with your exercise program.