Arthritis and Exercise, Part 4 Exercise Guidelines and Considerations

Why you Should Exercise if you have Arthritis
by Susan Ingraham, BCRPA-certified fitness instructor for older adults

If you have any form of arthritis, here are some guidelines to follow when exercising:

1. Expect fatigue: Fatigue is a side effect of the disease, especially with RA. Find a balance between exercise and rest, as you need both.

2. Expect some pain: You should respect and expect pain, especially during exercise. Modifications need to be made based on your personal pain tolerance.

3. Use the 2-Hour Pain Rule: If you experience more than typical joint pain two hours after exercise, it indicates that you have overexerted. You need to adjust your workload the next time you exercise.

4. Respect your limits: Only you know how you feel. If the exercise is uncomfortable or hurts, you should stop, slow down, change weights, rest — whatever seems right for you. Work at your own pace and don’t attempt to keep up with anyone else.

5. Warm-ups should be long and slow: The warm-up phase is an essential component of the workout. Your instructor should begin with slow, range-of-motion exercises and gentle large muscle movements.

6. Use heat prior to exercise: A hot shower, heating pad, electric blanket, or hot towel is sometimes recommended before exercise. Heat helps to decrease pain and stiffness and may make exercise easier.

7. Progress slowly: Modify whenever necessary. Decrease repetitions and speed of the movement when appropriate.

8. Use proper body mechanics: Use your joints in their most stable position.

9. Avoid jarring movements: Avoid quick directional changes as they can compromise joints and aggravate joint pain.

10. Follow the tenets of joint protection: If you follow the basic tenets of joint protection, your joints will be stabilized and in their strongest, most workable position. The basic tenets of joint protection are: (1) do not compromise the joint; (2) limit extreme weight-bearing flexion (e.g. don’t do a deep squat); (3) use positions that stabilize the joint (e.g. keep wrist in line with the arm); (4) never force joints into uncomfortable positions; (5) use stronger joints for support whenever possible; (6) avoid being in one position for a prolonged period of time; (7) conserve energy; (8) avoid overexertion or overloading of joints; (9) use adaptive equipment when necessary; and (10) stop any movement at the point of pain.

11. Attempt complete and full range of motion movements, as much as can be tolerated: This might be accomplished by decreasing the speed of the movement, a slower tempo of music, warming up with range of motion activities, and flexibility stretching at the end. Some activities reduce or eliminate stress on the joints, such as swimming and gentle walking.

12. Use isometric exercises: These exercises use a stable joint position. Pressing the hands together, pressing down on a ball, squeezing the ball — these are isometric exercises, and they reduce joint movement yet strengthen muscles.

13. Increase chest expansion: Do deep-breathing exercises before and after exercise.

14. Include Relaxation: Relaxation reduces muscular tension and soothes muscles and joints. Every exercise session should end with flexibility and relaxation.

15. Avoid becoming chilled: Cold drafts and/or becoming chilled while exercising leads to increased muscle tension. Avoid being in front of the fan or near an open window while exercising.

16. Use appropriate footwear: Find a shoe that provides plenty of room for your toes, a stable and comfortable sole, extra cushioning and space for orthotics, and possibly velcro for easy closure.

17. Try to exercise at the best time of day for you: People with RA tend to be less stiff and sore later in the day. Those with OA may be better able to tolerate exercise in the morning before activities of the day have increased their pain.

18. Use medication properly and talk to your doctor: Follow the schedule your doctor has recommended. Let your doctor know how you are feeling and explain what your exercise regimen entails.

These are all things within your control and, if followed, will help you have some control over your condition. Hopefully, your exercise instructor is well-versed in this information, as well, and will help you to exercise properly.

Source: Exercise and Arthritis by Stephanie Harris, MD, and Gwen Hyatt, MS