Does this sound familiar? “My joints are achy, I feel stiff all the time and it’s hard to get out of bed in the morning.” Sounds like the perfect excuse not to exercise, right? Wrong! In fact, this is precisely the time for you to get up and get moving! So where do you go from here? How do you begin a program? Here are some common questions/answers to help you get started.

Should people with arthritis exercise?

Yes! Studies have shown that exercise helps people with arthritis in many ways. Exercise reduces joint pain and stiffness and increases flexibility, muscle strength, cardiac fitness, and endurance. It also helps with weight reduction and contributes to an improved sense of well-being.

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

Three types of exercise are best for people with arthritis:

• Range-of-motion exercises (e.g., stretching) help maintain normal joint movement and relieve stiffness. This type of exercise helps maintain or increase flexibility. Persons with arthritis should try to move each joint through its complete range of motion daily to prevent stiffness and loss of motion.
• Strengthening exercises (e.g., weight training) help keep or increase muscle strength. Strong muscles help support and protect joints affected by arthritis. Weak muscles add to joint problems.
• Aerobic or endurance exercises (e.g., bicycle riding, walking) improve cardiovascular fitness, help control weight, and improve overall function. Weight control can be important to people who have arthritis because excess weight puts extra pressure on many joints. Studies have shown that aerobic exercise can reduce inflammation in some joints.

How does a person with arthritis start an exercise program?

If you have arthritis, discuss your exercise options with your doctors and other health care providers. Most doctors recommend exercise for their patients. Many people with arthritis begin with easy, range-of-motion exercises and low-impact aerobics. As they become more comfortable with a low-level program, it is possible to progress to more advanced exercises. For example, an arthritis patient might start with water exercise (easiest on the joints) and progress to walking and/or biking. People with arthritis can participate in a variety of, but not all, sports and exercise programs. The doctor will know which, if any, sports are off-limits.

The doctor may have suggestions about how to get started or may refer you to a physical therapist. It is best to find a physical therapist who has experience working with arthritis patients. The therapist will design an appropriate exercise program and teach you about pain-relief methods, proper body mechanics (placement of the body for a given task, such as lifting a heavy box), joint protection, and conserving energy. Here are some easy things you can do to help protect your joints (and in some cases, conserve energy too):

• Avoid keeping your joints in the same position for long periods of time. To reduce stiffness, avoid prolonged sitting and get up to walk around every hour or so.
• The strongest or largest joints and muscles should be used instead of the weakest ones, and weight should be distributed over several joints. For example, push open a heavy door with the side of your arm, not with your hand and outstretched arm. Carry a heavy bag or purse over your shoulder instead of holding it by the fingers.
• Maintain good posture and body mechanics, keeping joints in their most stable and functional position. Bad posture can lead to possible deformities and increased pain.
• Use a straight-back chair with a firm seat when sitting. When rising from a chair, use your leg muscles while also pushing off of the chair arms with palms or forearms (not fingers).

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 should be done every other day unless you have severe pain or swelling in your joints.
• Endurance exercises should be done for 20 to 30 minutes three times per week unless you have severe pain or swelling in your joints. According to the American College of Rheumatology, 20- to 30-minute exercise routines can be performed in increments of 10 minutes over the course of a day.

Exercises should be done on a regular basis. You should try to do them on good days and bad days, although you may have to modify the program if you are having more pain than usual. An inflamed joint should only be moved gently through its range of motion. Strength and endurance exercises should be decreased during a flare-up.


What are the important things to know?

• People with arthritis need to move their joints daily to prevent stiffness and loss of joint movement.
• An inflamed joint should only be moved gently through its range of motion.
• It is important to listen to your body and not overdo it. If an exercise hurts, stop! Pain is your body’s way of telling you something is wrong. If you get tired, rest! Wait a few minutes, then continue when you are ready.
• Always begin a session with some slow warm-up exercises to reduce stress on the joints.
• You should attempt to achieve a full range of motion by moving until you feel a slight stretch. Do not force the motion, going only as far as you feel comfortable.
• Move at your own pace, performing exercises in a slow and steady motion.

What type of strengthening program is best?

This varies depending on personal preference, the type of arthritis involved, and how active the inflammation is. Strengthening one's muscles can help take the burden off painful joints. Strength training can be done with small free weights, exercise machines, isometrics, elastic bands, and resistive water exercises. Your choice of equipment will depend on your preference and limitations. Correct positioning is critical, because if done incorrectly, strengthening exercises can cause muscle tears, more pain, and more joint swelling.

Regular, moderate exercise offers a whole host of benefits to people with arthritis. Mainly, exercise reduces joint pain and stiffness, builds strong muscle around the joints, and increases flexibility and endurance. But it also helps promote overall health and fitness by giving you more energy, helping you sleep better, controlling your weight, decreasing depression, and giving you more self-esteem. Furthermore, exercise can help stave off other health problems such as osteoporosis and heart disease.


How much exercise is too much?

Most experts agree that if exercise causes pain that lasts for more than 1 hour, it is too much. Work with your physical therapist or doctor to adjust your exercise program when you notice any of the following signs of too much exercise:

• Unusual or persistent fatigue
• Increased weakness
• Decreased range of motion
• Increased joint swelling
• Continuing pain (pain that lasts more than 1 hour after exercising)

How can water exercise help arthritis?

Gentle, regular exercise can improve an arthritic joint by nourishing the cartilage and easing stiffness. Warm water exercise is particularly helpful, because your body weight is supported and the resistance of moving through water boosts muscle strength and endurance. Heat also relaxes joints and muscles and helps to relieve pain. Activities such as stretching or walking through water can exercise the joints without putting them under strain. Many places offer warm water exercise programs, including YMCAs, recreation centers and local swimming pools.


Joint Check Activity

Performing a joint check activity can help you become more aware of the extent of any limitations, whether joint flexibility is improving from an exercise program, and whether any new problems are developing. If you can’t perform an action or if it causes pain, it could indicate a possible problem in the related joints. You should be able to hold each position comfortably for five seconds. The seven exercises are as follows:

• Put your hands close to, but do not touch, your mouth and face, with hands forming an inverted V at a 45 degree angle from the corners of your mouth. Hands and arms should be in a straight line (checks elbows, shoulders and hands).
• Sit in a chair, with your buttocks firmly at the rear of the seat. Lean over with knees together and touch your toes, keeping your hands and arms outside of your knees (checks elbows, shoulders, knees, spine, back, hands, and/or ankles).
• Place the flat of your hands on your upper buttocks (checks back, elbows, shoulders and neck).
• Place both hands behind your back, touching the middle of your back (checks elbows, shoulders, back, neck, and/or hands).
• Touch the top of your head with both hands, creating a diamond shape with your hands and arms (checks shoulders and elbows).
• Place your hands behind your neck, touching it. Elbows, hands, and arms should form almost a straight line across your back, about ear level (checks neck, shoulders, elbows, and/or hands).
• Make a fist, curling the fingers to the palm of the hand. Bend the thumb over the knuckles, across the outside of the fingers (checks finger joints).

Information provided by:

National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, and the Arthritis Foundation

	Aerobic Exercise Strength Exercise Stretching Anaerobic Exercise Warm Up, Cool Down Exercise Intensity Body Composition

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