Exercise and Arthritis

This is nothing new, but is nonetheless worth repeating: health and regular exercise go hand in hand, and for people suffering from arthritis, it takes on an added importance as a component of a comprehensive health care management program for people with arthritis.

Arthritis is a general term that means "joint inflammation" and in actuality, refers to more than 100 rheumatic diseases. Rheumatic diseases in turn are conditions characterized by inflammation or degeneration of the connective tissue structures of the body, especially the joints and related structures, including muscles, bursae, tendons, and fibrous tissue. Most rheumatic diseases are chronic, that is, long-lasting and have no cure. They can, however, be usually managed through proper treatment programs.

The benefits of proper exercise for everyone, but especially for people with arthritis, are numerous. It promotes optimum joint flexibility, endurance, coordination, muscle strength, cardiovascular conditioning. Exercise does not have to be the stereotype concept of gym-based physical activity. There are generally three (3) types of exercises that are beneficial and should be a part of an individual's complete exercise program: These are categorized into the following:

1. Activities of daily living (ADL) which includes tasks that individuals normally perform as part of the daily routine - cooking, dressing, gardening, climbing stairs.
2. Recreational activities which include involvement in games, sports, walking, running, swimming, golf, hobbies, etc.
3. Therapeutic exercises which include those prescribed by health professionals designed to specifically correct specific problems or achieve specific goals such as increasing joint mobility, endurance and developing muscle strength.

The first two categories (1 and 2) are self-explanatory. They involve physical activities that we are expected to do every day. We just need to be more active in pursuing them, rather than remaining sedentary or passive.

The third category, Therapeutic Exercises, needs further elaboration. This type of exercise can be further divided into three classifications:

• Range of Motion Exercises - Normally, each joint in the body can be moved to a certain extent, in various directions by the muscles attached to it. This is called Range of Motion. There are exercises that help maintain normal joint movement, relieve stiffness, or improve flexibility and movement. It is important for people with arthritis to try to move each joint through its complete range of motion daily in order to prevent stiffness, loss of motion and deformity.
• Strengthening Exercises - These are exercises designed to maintain or increase muscle strength since weak muscles add to joint problems. There are two kinds of strengthening exercises commonly used for arthritis: Isotonic and Isometric. In Isotonic exercises, the joints are exercised against gravity or other resistance. In Isometric exercises (or "muscle-setting" exercises), the muscles are strongly contracted without moving the joints. Both exercises provide a safe and effective way of increasing strength and can be particularly helpful for those suffering from joint pains because the muscles can be strengthened with very minimal actual joint motion.
• Endurance Exercises - These exercises help strengthen the heart, make the lungs more efficient - enabling a person to have more stamina for longer work without tiring quickly. Endurance exercises can also enhance sleep, improve balance, control weight, improve overall health, lift spirits and improve overall health. Walking, bicycling, swimming develop overall fitness and stamina. It is, however recommended that people suffering from systemic forms of arthritis or joint problems should initially seek guidance from their physician or therapist on the appropriateness of the types of exercises and how to proceed safely with them.

General Guidelines:

• Arthritis exercises should be done regularly - both on good days and bad days. It should be modified if the person is experiencing more pain than usual such that, an inflamed joint should only be moved gently through its range of motion, and strengthening and endurance exercises should be decreased during flare ups.
• Do not Over Exercise - Vigorous exercises that aggravate inflammation in the joints is harmful. If exercise-induced joint pain lasts longer than two hours, then too much exercise was done.
  
• Consult your Physician or Therapist - The amount and type of exercise that people suffering from arthritis should do at any particular time needs to be determined by the patient themselves, their doctors and therapists. So, if you are already suffering from severe joint pains or muscle weakness, it is important that you consult your physician or therapist and seek guidance about what type of exercises you can do.

The Arthritis Foundation has exercise programs that are specifically designed for people with arthritis, which of course are equally suitable even for non-arthritis participants. This includes the regular PACE Exercises, Tai-Chi for Arthritis Exercise and Water-based Arthritis Exercises. You can contact the Arthritis Foundation chapter nearest you for more information as to where and when these classes are held.