Arthritis & Exercises
- Increase strength of muscles that move the joint
- Retarding the bone loss
- Controlling the joint swelling and pain
- Improving the joint lubrication
- Reducing the joint stiffness
- Enhancing the energy and reducing fatigue
- Helping in weight reduction
- Providing psychological benefits of the feeling of well being
- Preventing the joint deformities
- Improving posture and body language
- Improving sleep patterns
Characteristic problems of RA Patients
- Joint pain and swelling
- Loss of flexibility of the joints
- Decrease in muscle strength and endurance
- Deformities due to lack of support
- Fatigue & deconditioning
How to combat flare-ups or active swollen painful joints
RRest by using support and reducing movements
IIce by use of cold packs for about 10 minutes, 2-3 times a day
CCompression by use of elastic crape bandages and supports
EElevate by keeping the hand or leg elevated
Steps to fitness
- Range of motion (ROM) and stretching exercises
- Muscle Strengthening Exercises
- Aerobic exercises
- Recreational exercises
Range of motion (ROM) and stretching exercises
Benefits of ROM exercises
- Elongation of muscles
- Attain full range of motion
- Improves flexibility
Objectives of stretching exercises
- The objective is to move the limb gently to just beyond the normal/restricted range and hold it there for 15 - 20 seconds. This is to be done 5-7 times every session.
- This is to be repeated regularly / daily with slight improvement every time till full range of motion is achieved.
- This can be the warm up & cool down part of your exercise session
Heel cord and Calf Stretch
- This exercise stretches the heel cord and the back of the lower leg.
- Stand 2 - 3 feet from a wall or tree and both toes should be pointed straightforward as you lean toward the wall with your hands.
- Keep the heels flat to stretch the calf. Hold 10 - 20 seconds and repeat.
- Sit sideways on bench.
- Keep one leg stretched out on bench, straight.
- Keep other leg off of bench, with foot flat on floor.
- Straighten back.
- Lean forward from hips (not waist) till you feel stretching in leg on bench, keeping back and shoulders straight.
- Omit this step if you have had a hip replacement, unless surgeon/therapist approves.
- Hold position.
- Repeat with other leg.
Inner Thigh Stretching
- This exercise stretches the adductors or muscles of the inner thigh.
- Sit with your back straight, bend your knees and put the soles of your feet together.
- Slowly press the knees to the floor and lean forward from the hips. Hold for 10 - 20 seconds and repeat.
- This exercise is to stretch the muscles of the front of the thigh.
- Place your right hand against a wall or tree for balance, grab your left ankle with your left hand and pull it up and back until you can feel a stretch.
- Keep the back straight and the knee pointing toward the ground.
- The standing leg should have a slightly bent knee.
- Hold the stretch for 10 - 20 seconds for each leg and repeat.
Lower Back Stretch
- This exercise stretches the muscles of the lower back.
- Lie flat on your back with your legs extended and pull the right knee up to the chest.
- Press your back to the ground.
- Hold the position 10 - 20 seconds and repeat with the left knee.
Back and shoulder muscles stretch
- Use a length of rubber tubing
- Grasp each end, raise arms to shoulder height and extend arms, keeping elbows straight, outwards and backwards by squeezing shoulder blades together.
- Hold for 10 seconds and repeat about 6 times.
Upper arm and chest muscles stretches
- Interlock the fingers with palms out.
- Extend arms above head, keeping fingers locked. Stretch upwards and hold for 10 seconds.
Muscle Strengthening Exercises
- Improves muscle power
- Better support to the joints
- More activity with less pain
Strengthening exercises - Types
Isometric -Exercise without movement of the joint. Performed when joint is swollen and painful.
Isotonic -Accompanied by joint movement. Done under normal conditions.
Common isometric exercise
- Clench your fist and apply force, & touch the tip of each finger with that of the thumb and apply force.
- Do each of these exercises for 10 seconds and repeat multiple times.
- Hold your wrist as demonstrated and move it from side to side and up and down.
- You can add rotating of the wrist to complete
- Keep a cushion below the knee, and raise the leg as demonstrated and hold position till the count of 10. Repeat as many times as comfortable.
- Keep a cushion under the ankle and press the knee down and hold position for the count of 10. Repeat as many times as comfortable.
- ove your ankle from side to side and up and down.
- Use a roller to slide your foot.
Aerobic exercises -Uses large muscles in a rhythmical, continuous activity. The most effective
Why Aerobic exercises
- Cardiovascular deficit in RA is 40% and in OA
- Increased oxygen uptake
- Increased Ventilation & Heart-rate
- Early onset of Fatigue
- Leads to increased Energy expenditure
- If knee is sore, walk slowly and swing your arms
- Wear supportive shoes with
- Athletic (shock absorbing) insoles can help increase comfort and reduce shock on feet, knees, hip and spine
- Start on a flat level surface
- Use cane if helpful
- Warm up and cool down with
- Choose a comfortable pace
- Speed of treadmill should not be more than 6.5 km per hour
- Slope should be near flat
- For patients with heart problem, monitoring of heart rate and BP essential
Swimming & water aerobics
- Performed in presence of
- Use mask or a snorkel in case of neck problem.
- Take a warm shower after
- Regulate exercise intensity by changing the speed, arc of movement and length of lever arm.
- Begin and end in a slower pace
- For water aerobics wear tights, t-shirt, disposable latex gloves to retain body heat in water.
- Use floatation device to add buoyancy if knees and hips
Bicycle (outdoor or stationary)
- Start and end with no resistance or on flat ground.
- Pedal with ball of your foot.
- Make sure seat height allows your knee to be comfortably straight at the bottom of the pedal stroke.
- Don't lean on or over handlebars.
- Use pedal straps.
- Keep speed of pedaling at or below 60 revolutions per minute.
Your exercise plan
Warm up - 8-12 mins
- Deep breathing exercise
- 5-7 deep breathes along with movement of arms
- Stretching exercises including trunk rotation
- Strengthening exercise of joints of your choice
Aerobic exercise - 15-20 mins
- This forms the major part of your regime
- Choose your type of exercise and a pace that is convenient to you
- Increase the duration of exercise gradually as you start getting used to it
Cooling down - 5-8 mins
- Stretching exercises
- Gentle movements
- Deep breathing exercises
Stop your exercise immediately if
- Your heartbeat increases steeply
- You sweat profusely
- Start feeling weak
- If your joint pains for more than 30 minutes after exercise rest the joint and apply hot/cold packs as per convenience
- You may have to take pain - killers during initiation of exercise
- Consult your doctor/therapist if pain persists