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Patient Education

Living with Arthritis

Arthritis Management

Arthritis and Exercise
Osteoarthritis

Osteoporosis

Back Pain and Sciatica

Joint Injections - Glucocorticoid
Rheumatoid Arthritis
            

Arthritis & Exercises

The benefits of exercise are many, more so in a patient of arthritis where exercises help in overcoming the disability by the following ways
  • 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

  • R

     Rest by using support and reducing movements

  • I

     Ice by use of cold packs for about 10 minutes, 2-3 times a day

  • C

     Compression by use of elastic crape bandages and supports

  • E

     Elevate 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
Arthritis Stretching Exercise Instructions

Stretching Exercises

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.
Hamstring Stretch Exercise of Arthritis

Hamstring Stretch


  • 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.
Arthritis Exercise Inner Thigh Stretching

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.
Quadriceps Stretch Arthritis Exercise

Quadriceps Stretch


  • 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.
Arthritis Lower Back Stretch Exercise

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.
Arthritis Exercise Back Shoulder Muscles

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 Arthritis Exercise

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

Benefits


  • 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

Hand Exercises


Arthritis Hand Exercises Instructions
  • 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.

Wrist Exercises

Wrist Arthritis Exercise
  • 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
    the above.

Knee Exercises


  • 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.

Foot Exercises


Foot Arthritis Exercise Instructions
  • ove your ankle from side to side and up and down.
  • Use a roller to slide your foot.

Strengthening Exercise

Medical Centre Ghaziabad, Uttarpradesh1

Aerobic exercises -

Uses large muscles in a rhythmical, continuous activity. The most effective
activities involve:
  • Walking
  • Treadmill
  • Swimming
  • Cycling

Why Aerobic exercises


  • Cardiovascular deficit in RA is 40% and in OA
    is 20%
  • Increased oxygen uptake
  • Increased Ventilation & Heart-rate
  • Early onset of Fatigue
  • Leads to increased Energy expenditure

Aerobic Exercises


Walking


Aerobic Walking Exercises for Arthritis
  • If knee is sore, walk slowly and swing your arms
  • Wear supportive shoes with
    good soles
  • 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
    a stroll
  • Choose a comfortable pace

Treadmill


Treadmill Aerobic Exercises Arthritis
  • 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


Swimming and Water Aerobics for Arthritis
  • Performed in presence of
    a supervisor.
  • Use mask or a snorkel in case of neck problem.
  • Take a warm shower after
    the exercise.
  • 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
    are painful.

Bicycle (outdoor or stationary)


Bicycle Exercises Arthritis
  • 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

Respect pain


  • 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