Common Questions and Answers about Arthritis and Exercise

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Editor’s note: the following article is an excerpt from the National Institute of Arthritis and Musculoskeletal and Skin Disease, “Health Topics: Questions and Answers about Arthritis and Exercise.” NIH Publication No. 01-4855.

Should People With Arthritis Exercise?

Yes, people with arthritis should exercise. Many studies have shown that exercise helps people with arthritis reduce joint pain and stiffness, increases flexibility, muscle strength, cardiac fitness, and endurance. It also helps with weight reduction and contributes to an improved sense of well-being.

How Does Exercise Fit Into a Treatment Plan for People With Arthritis?

Exercise is often only one part of a comprehensive arthritis treatment plan. Some treatment plans may also include rest and relaxation, proper diet, medication, instruction about proper use of joints and ways to conserve energy (that is, not waste motion), as well as the use of pain relief methods.

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., dance) help maintain normal joint movement and relieve stiffness. This type of exercise helps maintain or increase flexibility.

Strengthening exercises (e.g., weight training) help keep or increase muscle strength. Strong muscles help support and protect joints affected by arthritis.

Aerobic or endurance exercises (e.g., bicycle riding) improve cardiovascular fitness, help control weight, and improve overall function. Weight control can be important to people who have arthritis because more weight puts extra pressure on many joints. In addition, some studies show that aerobic exercise can reduce inflammation in some joints.

Most health clubs and community centers offer exercise programs for people with physical limitations.

How Does a Person With Arthritis Start an Exercise Program?

People with arthritis should first discuss exercise options with their doctors and other health care providers. Most doctors recommend exercise for their patients, and many people with begin with easy, range-of-motion exercises and low-impact aerobics. 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 make a referral to a physical therapist. It is best to find a physical therapist that has experience working with people who have arthritis. These experts can design an appropriate home exercise program and teach clients 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.

Up to Exercise: How to Get Started

When beginning and exercise regimen, start with supervision from a physical therapist or qualified athletic trainer. Many people with arthritis also choose to apply heat to sore joints before a work out to reduce pain. Always stretch and warm up with range-of-motion exercises before you begin. Start strengthening exercises slowly with small weights (a 1- or 2-pound weight can make a big difference). Some arthritis sufferers choose to use cold packs after exercising to help prevent soreness.

Add aerobic exercise to the routine and consider appropriate recreational exercise (after doing range-of-motion, strengthening, and aerobic exercise). Fewer injuries to joints affected by arthritis occur during recreational exercise if it is preceded by range-of-motion, strengthening, and aerobic exercise that gets your body in the best condition possible. Ease off if joints become painful, inflamed, or red, and work with your doctor to find the cause and eliminate it. Choose the exercise program you enjoy most and make it a habit.

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 a 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.

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. Correct positioning is critical, when performing exercises because if done incorrectly, strengthening exercises can cause muscle tears, more pain, and more joint swelling.

Are There Different Exercises for People With Different Types of Arthritis?

There are many types of arthritis and experienced doctors, physical therapists, and occupational therapists can recommend exercises that are particularly helpful for a specific type of arthritis. Doctors and therapists also know specific exercises for particularly painful joints; however, there may be exercises that are off-limits for people with a particular type of arthritis, or when joints are swollen and inflamed. People with arthritis should discuss their exercise plans with a doctor. Doctors who treat people with arthritis include rheumatologists, orthopedic surgeons, general practitioners, family doctors, internists, and rehabilitation specialists (physiatrists).

Should Someone With Rheumatoid Arthritis Continue To Exercise During a General Flare? How About During a Local Joint Flare?

It is appropriate to put joints gently through their full range of motion once a day, with periods of rest, during acute systemic flares or local joint flares. Patients can talk to their doctor about how much rest is best during general or joint flares.

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