How to Exercise with Arthritis
By Dr. David Ryan (Cecil Award Winner, National Arthritis Foundation)
Millions of Americans are affected directly with some form of arthritis. Chances are that you will develop some form of arthritis. You have to approach exercise differently if you have this disease. Interestingly enough, over 15 million people over the age of 45 will attempt to begin an exercise program and over 70% of them will quit, many due to the secondary complications associated with arthritis.
Training with many forms of arthritis will leave your body in pain almost one hour post exercise. Many scientists feel you can honestly set your clock by the timing of this reaction. It is a simple inflammatory response, but it can be controlled and avoided with some simple changes to the exercise program and technique.
Some forms of arthritis are uniquely inflammatory and often result in substantial autoimmune disorders. Rheumatoid (RA) is one such form of the over 170 types of arthritis that are currently known. Specific blood test and radiographic exams, along with a detailed case history help to determine the specific correct diagnosis. It is very important to verify the type of arthritis you have to achieve the best results from adaptive training and exercise.
When attempting to exercise with arthritis, this article is geared towards helping those individuals who have the most common form known as osteoarthritis. Many other forms may not respond to the protocol of exercise given here, so seek out a health care professional to detail the best program for you.
Arthritis literally means “joint inflammation” and typically is brought about by joint dysfunction. In many cases the lack of proper movement results in a change in local joint chemistry and leads to the formation of osteophytes (small bone spurs). This is why any movement, chiropractic manipulation and specifically exercise, are very beneficial to stopping and even reversing the effects of arthritis. The trick is to obtain the mobility without further joint irritation.
Jim Fries, MD a noted rheumatologist at Stanford University Medical Center, cited three ways to help you control arthritis: exercise, weight loss and joint protection. They are listed in order of importance so it is important to learn them in this sequence.
Before you start: See a health care professional: DC, DO or MD for the correct diagnosis, then warm the area up using a moist hot pack or topical cream and keep the area covered during exercise. Perform no weighted movements using the area to help assist with warm-up.
Reduce the load and learn to flex
The concern of osteoarthritis (OA) is with excessive irritation, resulting in too much inflammation by the joint. This will result in pain, which leads to spasm, which leads to more spasm and all results in more irritation, inflammation, alienation and deterioration or degeneration.
The term, degenerative arthritis is commonly associated with OA, but many forms of arthritis can be degenerative. It is a simple concept to reduce the load when exercising. This takes many forms; lighter weights, less speed or acceleration of movement, less impact, less range of motion, etc. Using less weight is often the biggest concern of most fitness athletes for many reasons. They fear less weight will result in muscle atrophy; they also have egos to contend with.
With only one workout, most trainers will be able to help their clients experience post-exercise soreness and that should convince clients that less weight and flexing during the exercise results in adequate muscle stimulation.
Maintaining size and strength by learning to flex during the movement provides a significant amount of muscle stimulation without irritating the joint.
To learn these techniques try this procedure: Take the opposite hand that you write with. Pick up a dumbbell weight that you can do curls, with some stress, approximately for 12 reps. After you have done this, now take a lighter weight, put this into your writing hand and with a slower movement, squeeze and flex your bicep muscle as you move the weight in a curl.
Really focus on squeezing during the negative portion of the movement. If you squeeze hard enough, you will likely not be able to achieve 12 reps. If you can, then slow down the whole movement.
Learning to flex while you are moving the weight will result in maximum muscle contraction without irritating the arthritic joint. You can actually stimulate your clients the muscle to recruit more fibers by simply flexing and that is a trick bodybuilders have used for years.
If you have limited mobility, isometric contractions perform with slow gentle range-of-motion exercises are your best choice. Find 5 or 6 different locations within your normal range of motion and perform an isometric contraction at those locations. Choose the endpoint, beginning and several mid range points of movement. Squeeze and hold the contraction for 6-12 seconds. The harder you contract the muscle(s) more fibers you will stimulate.
It is important to balance your joint strain from front to back. Muscles that are too strong on one side of the joint, will pull that joint out of position and result in abnormal wear and tear.
For example, try to equalize your bench press and the bent-over row. If you can bench press 100 pounds and only use 50 pounds for bent-over rows, it is likely that your shoulder will eventually sit forward, thus causing abnormal wear and tear on that joint. The same rule lies to the need for hamstrings and quadriceps and the elbow for biceps and triceps.
Stretching after you exercise promotes maximum circulation to the joints. Never balance on a stretch and it is best to begin stretching with a reduced range of motion, hold for 10 seconds, reset and attempt a farther range-of-motion and hold for an additional 10 seconds. Stretching prior to a warm-up will result in micro-tearing.
Individuals with arthritis respond best if they exercise in the morning to late morning. You may be stiffer at the start, but you will have less pain the rest of the day.
Stop exercising if you experience any of the following symptoms:
• sharp pain during exercise
• radiating pain or numbness in arm or leg
• shortness of breath
• chest pain or tightness
• dizziness or nausea
• slurring of speech
Contact your doctor if the symptoms persist. Arthritis can cause these reactions but they are usually controllable with ice wrapped in a wet towel placed on the affected joint for 10 minutes only, remove for one hour, then repeat. Avoid the use of long term NSAIDs, since studies have shown over 16,500 people die yearly from their use.
Weight loss is calories in verses calories out. Less weight means less stress on the joint. It is just that simple. Use the Dr. Ryan’s two fist method: Eat one fist-sized portion of protein and the other fist-sized portion of fruits/vegetables/grains.
Stay away from processed sugars/high fructose corn syrup, salt and high fat foods, as these foods are associated with inflammation and irritate most arthritic conditions.
Supplements that have been shown to help with most arthritis:
• Glucosamine and Chondroitin Sulfates (found in ElastiJoint)
• Fish oil
• Vitamin C (also found in ElastiJoint)
• Alfalfa tablets
• Cherry juice
Joint protection is available through the use of many orthopedic braces or taping procedures. Your physician is best suited to provide these options for you.
Dr. David Ryan
Columbus Chiropractic Center Director
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