Exercise and Arthritis

Everyone should probably be doing more exercise but this is especially true for people with arthritis who may have problems with joint pain, stiffness and reduced mobility. Many people with arthritis worry that exercise can harm the joints.

This is not true. It is normal to sometimes feel a little sore or uncomfortable after exercise, especially if it is something you haven’t done for a while, but it is important to remember that this does not mean that you are harming your joints. In fact, regular exercise is essential as it helps to strengthen the muscles that protect and support the joints. Exercise has even been proven to help reduce the pain of arthritis and improve function.

 

The deconditioning cycle

Avoiding activity due to pain is not advised as this will lead to the joints getting a little stiffer and the muscles weakening. This is called the deconditioning cycle.
Pain cycle(2)

If you have arthritis, it is vital that you try to stay active or increase your level of activity as this can help reduce pain, improve function and keep you more active.

Even training with weights will not harm your joints although you should seek advice regarding which exercises are suitable for you. You should always start slowly and gradually increase the amount of time that you spend exercising.

Speak to your GP or healthcare professional before starting a new exercise to make sure that you do it safely. At Arthritis Action we can also give you advice on exercising safely.

 

Benefits of exercise for people with arthritis

If you have arthritis there are many benefits to increasing your level of activity. You cannot cause more damage to the joints by exercising.

Exercise causes the body to produce endorphins. These are the body’s own natural painkillers. Exercise can calm the mind and help improve sleep quality. It uses up calories and gives you energy. It improves muscle strength which can reduce pain and improves balance leading to reduced risks of falling.

The benefits of exercise include:

  • Less pain
  • Increased energy
  • Improved function
  • Better memory and concentration
  • Weight control
  • Social benefits such as meeting similar people, making friends and reducing isolation
  • Improves mood. Reduces stress and depression
  • Improves joint flexibility, ligament strength and muscle tone
  • Improves heart and lung function
  • Preserves bone density
  • Improves balance (reduce risk of falling)
  • Reduces blood pressure
  • Reduces cholesterol
  • Improved blood sugar control
  • Improves sleep quality of sleep. Reduce fatigue
  • Boosts immunity

 

Exercise does not have to be very vigorous to produce benefits. Even gentle stretching or Tai Chi can improve balance and help keep the joints moving, and simple walking can dramatically improve fitness and reduce joint pain.

Types of exercise

There are three main types of exercise and each has different benefits.

  1. Aerobic exercise improves fitness, stamina and cardiovascular health
  2. Resistance exercises improve muscle strength and help with pain reduction and balance
  3. Flexibility exercises which can reduce stiffness and improve mobility

Ideally you should try to do some of all these three types of exercise for the best results.

 

Aerobic (cardiovascular) exercise

This type of exercise is designed to make your heart beat faster and to improve your overall level of fitness and stamina. Any type of exercise which makes you breathe deeper and faster can be aerobic. Examples include walking, housework, dancing, swimming, gardening, climbing stairs and cycling.

 

Muscle-building (resistance training)

This type of exercise will improve strength, balance and posture, as it involves exercising your muscles against resistance. Examples of this type of exercise include strengthening exercises for the knee, balancing on one leg, weight training and press-ups.

 

Flexibility

Exercise is easier and less painful if your muscles are more flexible. This kind of exercise includes yoga and Pilates. These exercises will not help you lose weight or become fitter but improving flexibility is excellent for helping reduce stiffness, reduce muscular aches and pains and can help with improving posture and balance.

 

Weight bearing exercises

Weight bearing exercises put a small amount of weight through the skeleton, which is an excellent way of reducing the risk of osteoporosis – a medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes and can occur in both men and women.

Weight bearing exercises include activities such as walking, carrying shopping, housework and dancing, but not activities in which your weight is totally supported such as swilling.

 

Exercise for weight loss

Increasing energy expenditure through regular exercise and physical activity is an integral component to promote weight loss and prevent weight regain. These can be further enhanced by following a restricted calorie eating regime.

If you would like to try to lose weight through exercise, you are best to try a combination of muscle-building exercise plus moderate intensity aerobic exercise. Muscles are the tissues which use the most energy in the body, so it makes sense that if you want to lose weight, it will be easier if you have more muscle bulk.

Interestingly, doing 30 minutes of exercise per day can increase the metabolism for 48 hours, so that you are burning off more calories even when you are not exercising.

Exercising in water can be an easy way to start as there will be less pressure on your joints.

 

Keeping up the momentum

Committing to doing a little more exercise is an important first step, but it is important to maintain the momentum. Like every habit which takes a bit of effort, it can take some willpower to keep up the good work. However there are a number of things you can try to make it more likely that you will continue.

Try something fun – if you chose an exercise that you enjoy, you are much more likely to maintain the activity. This could be something you’ve never thought of before such as Zumba, dancing, skating, or golf. If you hate the thought of organised exercise, you can still become more active by trying simple things like standing up a bit more, moving around more to music when you do the housework or dancing while waiting for the kettle to boil.

Exercise with others – doing exercise in a class or a gym can be intimidating to start with. Doing exercise together with a friend or family member can make the time pass faster, adds a fun social aspect and improves motivation.

There may still be days when you may not feel like exercising, but these will become less and you will look forward to the benefits that exercise brings once you get into the routine.

Other tips:

  • Buy a pair of trainers and get out walking.
  • Try different types of exercise for variety.
  • Buy a pedometer (step-counter) and count the number of steps that you walk per day. You may surprise yourself with how many steps you are already walking. 10,000 steps daily is the recommended number, but 3,000-5,000 steps can significantly help with the pain of osteoarthritis of the knee and hip.
  • Get yourself an MP3 player and exercise to music, audiobooks or podcasts. Even dancing when doing the housework or waiting for the kettle to boil counts as exercise.
  • If you feel nervous about exercising in a gym, there are often very quiet times or women-only sessions. Most gym staff are very encouraging as they want more people to enjoy exercise so don’t be afraid to ask.
  • Set yourself a small goal or target such as walking a certain number of steps or flights of stairs, or train for a small fun walk or cycle for charity.
  • During television adverts, try standing up and sitting down without using your hands to help you get up as many times as you can. This can improve the strength in your knee muscles and reduce knee pain.
  • When washing up or brushing your teeth, try to keep moving, bend and straighten your knees or bend from side to side to improve flexibility in your back.
  • If you are going to exercise, it is important to use the right type of footwear. A soft supportive running style trainer will help to shock absorb and protect your joints whilst you get used to the new activity.

Frequently asked questions about exercise

 

Will exercise hurt or harm my joints?

When you first start exercise, you may feel a temporary increase in discomfort and stiffness. This is normal and will settle after a day or so. The pain after exercise will eventually become less if you keep going. Exercise will not do any harm to your joints.

 

Is it safe to exercise when my joints hurt or are swollen?

Yes. Even though you might not feel like exercising, there is some evidence that exercise can reduce swelling in inflamed joints. If you have gout, however, your joints may be extremely swollen and tender and you should rest the affected joint if you get a flair-up. It is safe to exercise the other joints though!

 

What type of exercise is best for me?

It doesn’t really matter what type of exercise you do but you should try to find a type of exercise which you enjoy and that you are likely to continue. The best exercise is probably one which improves fitness, muscle strength and flexibility at the same time, but any exercise is better than nothing. Even simple vacuuming or doing housework to music or gardening or walking will do.

If your joints are very painful, exercising in water can be a good place to start and many swimming pools have sessions for women only, people with disabilities, or pools where the water is kept warmer at certain times.

 

Small amounts of exercise can still have huge health benefits.

Meeting exercise targets may seem very challenging for many people and most of us have a very long way to go before reaching the recommended levels of activity. For those with arthritis, the challenges may be even harder so don’t feel guilty if you are less active than the guidelines suggest.

The good news is that even small increases in your level of activity can have a large benefit on your health and wellbeing.

To make the goal of more exercise easier, activities can be broken up into 10 minute intervals of more simple physical jobs such as housework, gardening, or brisk walking.

Other simple ways of increasing the amount of activity you do are to:

  • Reduce the amount of time you spend sitting by turning off the television for an hour or so every day. Standing up more can improve muscle strength and balance and helps to burn calories.
  • Try parking the car further away from the entrance to shops.
  • Try to always stand up from sitting without using your hands. If this is difficult, practice from a high chair and work towards several repetitions. This exercise is excellent for strengthening the thigh muscles and can help a lot with knee pain.
  • Try to use the stairs rather than a lift.

 

Where do I start?

 

Physical therapy

– If you are not confident to begin an exercise programme on your own, a physical therapist (such as a physiotherapist or osteopath) can give you advice. If you are a full member of Arthritis Action, you can get access to one of our Associate Practitioners who can help you with this.
Exercise on referral – in some areas, your GP may be able to refer you to a local health centre for a certain number of subsidised exercise sessions where you can get support from a personal trainer or gym instructor until you have the confidence to continue on your own. Ask your GP for more details.

ESCAPE pain

– this is a rehabilitation programme for people with chronic joint pain (focusing especially on the knees and hips) that integrates educational self-management and coping strategies with an exercise regimen individualised for each participant. It helps people understand their condition and is directed at helping them cope with their pain better.
The programme which runs for an hour, twice per week for six weeks has been shown to:

  • reduce pain
  • improve physical function
  • improve the psychosocial consequences of pain – depression, people’s sense of being in control of their problems, self-confidence and self-esteem
  • reduce healthcare and utilisation costs

For more information visit: http://www.escape-pain.org/