Exercising When You're in Pain

When you're in pain, exercising is probably the last thing you feel like doing. But it's important to keep moving and stay strong when you have a chronic condition like arthritis so the situation doesn't get worse. With the right approach to exercise, you can preserve range of motion and flexibility around the affected joints. You also can increase muscle strength and endurance, which will enhance the stability of your joints, increase your cardiovascular conditioning -- and help you feel and function better in everyday life. In fact, in a recent review of the medical literature, researchers from the University of Melbourne in Australia concluded that aerobic, strengthening, aquatic and tai chi workouts "are beneficial for improving pain and function in people with osteoarthritis."

There is none; the best choice is whatever you will keep doing. Walking, though, is the most popular and, for many people, may be more easily sustainable than more vigorous types of exercise. In a study at the Cooper Institute in Dallas, women who walked three miles five days a week for 24 weeks significantly increased their HDL. HDL is a little lipid package that transports the heart-damaging LDL out of the body.

The ideal exercise prescription for those with arthritis is a combination of light aerobics, stretching and strength-training exercises. "If you're in pain, you want to do gentle exercises that are not stressful for your joints," advises Lisa Konstantellis, M.S.P.T., manager of the Joint Mobility Center at the Hospital for Special Surgery in New York City. "Then, as the flare eases, you can slowly increase either the duration or intensity of your exercise." (If you're entirely new to exercise, consult with your physician to be sure it's safe for you.)

"What you want to do is gently coax your body into movement," says Frank Musumeci, P.T., C.P.T., biomechanical and musculoskeletal director at the Pritikin Longevity Center and Spa in Miami. "Osteoarthritis results in a thickening of the joint capsules in response to chronic inflammation. That's what accounts for the stiffness and a lot of the pain." He adds, "When you want something to become more flexible, it helps to heat it before exercising."
If you're in pain, take a hot shower or sit in a hot tub for 15 minutes to warm up your muscles before getting active. Then, engage in light, repetitive aerobic exercise such as gentle walking (either outside or on a treadmill with arm rails), or using a cardio machine such as a cross-country ski machine, elliptical machine, stationary bike or Arc Trainer. Each of these activities will boost cardiovascular conditioning as well as strengthen key groups of muscles without placing stress on the joints. Other good choices: swimming, doing water aerobics or even walking or jogging in a pool. "The temperature of the water is soothing on joints," Konstantellis says, and the water itself provides natural buoyancy and cushioning for achy joints.

What's more, "this prelude will increase blood flow to the joint capsules and connective tissues, making them more pliable," Musumeci says. Once this happens and after you've completed your aerobic workout, it's time to stretch your calf muscles (along the back of your lower legs), hamstrings (along the back of your thighs), quadriceps (in the front of your thighs), hip muscles and the muscles in your back and shoulders. You can do this with yoga postures or traditional stretches. The key is to stretch gently and slowly -- to the point of mild discomfort but not pain; otherwise, you risk injuring your muscles.

To provide your body with greater stability, Musumeci says it's also important to strengthen your core muscles (by doing the plank and its variations) and shoulder muscles (with a rowing type of exercise). After a workout, you can apply ice to the troublesome joint for 15 to 20 minutes to prevent inflammation and pain.
Most important, listen to your body and modify the intensity and duration of your workouts if you're having a flare-up of arthritis pain. "Just getting the joint moving will help with circulation, loosen up tight muscles and generally help you feel better," Konstantellis says. "People think more is better, but you have to work within your level of tolerance. It's the small successes that keep you motivated to keep moving."

P.S.- DR. HOOSHANG HOOSHMAND OF VERO BEACH, FL.; IS A WORLD REKNOWN AUTHORITY ON RSD/CRPS AND FIBROMYALGIA, AND HE STATES TO EXCERCISE 10 MINUTES ON AND 10 MINUTES OFF FOR A WORK OUT WITH EXCRUCIATING PAIN.