Saturday, November 26, 2011

How to Make Exercises for Arthritis Pain-Free - 9 Tips to Start an Arthritis Exercise Program

Most people don’t love trekking to the gym. Add achy, stiff joints to the mix, and it’s no wonder many arthritis sufferers aren’t getting enough exercise. So how can people with this chronic inflammatory disorder reap the benefits of working out safely and effectively? Read on for our fitness experts’ 9 best tips...

When your arthritis flares up, your first instinct may be to take your medication and lie down for a long rest.

But too much inactivity can actually make arthritis pain, stiffness and swelling worse.

“It’s important to move your joints when you have arthritis,” says Cynthia Ivy, an occupational therapist who works with arthritis patients at Mayo Clinic Arizona in Scottsdale.

“Exercise produces synovial fluid, which lubricates the joint,” she explains. “It also keeps surrounding muscles and tissues strong, so they support the joint better.”

The result? Less pain and, over time, less damage to the joint, Ivy says.

Despite the many benefits of exercises for arthritis, most people with the condition aren’t meeting even the minimum requirements for 20 minutes of daily activity, even though they’re claiming otherwise.

About 30%-40% of arthritis patients say they get about 20 minutes of exercise each day, according to recent anecdotal surveys.

But a recent study from Northwestern University Feinberg School of Medicine proves they don’t. Researchers used devices to track the activity levels of 1,000 people with knee osteoarthritis. Only 13% of men and 8% of women met the daily minimum.
In fact, almost half the people fell into the Department of Health and Human Services’ definition of “inactive”: They didn’t participate in any moderate exercise lasting 10 minutes during the week.

Whether you’re an active person who doesn’t want the disease to slow you down or are just getting started with an arthritis exercise program, here are 9 tips to help you stay pain-free and healthy:

1. Take Stock.
Before you build an arthritis exercise program, know what your starting point is and find an objective measure of your daily activity. Use a timer and keep a log.

“The best way to tell how long you’re exercising is to time yourself,” Ivy says.

Since doing exercises for arthritis can be hard when you’re not feeling well, “two minutes can feel like five,” she explains.

A pedometer is useful for walkers, says Michele Melkerson-Granryd, M.E.D., a specialist in exercise physiology in Austin, Tex., who has had two hip replacements.

Get a device that meets your needs: A simple pedometer measures only your steps; a more sophisticated one tracks activity levels and number of calories burned.

2. Set a Goal.
The minimum recommended goal is 20 minutes per day, but you’ll get the best benefits if you can work up to 30 minutes, says Ivy. If one session of 30 minutes is too much, break it into two 15-minute sessions, she advises.

Start slowly with a 5- or 10-minute walk several times a day, suggests Lisa Konstantellis, MSPT, a physical therapist and manager of the Joint Mobility Center at the Hospital for Special Surgery in New York City. Increase your daily total by five minutes each week until you’ve reached 30 minutes, she says.

If you’re using a pedometer, the Arthritis Foundation recommends that you aim for 10,000 steps per day. You’re almost halfway there with your daily routine, which can add up to 3,000-5,000.

3. Pick a Partner.
Doing exercises for arthritis won’t be a chore if you have company, so walk with a friend or sign up for a group class, like water aerobics or yoga.

“If you have a buddy to exercise with, you’re most likely to be consistent,” Konstantellis says.

“Start with your friends,” she says. “Or check with the local community center.”

The Arthritis Foundation also offers programs in many areas.

4. Do What You Love.
If you love being outside, go for a walk. In bad weather, use a treadmill or walk indoors at a local mall, for example.

Like to work out at a local gym? Get your heart pumping on the cardiovascular equipment, such as a treadmill, stationary bike or elliptical machine.

Even more strenuous activities – such as tennis, golf or skiing – are doable with some modifications.

You can make these activities less demanding, says Melkerson-Granryd. For example, with tennis, switch from singles to doubles, which requires less running and turning. If you play tournaments, compete at a lower level.

Or use a wrist or elbow brace to prevent arthritis pain in your hands and arms, Melkerson-Granryd says. Skiers should take less-strenuous trails (blue or green instead of black), resting between runs and wearing a knee brace, she advises.
Golfers can use a cart or play a shorter nine-hole course when tired.

If your hands bother you, use an arthritic grip on your clubs. It's larger, easier to hold and puts less pressure on your hands.

In an aerobics class, take a rest about halfway through or work at a slower pace, says Melkerson-Granyd.

“We tell our clients to use a 0 to 10 scale to rate their [arthritis] pain,” Konstantellis says. “Zero is no pain, and 10 is excruciating. If you’re above a 5, it’s time to stop and rest.”

5. Get Wet.
If you’re concerned other activities will be too painful, get in the water.

“If you have access to a pool, this is one of the best forms of exercise for people with arthritis,” Konstantellis says. “It’s gentle on the joints, and the water creates resistance, which gives you a great workout.”

Sign up for a class at a local YMCA, community center or health club. Or check the Arthritis Foundation website for programs in some areas.

But you can get started on your own – just get in a pool and walk.
The Arthritis Foundation offers the following guidelines:

Stand upright, with your arms slightly bent at your sides, and walk forward, placing your whole foot (first heel, then toes) on the bottom of the pool.

If you plan to walk in deep water, get a flotation belt, which will keep you upright and floating at about shoulder height. Otherwise, you’ll want to work in water that’s waist- to chest-deep.

Protect your back by keeping your core muscles (in your stomach and back) engaged as you walk.

Intensify the workout by mixing in short intervals during which you lift your knees higher or pump your arms.

Check out 8 pool exercises great for arthritis.

6. Build Strength.
Moving is easier with strong muscles. So build yours up by lifting light weights or with simple strengthening exercises you can do without equipment at home.

For example, simply lifting your leg up off a chair and holding it for 6-10 seconds builds your quadriceps muscle, which helps support your knee, says Ivy.

Want more? The Arthritis Foundation has photos and videos of strengthening exercises for arthritis.

7. Stay Flexible.
Before you work out, do a series of range-of-motion exercises with your affected joint, Ivy advises.

“Every joint can move in a series of directions and in a certain range.”

Don’t be afraid to move the affected joint, because movement will help decrease pain. Just move it as far as you can in each direction, and stop before you reach a painful point.

“Do 10 pain-free repetitions of a range-of-motion exercise on every affected joint each day,” she says. Besides range-of-motion exercises for arthritis, yoga, tai chi and Pilates can also help maintain joint flexibility. They also strengthen your core muscles.

Use a video or take a class, and tell your instructor about your arthritis and any other conditions you may have. Ask for modifications to the poses so there’s less strain on your joints.

8. Don’t sit too long.
Whether watching TV, reading or working on the computer, remember to get up and move.

“Walk around the room or building every hour,” suggests Melkerson-Granryd. “If you’re on the phone, stand up and walk around your desk while you talk.”

9. Take Time to Recover.
It’s normal to have some pain and soreness after doing exercises for arthritis. If you’re uncomfortable, apply an ice pack or a big bag of frozen peas or corn – wrapped in a spare pillowcase – over the joint for 10-15 minutes, she suggests.

“Ice will help reduce inflammation and is good at dulling pain,” Konstantellis explains.

If the pain lasts for more than two hours, it’s a sign that you overdid it, says Ivy. Next time, build in more rest periods or go at a slower pace, she advises.

It may take some time for you to learn your limits – and how far you can stretch them without pain. They may vary from day to day, as symptoms flare and subside.

But with patience and persistence, there’s no reason you can’t reach the recommended daily goal of 30 minutes of exercises for arthritis, says Ivy.

For more information and expert advice, visit our Arthritis Health Center.
Are You Bad to the Bone?
For years, you’ve been the first one on the tennis courts, the weekend hiker, the intrepid gardener on your knees for hours. While all those activities are great for you, they can also be hard on your joints.

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