How to Exercise for Arthritis 10 Tips for Working Out Safely With Osteoarthritis Symptoms

Regular exercise is important if you have symptoms of osteoarthritis, a common degenerative condition of the joints. But if you work out too hard or don’t take precautions, you may end up with even more pain than before. Read on for 10 expert tips on how to exercise for arthritis relief the right way... When osteoarthritis pain flares, the last thing you want to do is exercise. But make an effort to exercise for arthritis anyway, because a lack of physical activity leads to a vicious cycle, says Ronald P. Reichman, M.D., a specialist in rheumatology and internal medicine at Cedars-Sinai Hospital in Los Angeles. For example, you may gain weight, which puts more stress on joints and increases osteoarthritis pain. Exercising reverses this. It can also fight arthritis-related joint stiffness and discomfort. “Exercise strengthens the muscles around joints and keeps them functioning and in proper alignment,” Reichman says. Like car tires, joints wear out faster when they’re out of alignment. So strengthening muscles – around the knee, for example – prevents further deterioration by keeping the joint moving correctly. Exercise for arthritis also maintains the joints’ range of motion – the extent to which they can be moved, rotated or extended. That makes it easier for them to handle everyday movements, Reichman says. Here are 10 expert tips on the best ways to stay active, fight arthritis and keep functioning at your best. 1. Start slowly. If you’re a beginner or returning after an exercise hiatus, don’t do too much too soon. That may cause pain and inflammation around joints, Reichman says. “Gradually add only a few minutes to each workout and slowly increase range of motion if you’ve lost flexibility,” he recommends. Start with just 10 minutes, even if you have to leave a class before it’s over. Then assess its impact on your body. “If you’re not in pain two hours later, add five minutes to your exercise routine the next day,” Reichman says. Ideally, you want to work up to 30 minutes of exercise for arthritis, says Robin K. Dore, M.D., a rheumatologist at St. Joseph’s Hospital in Tustin, Calif. “For joint benefit, however, it’s not necessary to move continuously for 30 minutes,” Dore says. It may be easier to do two 15-minute workouts or three 10-minute workouts throughout the day. 2. Lose weight. If you’re overweight, every pound you lose means less stress on joints during exercise. Losing five pounds translates to a reduction of 20-30 pounds of force across your knee from walking, says David Borenstein, M.D., president of the American College of Rheumatology in Washington, D.C., and author of Heal Your Back: Your Complete Prescription for Preventing, Treating and Eliminating Back Pain (M. Evans & Company). The same is true for going up and down stairs. “Walking upstairs generates forces across your knees equal to four times your body weight,” Borenstein says. “Walking downstairs generates seven times the force – which is why women with OA typically feel more pain going downstairs than walking up them.” 3. Do low-impact workouts. To reduce the risk of osteoarthritis pain, keep stresses on lower-body joints – such as knees and hips – to a minimum, Reichman says. “Light” exercise, such as walking, swimming or using an elliptical trainer, is best for people at risk for osteoarthritis symptoms, according to a 2010 University of California, San Francisco study. Magnetic resonance imaging (MRI) showed that light exercisers had healthier knee cartilage compared to runners or those who did strength-training often. And frequent knee-bending activities – climbing up at least 10 flights of stairs a day, lifting objects of more than 25 pounds, squatting or kneeling for at least 30 minutes a day – was associated with more cartilage abnormalities. Another good way to exercise for arthritis is stationary cycling, which reduces the risk of injury, unless you’re adept at cycling outdoors on a regular bike, says Reichman. Adjust your bicycle seat to a level that allows your knee to remain slightly bent on the down stroke. Or a recumbent bike may be better if you have back pain, because your lower back is supported and there’s no strain on your upper back and neck, Reichman says. 4. Warm up thoroughly. A gentle warm-up increases blood flow to muscles, loosens them and reduces risk of an injury that could lead to osteoarthritis pain, Reichman says. The Arthritis Foundation recommends a 3-5-minute warm-up of walking or marching in place. Start gradually and speed up the pace after a few minutes. 5. Try tai chi. The flowing movements of this Chinese martial art are an ideal exercise for arthritis. “Tai chi is a nice, slow way to warm up the body without putting a lot of strain on joints,” Borenstein says. Tai chi movements mimic those we do naturally in real-life situations, such as bending and reaching forward and sideways. People with symptoms of osteoarthritis or rheumatoid arthritis who practiced tai chi twice a week for eight weeks reported less pain, stiffness and fatigue and better physical function, according to a 2010 study by the University of North Carolina at Chapel Hill School of Medicine. They also reported lower blood pressure and better sleep. Tai chi classes may be offered at local schools, hospitals, martial-arts studios, fitness centers or the YMCA. Or purchase an instructional DVD from the Arthritis Foundation. 6. Get in the water. Water workouts are one of the best low-impact exercises for arthritis, because water reduces the effect of gravity and stress on the knee, Reichman says. It also offers both cardio and resistance training, because your muscles are pushing against water. Because water supports and stabilizes your upper body, “water exercise is especially helpful for women with osteoarthritis pain in the back or neck,” Borenstein says. To alleviate pain while swimming, use a snorkel and mask so you don’t lift your head to breathe. “They enable you to swim without extending the spine, which can cause pain,” he says. Also, work out in a heated pool if you can. Most people feel less osteoarthritis pain in warmer water, says Borenstein. “Cool water can heighten sensitivity and cause those with OA to become more aware of aches and pains,” he says. The Arthritis Foundation helps organize water exercise classes in many areas; you can find information here. 7. Walk softly. If you feel osteoarthritis symptoms in your hips and knees, the floor or surface you’re exercising on and your footwear may exacerbate it, says Borenstein. For example, the mall may be OK for a stroll, “but walking on cement combined with the wrong shoe can cause osteoarthritis pain to flare,” he says. That’s because hard cement floors create more pressure against your foot and send it throughout your extremities, says Borenstein. That’s why a softer surface, such as a school running track or cushioned treadmill, is better for people with osteoarthrtitis, he says. When choosing athletic footwear, make sure it offers enough support and cushioning. “You should feel the bottom of the shoe, not the floor,” Borenstein says. If osteoarthritis affects your toes, you may need a shoe with a wider toe box, he says. 8. Stay warm. Warmth improves blood flow to your limbs, says orthopedic surgeon Thomas P. Schmalzried, M.D., medical director of the Joint Replacement Institute at St. Vincent Medical Center in Los Angeles. “Good circulation decreases inflammation in the joints, and osteoarthritis pain and swelling,” he says. When you exercise for arthritis in cold weather, wear layers of clothing to help control your body temperature, he suggests. “Extreme heat can cause lightheadedness and dizziness, and cold may increase muscle tightness,” Dore explains. And warm your body temperature before starting. For example: Take a warm shower Sit in a warm whirlpool bath Apply a heating pad to sore joints (but not if they’re inflamed – that is, swollen and tender) Use hot packs or warm compresses (or try disposable heat packs) 9. Include weight-bearing exercise. This strengthens your muscles, helping them support and stabilize joints and ward off further damage. But watch out: The wrong exercises can make osteoarthritis pain worse. If you have lower-extremity joint pain, such as in the hips or knees, avoid lunges, which strain these joints, says Borenstein. “They’re a popular exercise for women because they target the hips and legs,” he says. “But if you have a weak spot, it’ll quickly become evident [in the form of joint pain].” Instead, do leg raises to strengthen quadriceps (the muscles in front of the thighs), which help stabilize the knee joint. Here’s how: Lie on your back with one knee bent and your foot on the floor, and the other leg straight out on the floor. Slowly raise the straight leg until your thighs are parallel to each other (at a 45° angle); pause and slowly lower it to the ground. Start with three sets of 10 reps per leg. For added resistance, use ankle weights. You can also do leg raises on a weight machine at the gym, but be careful not to use more weight than you can easily handle without pain. Walking also counts as a resistance exercise for arthritis, since your whole body is supported by your legs. 10. Stretch it out. Just like a warm-up exercise for arthritis, gentle stretching can help prevent injuries if you have osteoarthritis symptoms. For example, if your Achilles tendon (the muscle at the back of your ankle) isn’t flexible and you do a lot of walking up hills, it may not be able to move through its entire range of motion. Over time, the overuse increases small, microscopic injuries, which can result in tendonitis. Stretching regularly will help the Achilles tendon move through its normal range of motion more easily. But the key to safe stretching is to do it only when muscles are warm, says Schmalzried. A cold muscle doesn’t have the same ability to stretch, and can quickly become strained. How to tell if stretching is safe to do? A little perspiration on the forehead is a good sign, Schmalzried says. When stretching, maintain gentle, continuous pressure – don’t “bounce,” Schmalzried advises. Hold each stretched position for a count of 10; relax for a count of 5, then do it again. Gentle stretching exercises should be done every day to fight arthritis, says Schmalzried. “Work up to 15 minutes a day.” For more information, visit our Osteoarthritis Health Center. How Much Do You Know About the Types of Arthritis? About 46 million American adults – nearly one in five – suffer from some type of arthritis. It’s estimated that number will rise to 67 million by 2030. Do you or someone close to you have arthritis?