Exercise and Arthritis
Dr Vernon Coleman
As an arthritis sufferer it is vital that you know when to rest and when to exercise. Too much exercise can cause pain and damage your joints. But too little exercise can lead to your joints becoming stiff and unusable – and can, in the long run, create more pain. When your joints are inflamed they must be rested – and your whole body may need to be rested if you suffer from an inflammatory or auto immune disorder – but if you rest too much your joints will get stuck in one position and your muscles will waste away. It is important, therefore, that you establish a regular, daily exercise programme designed to keep you as supple and as strong as possible. It is much better to do a small amount of exercise every day then a huge amount of exercise once a week.
Important: before beginning any exercise programme you should always consult your own family doctor.
Exercise rules for rheumatoid arthritis
1. Rest is important for sufferers of this disease. If your joints are swollen, stiff and painful then you must rest completely – ideally in bed.
2. Try to use affected joints for short periods of time only. It is important to try to exercise a joint when it is not painful so that you can keep it mobile and prevent it from becoming stiff and unusable.
Exercise rules for osteoarthritis
1. General rest is not normally necessary since osteoarthritis usually affects individual joints – but any joint which is painful should be rested.
2. Stiffness can set in if a joint is allowed to ‘set’ in the same position for more than an hour or so. You should, therefore, put all your affected joints through the full range of possible movements every hour at least. Exercise your joints before going to bed at night – and again, first thing in the morning.
3. You should never exercise when your joints are painful but you should try to exercise as much as you can when they are not painful.
4. If, after exercise, an affected joint aches more than usual – and the ache lasts for two hours or more – then your exercise programme is too severe and needs to be reviewed and downgraded.
Protect your joints whenever you can
Even though you need to exercise your joints regularly – and you should try to carry on your life as normally as possible – you must take care not to put too much of a strain on any joint in your body. Here are some tips designed to help you protect your joints from unnecessary stresses and strains:
* Make sure that your clothes are easy to get into and out of. Don’t have buttons in inaccessible positions. Choose clothes that are roomy rather than constricting.
* Adjust the height of your bed and of any chairs you use regularly so that you do not have to strain your back, hips or knees when getting in or out of them.
* Plan your day so that you don’t have to go up and down stairs unnecessarily.
* Never wear shoes that are painful or that do not provide you with sufficient support. Avoid high heeled shoes and make sure that your shoes are big enough. Try to wear shoes that are lightweight rather than heavy boots.
* Use a shoulder bag rather than a bag that you have to carry in your hand. But don’t overfill it with heavy items. And do switch it from shoulder to shoulder.
* If you have to do a lot of physical work allow yourself enough time to take regular breaks.
* Try to avoid physical activities which mean putting repeated stress on one particular joint.
* Do not be shy about using aids and appliances to reduce the strain on your joints
* Learn how to lift properly in order to reduce the strain on your back, hips and knees.
* Protect the small joints in your hands by using two hands instead of one whenever possible. And use the palm of your hand and the muscles in your forearm when you need to do any heavy work with your hands – rather than putting all the strain on your fingers (for example, when turning a stiff tap or taking the top off a jar).
The importance of general exercise
A good, general exercise programme won’t stop you getting pains but it certainly could help strengthen your general level of fitness, increase your resistance to muscular stresses and strains and reduce your susceptibility to joint problems. If you are unfit taking up exercise could be dangerous. If you suddenly throw yourself into a hectic exercise programme you could seriously injure yourself. But not doing any exercise is even worse. Unless you exercise regularly your health will be at risk and in addition to getting backache and arthritis you will be more prone to disorders as varied as osteoporosis, heart disease and depression.
Most of us live fairly sedentary lives. We travel in motor cars, buses and trains and we use gadgets and machines to help us cut down the workload in the house and garden. But your body needs exercise. In a few thousand years’ time we may well have adapted to our sedentary existence. But at the moment your body is still designed for action. Many of the diseases which are commonest today are partly caused by the fact that most of us do not exercise enough.
So, how much exercise should you do and what should you do?
The first thing you must do is check with your doctor. Don’t just rush down to your gym and start lifting the heaviest weights you can find or pedalling the exercise bicycle as fast as it will go – you’ll almost certainly make yourself ill if you do. And you could kill yourself. Try to find a gym with a good coach, a well-run aerobics class or a sports club that you can join. A good coach is vital: he or she will show you how to take your pulse before and after every exercise session. Within a few weeks you should notice that your pulse will go back to its normal rate quicker and quicker after exercising. You should also notice that your normal pulse rate gets lower as you get fitter.
One of the by-products of taking up an exercise programme is that you’ll meet new friends with whom you can share the trials and tribulations of getting fit. You’ll do better and get more out of your exercise programme if it is fun so try to choose a type of exercise that you think you’ll enjoy. Allocate time for exercise and stick to it. If you decide to exercise only when you’ve got a free moment you’ll never do anything. You need to set aside time for a properly organised exercise programme. But it need not be much. Three sessions a week will be plenty. You should allow a full hour for each session though to start with you probably won’t be able to manage that much. If you are really pushed for time you can squeeze a useful exercise programme into just three twenty minute sessions. Can there be anyone who is so busy that they can’t manage one hour a week? Try to make your exercise time inviolable and give it priority over other, less vital tasks.
You don’t need a lot of money to take up exercise but do buy the right gear – the best you can afford. Remember: you’re not trying to look fashionable but you do need shoes that are comfortable and give good support and since you’ll be sweating a lot when you start exercising properly you’ll need clothes that can be washed often, quickly and easily.
Finally, remember the most important rule for exercise: it should never hurt. Pain is your body’s way of saying stop. If you ignore a pain – and attempt to blunder bravely through the pain barrier – you will almost certainly injure yourself.
General warnings
1. Do not start an exercise programme until you have checked with your doctor that the programme is suitable for you. Make sure that you tell him about any treatment you are already receiving and about any symptoms from which you suffer.
2. You must stop exercising if you feel faint, dizzy, breathless or nauseated or if you notice any pain or if you feel unwell in any way get expert help immediately and do not start exercising again until you have been given the ‘all clear’ by your doctor.
Joint Warning: the wrong sort of exercise can damage your joints
Your joints can be put under a tremendous amount of strain by any repetitive exercise. As a result arthritis – particularly osteoarthritis in which the joints are ‘worn out’ – and backache are common problems among sportsmen and athletes who do not take care. Warming up beforehand, resting or even stopping when you feel tired and cooling down gently after an exercise programme are all important.
Running is one of the sports most commonly associated with back, hip and knee injuries. Running tends to tighten the lower muscles of the back causing low back pain and increasing the risk of conditions such as ruptured disc and runners who exercise for too long on hard surfaces are particularly likely to suffer from backache. Every one hour’s running means that your joints get 10,000 vibrations. Running on cambered roads means that the strains on the back are particularly bad because one leg is always running lower than the other.
But running is not, of course, the only sport that can cause joint problems. Virtually any sport can cause trouble. Over enthusiastic swinging of a golf club, for example, can cause nasty strains that may take a long time to heal. The most severe and potentially serious joint injuries tend to occur in contact sports such as rugby and football where a sudden jolt can cause severe damage to almost any joint.
Swimming is good for you
Swimming will provide your body will an almost perfect exercise programme. It will improve the efficiency of your heart, it will help improve your muscle strength and it will improve your general flexibility. Swimming is one of the very few types of exercise that helps in these three important different ways.
Swimming will be particularly good for you if you have back or joint trouble because it will enable you to exercise without putting any stress or strain on your joints. The water will support the weight of your body and so you can exercise with the minimum of risk.
The best and most effective strokes are the front and back crawl which will give your whole body a good, general work out. If you swim breast stroke wear goggles and try to learn to swim without keeping your head lifting out of the water all the time. Extending your neck to keep your head out of the water can put a strain on your neck.
Walk your way to health
You don’t have to get hot and sweaty to improve your fitness. A gentle walk can help! A study of golfers showed that just walking round a golf course three times a week is enough to reduce the amount of cholesterol in the blood stream and to help get rid of excess weight! And the more you enjoy your game – and the better you are able to forget your worries and anxieties – the more you will benefit from it. To really benefit from your exercise walk as briskly as you can. Brisk walking can protect your heart just as well as more energetic exercise such as jogging or playing tennis.
You don’t need to suffer pain to benefit from exercise!
It is a myth that you need to experience pain to benefit from exercise. Pain is your body’s way of saying stop. If you ignore a pain – or try to exercise through it – you will do yourself harm.
Taken from How to Conquer Arthritis by Vernon Coleman – available as a hard cover, paperback and an eBook
Copyright Vernon Coleman July 2022
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