06 June, 2008

Exercise for arthritis

Many people use the word "arthritis" to refer to all rheumatic diseases. However, the word literally means joint inflammation; that is, swelling, redness, heat, and pain caused by tissue injury or disease in the joints and other supporting structures of the body such as muscles, tendons, ligaments, and bones. Examples of some rheumatic diseases are:

• Osteoarthritis
• Rheumatoid arthritis
• Fibromyalgia
• Systemic lupus erythematosus
• Scleroderma
• Juvenile rheumatoid arthritis
• Ankylosing spondylitis
• Gout

Exercise reduces joint pain and stiffness and increases flexibility, muscle strength, cardiac fitness, and endurance. It also helps with weight reduction and contributes to an improved sense of well being. Exercise is one part of a comprehensive arthritis treatment plan. Treatment plans also may include rest and relaxation, proper diet, medication, and instruction about proper use of joints as well as the use of pain relief methods.

Researchers have found that people who do moderate, regular running have low, if any, risk of developing osteoarthritis. However, studies show that people who participate in sports with high-intensity, direct joint impact are at risk for the disease. Sports involving repeated joint impact and twisting (such as baseball and soccer) also increase osteoarthritis risk. Early diagnosis and effective treatment of sports injuries and complete rehabilitation should decrease the risk of osteoarthritis from these injuries.

Three types of exercise are best for people with arthritis:

Range-of-motion (stretching) exercises help maintain normal joint movement and relieve stiffness. This type of exercise helps maintain or increase flexibility. These basically aim at improving the flexibility of the muscles around the joint. It is appropriate to put joints gently through their full range of motion once a day, with periods of rest, during acute systemic flares or local joint flares. Patients can talk to their trainer about how much rest is best during general or joint flares.
Strengthening exercises (e.g., weight training) help keep or increase muscle strength. Strong muscles help support and protect joints affected by arthritis. These should be done everyday. Strengthening one's muscles can help take the burden off painful joints. Strength training can be done with small free weights, exercise machines, isometrics, elastic bands, and resistive water exercises. Correct positioning is critical, because if done incorrectly, strengthening exercises can cause muscle tears, more pain, and more joint swelling.
Aerobic or endurance exercises improve cardiovascular fitness, help control weight, and improve overall function. Weight control can be important to people who have arthritis because extra weight puts extra pressure on many joints. Some studies show that aerobic exercise can reduce inflammation in some joints. These should be done for 20 to 30 minutes three times a week unless you have severe pain or swelling in your joints.

To start with, people with arthritis should discuss exercise options with their doctors and other wellness trainers. Most doctors recommend exercise for their patients. Many people with arthritis begin with easy, range-of-motion exercises and low-impact aerobics. People with arthritis can participate in a variety of exercise programs.

The doctor may have suggestions about how to get started or may refer the patient to a fitness trainer. It is best to find a trainer who has experience working with people who have arthritis. The trainer will design an appropriate exercise program.

How To Get Started

• Discuss exercise plans with your doctor.
• Start with supervision from a trainer.
• Apply heat to sore joints to start exercise program.
• Stretch and warm up with range-of-motion exercises.
• Start strengthening exercises slowly with small weights Progress slowly.
• Use cold packs after exercising.
• Add aerobic exercise.
• Consider appropriate recreational exercise.
• Ease off if joints become painful, inflamed, or red, and work with your doctor to find the cause and eliminate it.
• Choose the exercise program you enjoy most and make it a part of your lifestyle.

People with arthritis should work with their fitness trainer to adjust their exercise program when they notice any of the following signs of strenuous exercise:

• Unusual or persistent fatigue
• Increased weakness
• Decreased range of motion
• Increased joint swelling
• Continuing pain (pain that lasts more than 1 hour after exercising)

Most important is to use caution. ‘Too much, too fast, too soon’ is not always the best policy. Just remember that you are not competing with anyone but yourself. Hence always work at your own pace & listen to your body.

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