Thursday, July 26, 2012

Action Plan for Managing Arthritis Pain

You might remember your grandmother walking with a cane or your grandfather wincing while holding his cup of coffee. The pain from their arthritis may have kept them from going on walks, and they certainly weren’t going to the gym. After all, who wants to exercise when they’re in pain, right? But today, medicine teaches us to think differently about arthritis and exercise. 

“Many expert groups and medical consensus panels have come out with treatment recommendations for individuals with osteoarthritis,” says American Council on Exercise (ACE) spokeswoman Robyn Stuhr, M.A., who created an osteoarthritis course for ACE. “And regular exercise is at the heart of those treatment recommendations.”

Why Exercise is Important?
It's natural to want to stop moving when you feel pain, but forgoing exercise does more harm than good over time. “If you restrict your activity, you will lose strength, range of motion and stamina, which can actually increase joint pain and decrease your ability to perform a variety of daily activities,” Stuhr says. “Instead of accelerating joint degeneration, the right exercises can actually slow the progression of osteoarthritis and help you to maintain an active lifestyle.” 

Osteoarthritis (OA) is the most common form of arthritis. It’s a degenerative joint disease and the type of arthritis that many of us associate with aging. Osteoarthritis typically affects the hips, knees, hands, lower back and neck. When the cushion between bones, called cartilage, breaks down, the bones rub against each other. This causes pain and decreased movement. Although arthritis is common among the aging population, age isn’t the only thing that can lead to joint pain.


Exercise Type: Strength Training

Examples: Free weights, weight machines, resistance bands, isometric exercises (exercises that tighten your muscles without moving your joints), resistance exercises like standing calf raises or leg extensions.

Why it matters: Strength training is key in an exercise program for people with arthritis, because toning the muscles around the joint helps to protect the joint. “Strengthening exercises increase muscular support to the joints to decrease joint stress and decrease pain,” Stuhr adds. “Improved muscular efficiency also enables individuals with OA to perform various types of health-promoting, calorie-burning exercise.” 

Tips for success: It’s important to work the muscles around the joints that have arthritis. If you have arthritis in the knee, then you’ll work the quadriceps and hamstrings. Stuhr advises: “For guidance on which exercises are most appropriate for you, work with a physical therapist or certified personal trainer with experience in arthritic conditions. Studies have shown that quadriceps weakness can contribute to pain and dysfunction in individuals with knee OA, but full leg extensions are often not the best choice. This is where guidance from a knowledgeable professional is key.”

Exercise Type: Cardiovascular Fitness

Examples: Walking, bicycling, swimming

Why it matters: Cardiovascular exercise is important for multiple reasons. First, it helps to maintain heart health. Plus, it contributes to your overall health and boosts your energy. But perhaps the most important benefit for people with arthritis is weight loss. Losing weight reduces strain on the joints. There’s a “multiplier effect” with weight loss. If you lose five to 10 pounds, you could be taking off more pounds of pressure every time you step down.

Tips for success: Avoid high-impact exercises like running and jumping, which jar the joints.
“Generally, low-impact cardiovascular activities such as walking, water exercise, cycling or using an elliptical trainer have been shown to be well tolerated by individuals with OA,” Stuhr says. She adds that people with arthritis can follow the government’s recommendations for cardiovascular exercise—30 minutes a day of moderate exercise most days of the week.

“However, individuals with arthritis may have to vary their exercise regimens to decrease stress on affected joints,” she says. “For example, instead of walking five days a week, 30 minutes each time, their joints may better tolerate walking every other day and splitting the 30-minute walk into two 15-minute shorter walks.”

Exercise type: Flexibility

Examples: Basic stretching, yoga

Why it matters: There aren’t enough studies for experts to produce standardized recommendations for flexibility training. But experts agree that flexibility is an important part of an exercise program. Range-of-motion exercises, Stuhr says, decrease joint stiffness and help maintain normal range of motion. Flexibility is important for training your body and enhancing your range of motion for everyday activities. 

Tips for success: Gentle range-of-motion exercises can be done daily, Stuhr says. But if it hurts, stop. You shouldn’t work out to the point of pain. A little bit of slight discomfort to feel the stretch is fine.

Visit gwinnettjointprogram.com if you are suffering from joint pain to learn about the state-of-the art treatments offered at GMC.
 
Three Tips for Healthier Joints
In addition to an exercise regimen that combines strength training, cardiovascular fitness and flexibility, there are other steps you can take to help make your joints stronger.

  1. Got milk? A diet that includes calcium and vitamin D can help protect bones and joints. If you aren’t getting the recommended amount of calcium (1,000 milligrams for adults 19 to 50; 1,200 mg for 50 and older—that’s the equivalent of about three to four glasses of milk a day), talk to your doctor about a supplement.

  2. Limit repetitive activities. Prolonged positions and repetitive actions can be hard on affected joints. “Variety, crosstraining and low- to moderate-intensity interval training are extremely helpful,” says Edward Gilbert, M.S., CSCS, exercise specialist for GMC’s Gwinnett SportsRehab.

  3. Cushion joints. Protect your joints from shock and vibration, Gilbert says, by wearing supportive shoes or padded weightlifting gloves.

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