Features November 2006 Issue

Arthritis Do's and Don't

Despite osteoarthritis, you’d like to stay active, accomplishing necessary tasks and taking part in activities that you enjoy. But you don’t want to risk having pain and disability. To keep moving comfortably, you need to know which activities help your joints and which you should avoid.

“Staying active is critical, even it means modifying activities and doing them in a more mechanically efficient way,” says Chad Deal, M.D., head of the Center for Osteoporosis and MetabolicBone Disease at ClevelandClinic. “The longer you’re inactive, the stiffer you’ll be when you start to move around. So you need to exercise. But it has to be the right exercise, done with common sense.”

If you think exercise makes arthritis worse,think again. Exercise is critical because it strengthens the muscles around your joints, taking stress off your joints and increasing their range of motion. Exercise is also essential for cardiovascular health, a benefit that everyone needs. Weight-bearing exercises, such as walking, help increase bone density, preventing or slowing osteoporosis. According to the Arthritis Foundation, lack of regular, vigorous physical activity nearly doubles the odds for functional decline among seniors with arthritis.

High-intensity vs. high-impact
High-intensity exercise—the vigorous kind, such as a brisk walk that gets your heart pumping and increases circulation—is beneficial for your cardiovascular system and increases circulation—provides other health benefits as well. But don’t confuse high-intensity exercise with high-impact exercise, such as running or tennis, which put sudden pressure on your joints. “You can perform a high-intensity, but not high-impact, exercise like swimming, which may send your heart rate up to 130,” explains Dr. Deal.

If you suffer from arthritis in your lower extremities, avoid high-impact exercises. They can cause increased pain, swelling, and inflammation. “Instead, try an elliptical trainer or walking in a pool—water takes a lot of weight off the lower body,” says Dr. Deal. “You'll still get a cardiovascular workout, but with less strain on your hips, knees, ankles, and feet. ”Walking on a track or in your local neighborhood is fine, but you may have to modify your workout by walking, say, two miles instead of five. Swimming and bicycling are good choices because they place less stress on your knees, feet, and ankle joints. If you’re considering bicycling,make sure you’re fit enough to avoid the risk of falling off your bike.

Do cardiovascular exercise, such as walking, for 30 minutes daily or every other day. Warm up for five to 10 minutes first, with a slow version of whatever exercise you choose in order to prevent injury. Exercise with slow, easy movements and, during a flare-up, decrease the intensity of your exercise. “Be alertfor pain,” cautions Dr. Deal. “If your knee or hip hurts after exercise or the next day, you may have overdone it and you may need to adjust your routine.”

Stretch and strengthen
Your exercise regimen should include some range-of-motion exercises, such as raising your arms over your head or rolling your shoulders forward and backward. These movements relieve stiffness and increase joint flexibility. Do             strengthening exercises to build strong muscles, which act as shock absorbers, lessening the load on joints. The quadricepsmuscle on the front of the thigh and the hamstrings on the back of the thigh, for example, protect your knees, while the pelvic girdle muscles, hip flexors, gluteus muscles, and quadriceps protect your hip joints. A physical therapist or trainer can show your angle-of-motion and strength-training exercises that are appropriate to your particular needs.

You might try a gentle form of yoga or tai chi, which improve flexibility and balance and build muscle strength. Both have been proven to help people with arthritis deal with pain and stiffness.

Keep moving
Movement tends to diminish stiffness associated with arthritis. Try to move around and avoid sitting o rstanding for a long period of time. If you must sit for a sustained period, adjust your position by moving your head and arms, stretching your legs, and moving around every half hour.

Use the stairs instead of the elevator, park a few blocks from your destination, avoid drive-in windows,and limit TV watching. Choose active pursuits, such as housework, gardening, lawn mowing, car washing, or dancing. All of these will deliver a beneficial workout.

Other ways to keep moving
Walk around the aisles of your local supermarket; reach and stretch while doing daily chores like getting dishes from the kitchen cabinet; sit in a rocking chair while watchingTV or reading and rock to improve strength and flexibility, especially in your knees; get up and walk around during TV commercial breaks.

If excess weight has made you sedentary, lose those extra pounds. Every extra pound puts four times the stress on your knees. Losing as little as 11 pounds may significantly reduce the risk of knee OA.

Modifying activities
Arthritis can make everyday activities difficult. If you suffer from knee arthritis, bending your knees to retrieve something may be painful. Some people compensate by bending at the waist, but that can cause back problems. Instead, try this: Grasping a countertop for support, use the muscles in your arms and buttocks to lower and pull yourself up. Even easier, sit on a chair when bending over to reach for something on the floor.

To further protect your knees, invest in good shoes. If you wear high heels, toss them, and purchase shoes with strong support that holds your foot firmly in place. Investigate special insoles or orthotics if you have foot or ankle problems.

“People with arthritis can adjust their activities based on their pain,” says Dr. Deal. “If your arthritis is in your upper extremities—the elbow, hand, or shoulder—plenty of modifications are available. Golfers, for instance, can have their clubs adjusted, so the grip is larger to reduce pressure on the hands.”

Green-thumb therapies
If you’re into gardening, don’t let arthritis interfere. Gardening strengthens knees, arms, hands,and increases joint flexibility.“There are ways to garden that can help you overcome your difficulties,” says Dr. Deal, “such as sitting on a short stool to avoid bending.” Garden at times of the day when you feel well. If you encounter morning stiffness, garden in the afternoon. Before you begin, warm up joints and muscles by taking a short walk or stretching. Use tools with extended handles, or wraphandles with padding to make them easier to grip. Build an elevated garden, or plant window boxes. Related tasks like mowing, raking,sweeping, and pulling those pesky weeds are also good for your joints.

Maintaining mobility is important to joint health, general health, and your emotional well-being. “If your arthritis limits you to a point where you can no longer take part in the activities of daily living,” says Dr. Deal, “ask your doctor to refer you to a physical or occupational therapist, who can recommend specific exercises to get you back on track.”