ARTHRITIS & EXERCISE

The benefits of exercise are many, more so in a patient of arthritis where exercises help
in overcoming the disability by the following ways:
· Increase strength of muscles that move the joint
· Retarding the bone loss
· Controlling the joint swelling and pain
· Improving the joint lubrication
· Reducing the joint stiffness
· Enhancing the energy and reducing fatigue
· Helping in weight reduction
· Providing psychological benefits of the feeling of wellbeing
· Preventing the joint deformities
· Improving posture and body language
· Improving sleep patterns

Characteristic problems of RA Patients

· Joint pain and swelling
· Loss of flexibility of the joints
· Decrease in muscle strength and endurance
· Deformities due to lack of support
· Fatigue & deconditioning

How to combat flare-ups or active swollen painful joints:

R Rest by using support and reducing movements

I Ice by use of cold packs for about 10 minutes, 2-3 times a day
C Compression by use of elastic crape bandages and supports
E Elevate by keeping the hand or leg elevated

Steps to fitness:

1. Range of motion (ROM) and stretching exercises

2. Muscle Strengthening Exercises
3. Aerobic exercises
4. Recreational exercises

Range of motion (ROM) and stretching exercises

Benefits of ROM exercises

-Elongation of muscles
-Attain full range of motion
-Improves flexibility

Objectives of stretching exercises

-The objective is to move the limb gently to just beyond the normal/restricted range and
hold it there for 15 - 20 seconds. This is to be done 5-7 times every session.
-This is to be repeated regularly / daily with slight improvement every time till full range
of motion is achieved.
-This can be the warm up & cool down part of your exercise session

Stretching Exercises
 Heel cord and Calf Stretch
-This exercise stretches the heel cord and the back of the lower leg.
-Stand 2 - 3 feet from a wall or tree and both toes should be pointed
straightforward as you lean toward the wall with your hands.
-Keep the heels flat to stretch the calf. Hold 10 - 20 seconds and repeat.

Hamstring Stretch
-Sit sideways on bench.
-Keep one leg stretched out on bench, straight.
-Keep other leg off of bench, with foot flat on floor.
-Straighten back.
-Lean forward from hips (not waist) till you feel stretching in leg on bench,
keeping back and shoulders straight.
- Omit this step if you have had a hip replacement, unless surgeon/therapist
approves.
-Hold position.
-Repeat with other leg.

Inner Thigh Stretching

-This exercise stretches the adductors or muscles of the inner thigh.
-Sit with your back straight, bend your knees and put the soles of your feet
together.
-Slowly press the knees to the floor and lean forward from the hips. Hold for 10 - 20
seconds and repeat.

Quadriceps Stretch
-This exercise is to stretch the muscles of the front of the thigh.
-Place your right hand against a wall or tree for balance, grab your left ankle
with your left hand and pull it up and back until you can feel a stretch.
-Keep the back straight and the knee pointing toward the ground.
-The standing leg should have a slightly bent knee.
-Hold the stretch for 10 - 20 seconds for each leg and repeat.

Lower Back Stretch

-This exercise stretches the muscles of the lower back.
-Lie flat on your back with your legs extended and pull the right knee up to the chest.
-Press your back to the ground.
-Hold the position 10 - 20 seconds and repeat with the left knee.

Back and shoulder muscles stretch

-Use a length of rubber tubing
-Grasp each end, raise arms to shoulder height and extend arms, keeping
elbows straight, outwards and backwards by squeezing shoulder blades together.
-Hold for 10 seconds and repeat about 6 times. Upper arm

Upper arm and chest muscles stretches

-Interlock the fingers with palms out.
-Extend arms above head, keeping fingers locked. Stretch upwards and hold for
10 seconds
Muscle Strengthening Exercises

Benefits
-Improves muscle power
-Better support to the joints
-More activity with less pain

Strengthening exercises - Types

-Isometric
Exercise without movement of the joint
Performed when joint is swollen and painful

-Isotonic
Accompanied by joint movement
Done under normal conditions

Common isometric exercise

Hand Exercises
- Clench your fist and apply force, & touch the tip of each finger with that of the thumb
and apply force.
- Do each of these exercises for 10 seconds and repeat multiple times

Wrist Exercises
- Hold your wrist as demonstrated and move it from side to side and up and down
- You can add rotating of the wrist to complete the above

Knee Exercises
- Keep a cushion below the knee, and raise the leg as demonstrated and hold position till
the count of 10. Repeat as many times as comfortable
- Keep a cushion under the ankle and press the knee down and hold position for the
count of 10. Repeat as many times as comfortable.

Foot Exercises
- Move your ankle from side to side and up and down
- Use a roller to slide your foot

Strengthening Exercise

Aerobic exercises

Uses large muscles in a rhythmical, continuous activity.

The most effective activities involve:

-Walking
-Treadmill
-Swimming
-Cycling

Why Aerobic exercises

Cardiovascular deficit in RA is 40% and in OA is 20%

Walking Exercise

-Start on a flat level surface

-Use cane if helpful
-Warm up and cool down with a stroll
-Choose a comfortable pace
-If knee is sore, walk slowly and swing your arms
-Wear supportive shoes with good soles
-Athletic (shock absorbing) insoles can help increase comfort and reduce
shock on feet, knees, hip and spine

Treadmill

-Speed of treadmill should not be more than 6.5 km per hour

-Slope should be near flat
-For patients with heart problem, monitoring of heart rate and BP
essential

Swimming & water aerobics

-Performed in presence of a supervisor

-Use mask or a snorkel in case of neck problem
-Take a warm shower after the exercise
-Regulate exercise intensity by changing the speed, arc of
movement and length of lever arm
-Begin and end in a slower pace
-For water aerobics wear tights, t-shirt, disposable latex gloves
to retain body heat in water.
-Use floatation device to add buoyancy if knees and hips are painful

Bicycle (outdoor or stationary)

 -Start and end with no resistance or on flat ground
-Pedal with ball of your foot
-Make sure seat height allows your knee to be comfortably straight at
the bottom of the pedal stroke
-Don't lean on or over handlebars
-Use pedal straps
-Keep speed of pedaling at or below 60 revolutions per minute

Your exercise plan

Warm up - 8-12 mins

-Deep breathing exercise

- 5-7 deep breathes along with movement of arms
- Stretching exercises including trunk rotation
- Strengthening exercise of joints of your choice

Aerobic exercise - 15-20 mins

-This forms the major part of your regime

-Choose your type of exercise and a pace that is convenient to you
-Increase the duration of exercise gradually as you start getting used to it

Cooling down - 5-8 mins

-Stretching exercises
-Gentle movements
-Deep breathing exercises

Stop your exercise immediately if-

-Your heartbeat increases steeply
-You sweat profusely
-Start feeling weak

Respect pain
-If your joint pains for more than 30 minutes after exercise rest the joint and apply
hot/cold packs as per convenience
-You may have to take pain - killers during initiation of exercise
-Consult your doctor/therapist if pain persists

Types of Aerobic Exercise

Jun 10th, 2009
by admin.
 Aerobic exercise is any action that uses ample beef
groups that can be maintained continuously and adroit in nature. This blazon of exercise
agency to advance the ability of the cardiovascular arrangement in arresting and alteration
oxygen. It allows the affection and lungs to plan harder than at rest. This exercise is
performed at a abstinent akin of acuteness over a almost continued aeon of time.

There are altered allowances of accomplishing approved aerobic exercises. Some important
allowances are:

It strengthens the anatomy complex in respiration and facilitates the breeze of air in and out
of the lungs. It aswell strengthens and enlarges the affection beef to advance its pumping
efficiency. Your affection gets stronger and pumps added claret with anniversary beat. It is
aswell all-important in deepening anatomy throughout the body. It improves the
apportionment ability so it reduces claret pressure. It Increases the absolute amount of red
claret beef in the body, facilitating carriage of oxygen. Finally, it improves brainy bloom by
abating stress.

There are assorted types of aerobic contest that could advice you bake calories to advance or
lose weight. These contest are actual able to a convalescent and fit physique that you would
absolutely enjoy.

The a lot of accepted exercise is aerobic dance. Aerobic ball absorb aerobic movements in
which at atomic one bottom contacts the arena at all times. Aerobic ball helps in advancement
the all-round exercise and aswell turns out to be a admirable experience. It provides abundant
cardiovascular advantages forth with acceptable metabolic benefits. This is ideal for abundant
women and ample individuals.

Cycling is one of the best types. Cycling provides abundant cardiovascular benefits, after
causing any affectionate of automated accent to the back, hips, knees and ankles in the
anatomy of pain. Cycling is aswell alleged bicycling or biking. Aside from bloom allowances
that are acquired from this blazon of exercise, it is aswell a fun amusement and a accepted
sport.

Swimming can prove to be an ideal aerobic exercise. The affection amount acknowledgment
to pond is added abstinent than the acknowledgment apparent in dry acreage exercise. It does
not could cause abundant accent or ache to the joints of the physique and it even makes it fun
and enjoying. Laps prove to be a abundant way to bake the added calories and it can be the
best way to exhausted the calefaction abnormally during the summer heat.
One of the simplest aerobic contest is running. Active is a abundant way to bake calories. The
best allotment is you get a adventitious to adore the beatitude of attributes and get a feel of
beginning air in active outdoors. All you charge in this concrete action is a acceptable brace
of active shoes