Do you have arthritis? Osteoarthritis, a gradual loss of the cartilage that acts as padding between the surfaces of the bones, is so common that nearly everyone over the age of 40 shows some signs of it on X-rays. As it progresses, this degenerative joint disease causes pain and stiffness in the joints, but the right kind of exercise offers relief.
Unlike rheumatoid arthritis, a totally different disease, osteoarthritis results from normal wear and tear. It usually occurs in the weight bearing joints of the hips, knees and feet as well as in the neck and lower spine; and in the hands. Dr. Peter Bruno, attaching physician at Lenox Hill Hospital and Medical Director for the Insall Scott Kelly Institute for Orthopedics and Sports Medicine in New York City, compares the wearing away of cartilage to the Teflon coating on a nonstick fry pan, “If you keep rubbing it and irritating it, gradually the Teflon comes off and the bone underneath starts to pit. ”
Although the natural tendency is to minimize movement to avoid pain in the arthritic joints, this unfortunately can lead to more pain and stiffness. Inactivity, a frequent consequence of arthritis, creates a downward spiral and causes a cascade of other health risks. Appropriate exercise will actually diminish the discomfort, increase mobility and strengthen the muscles that support the joints.
A well-rounded exercise program should focus on cardio activity, strengthening and stretching.
Start every session with a thorough warm up to increase core body temperature and circulation, make the muscles more supple and the joints more limber. Easy ways to warm up include walking, marching in place and stationary bike. Try to incorporate some upper body movements as well. One of my clients used a pulley attached to a door in her apartment to warm up her badly arthritic shoulder. The pulley is helpful because you can pull each arm up individually to your level of comfort and gradually increase the range of motion.
Cardio activity enhances aerobic capacity, improving overall fitness and reducing inflation. It also helps you lose weight, decreasing the amount of stress on the joints and relieving the aches to allow you to become more active. To get started, Dr. Bruno recommends a minimum of 20 minutes of cardio activity per week and says to take a “slow and steady approach so you can stay active through life.” He offers three general guidelines:
- Start slow, not too much too soon
- Make it easy: do something that's convenient and you can continue easily
- Do low impact activities to protect the joints: for example, brisk walking, cycling, elliptical machine
Strength training exercises build up muscle tone to support vulnerable joints, making them more stable and improving alignment so they function more efficiently. Toned muscles also provide shock absorption and reduce mechanical stresses that can accelerate cartilage degeneration. Using light weights, begin with 2-3 repetitions of each exercise and gradually progress to 10-12.
Although you may feel slight discomfort at first, it usually gets easier; however avoid any exercises that increase joint pain, especially if it lasts for two hours after exercising. Do the exercises 2-3 times a week on nonconsecutive days.
Stretching improves flexibility by lengthening the muscles and tendons, helping you maintain and improve mobility. It decrees joint stiffness and increases the range of motion around the joint. Concentrate on the large muscles of the legs, the low back, and hands (try stretching your fingers in the warm, humid air of the bath or shower). Stretch every day and even several times through the day. Hold a stretch for 10-30 seconds and avoid bouncing.
Of course, this information should not take the place of guidance from your own physician or other medical professional. Always consult with your doctor before beginning an exercise program or becoming much more physically active.