Exercise Types

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Exercise will not make your arthritis worse – as long as it is the right sort. There isn’t just one particular exercise or activity that is recommended for all people with arthritis. Choose an activity that you enjoy and that is convenient for you to do. Low-impact exercises, with less weight or force going through your joints, are usually most suitable.

Examples of low-impact activities include:

  • Walking
  • Swimming and exercising in water, such as hydrotherapy (with a physiotherapist)
  • Cycling
  • Yoga, Tai Chi and Pilates
  • Dancing

The wrong sort of exercise could put strain on your joints and damage them further. Ask your GP to refer you to a physiotherapist, who will help you work out an appropriate programme depending on the type and severity of your arthritis and your general level of fitness. There are three main types of exercise for people with arthritis:

1. Range of movement

2. Strengthening

3. Aerobic exercise

A good exercise programme will generally include a combination of all three.

 

Range of Movement

Range of movement (ROM) exercises form the backbone of every exercise programme. It is important to do these as they help maintain flexibility, relieve stiffness and are important for good posture and strength. Range-of movement exercises involve moving your joints through their normal range of movement and then easing them a little further, such as raising your arms over your head or rolling your shoulders forward and backward. ROM exercises are done smoothly and gently so they can be

carried out even when in pain and during a flare-up.

Tips for range of movement activities:

  • ROM activities are best done daily in a non-weightbearing position, such as lying or sitting on your bed or couch.
  • When doing ROM exercises, move your joints within the full range as much as you can tolerate and not any further.
  • If you are experiencing pain in your joints, your ROM will be limited, but it is important to move within your limits every day.
  • For ROM exercises, if the joint you are moving feels good you can repeat these activities five to 10 times, holding each position for no more than three seconds.
  • Stretches are best done when the muscles are warm, such as after a walk or fitness class.
  • Stretches should be a smooth movement; avoid bouncing or jerking.
  • If the joint you are moving is hot, swollen or painful, avoid stretches for that day.

Strengthening

Strengthening exercises are important for everyone, but especially for people with arthritis, because they help strengthen the muscles which move, protect and support your joints. Many people become less active when they develop arthritis because of the pain and fear of causing damage. This can lead to muscle wastage and weaker joints. By developing strong muscles, joints become more stable and activities such as walking and climbing stairs are easier.

Strengthening exercises encourage the body to work harder than normal. Start slowly, gradually building up the repetitions. As the muscles get used to doing more, they become stronger. The type of exercises you do will depend on which joints are affected and how severe your condition is. Always check with a doctor or physiotherapist before starting a regime.

Strengthening exercises are done by tightening and releasing the muscles around a joint. The type of exercises you do depends on which type of arthritis you have, which joints are affected and the severity of your condition. Some exercises may be harmful so always check with a doctor or physiotherapist before starting on a regime –they may be able to suggest alternative moves.

There are many ways you can do muscle strengthening activities:

  • Lifting weights using machines, dumbbells, or weight cuffs
  • Working with resistance bands
  • Using your own bodyweight as resistance (e.g., push-ups, sit ups)
  • Heavy gardening (e.g., digging, shoveling)
  • Some group exercise classes.

Tips for strengthening activities:

  • It is important to avoid doing strengthening exercises on consecutive days so that you have a day of rest in between.
  • When starting out, it is advisable to use light weights or resistance bands.
  • Pick a resistance that allows you to do 10 to 15 repetitions. As your strength improves and this becomes easy, you can progress to heavier weights or stronger resistance bands and continue to progress to a weight or resistance level you can tolerate.
  • If the joint you are moving is healthy or free of pain, you can repeat the strength exercises 10 times. If the joint continues to be pain-free, then you can increase the number of repetitions to three sets of 10.
  • Always take a break after each set and in between activities.
  • If the joint you are exercising is slightly swollen and only mildly painful, cut the repetitions in half and increase their number only very gradually.
  • If the joint you are exercising is hot, swollen and painful, do not perform strengthening exercises without first consulting your health-care provider.

Aerobic

Aerobic just means exercise that raises your heart rate and makes you breathe a little harder than when you are stationary. This form helps with your overall fitness and is also known as endurance or cardiovascular exercise. It uses the body’s large groups of muscles in continuous motion.

Aerobic exercise burns off calories, speeds up the body’s metabolism, helps maintain a strong heart and helps muscles work more effectively. It also helps control and reduce weight, improves sleep, strengthens bones, reduces depression and builds up stamina. Begin any exercise by stretching to warm up. To get any benefit, aerobic exercise must be done for a prolonged period (20-30 minutes) two to three times a week. These exercises done correctly and consistently will provide some relief from the pain of arthritis, help with good posture, and increase your energy and vitality.

Forms of aerobic activities

There are so many aerobic activities, so it is advisable to find at least one that is both enjoyable and appropriate for your joints. The best forms of low-impact aerobic exercise for people with arthritis are walking, cycling and swimming. These are all discussed below in more detail. Other popular aerobic activities include golf without a buggy, gardening, vacuuming and low-impact dancing.

Walking

For people with arthritis, walking puts less stress on your joints and is considered to be much better and safer than running. Walking allows you to stretch your back, leg muscles and joints that can become stiff from sitting. Walking is also relatively inexpensive; all you need is a good pair of walking shoes that have flexible soles and provide adequate arch support. Another benefit of walking is that it can be done at almost any time in any place. If you have hip, knee, ankle or foot problems, it is important to confirm with your healthcare provider that this is an appropriate activity for you.

Swimming & water activities

Water activities are helpful because your bodyweight is supported, and moving through the water adds resistance. This boosts muscle strength and endurance. Activities such as stretching or walking through water can exercise the joints without putting them under strain. The soothing warmth and buoyancy of warm water make it an ideal environment for relieving arthritis pain and stiffness. You don’t have to be a good swimmer to exercise in water! You can use the shallow end of the pool, hold on to the side or use a flotation device. Since exercising in water is relatively easy, you may be tempted to overdo it. If you’re in an aquafit class, start off slowly and don’t try to compete with the more experienced participants or keep up with the music.

Hydrotherapy

Gentle exercise can be carried out in hydrotherapy pools that will usually be heated to around 34 degrees centigrade. The warm water soothes the joints, relieves stiffness, and promotes better blood circulation. It is ideal for gentle, low-impact exercise and also offers the resistance needed to keep muscles and joints in shape. Because the water supports your weight, the range of movement in your joints should increase and pain should decrease.

Most hydrotherapy pools range in depth and if you cannot lower yourself into the water, there will usually be a hoist.

Cycling

Cycling, whether done outdoors or on a stationary bicycle, strengthens muscles and is also a good cardiovascular workout for your heart and lungs. Just remember that the seat height should be adjusted so that your knee is slightly bent when the pedal is at its lowest point. For those with a sore back, the seat and handlebars can be adjusted to ensure your back is not too stretched out. If you are using a stationary bicycle, a recumbent model can decrease back strain, as you will be sitting up while cycling. Cycling is an ideal endurance activity because it provides much-needed resistance, however, if you have knee problems, it is advisable to start slowly and use the least amount of resistance when cycling. A lower resistance can be achieved by ensuring your gears are at the lowest setting.

Tips for aerobic activities:

  • When you start out, strive for a moderate intensity level with slight breathlessness and an increased pulse but you can still talk comfortably and feel warm with some sweating.
  • Check with a doctor before beginning a regime, especially if you have moderate to severe arthritis, a heart condition or high blood pressure.
  • Avoid activities that include jumping, rapid twisting, turning and sudden stops, as they are very stressful on your knees and spine.
  • Before starting to exercise, warm up by doing some gentle stretches. Likewise, cool down after stopping. This can be done by slowly doing a bit more of the exercise you were doing or by doing more stretching exercises.
  • It is recommended that aerobic exercises are done for a prolonged period (20-30minutes) two to three times a week. If this is too much to begin with, build up slowly until the body is ready for a full workout. If you find it too much to do 20 to 30 minutes at one time, try doing blocks of 5 to 10 minutes, resting in between, until you have done a full workout.

Exercise in Daily Life

If you are not physically active or have never exercised before, starting a new routine might seem intimidating. Although it is important to maintain regular, structured exercise, it is possible to incorporate exercise into a daily routine in surprisingly easy ways. Physical activity cannot replace structured exercise, but it does help maintain joint movement and fitness. Try incorporating one or more of the following into your daily routine.

  • Vacuuming is a good example of aerobic exercise. It uses both arm and leg muscles, particularly if using an upright cleaner. Washing floors gives a similar workout. Don’t try to do the whole house at once, build up to a maximum of 20 to 30 minutes to get a good aerobic workout.
  • Doing the washing up can also help maintain movement. Washing up in warm water can help loosen up finger joints and emptying the dishwasher can help stretch arm and leg muscles.
  • Learn to play the piano or take up knitting: Both of these hobbies are great exercise for fingers and can be very enjoyable. Playing the piano in particular gives fingers a good stretch.
  • Gardening is another good opportunity to exercise joints. Making a few adaptations to the way you garden may be necessary (perhaps using different equipment), but gentle gardening activities such as digging, pruning, raking and weeding allow for stretching without putting too much stress on joints. Changing gardening jobs regularly works different sets of muscles. Try doing a little, often. Limit it to a maximum of 30 minutes at a time to avoid overdoing things.
  • Use the stairs instead of taking lifts and escalators if you do not have problems with your hips or knees.
  • Make more than one trip from the car to the house with the groceries.
  • Walk to the local shop instead of driving.
  • Get off one stop early if you take public transport.

Exercise at Work

  • Take frequent ‘stretch’ breaks at work to walk to the water cooler or bathroom.
  • Choose a parking spot furthest away from the entrance.
  • Walk down the hall instead of using the phone or e-mail.
  • Take a walk during the morning or lunch break.
  • Walk /cycle to work
  • Go to the gym /swim during lunch. 
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