Arthritis and exercise

Regular gentle exercise helps keep your joints flexible, maintains muscle strength and improves your endurance. It even improves your ability to perform basic tasks such as writing.

Of course, exercise is also good for your mental health, improving your self-esteem and giving you a sense of accomplishment and general well-being.

But the most important reason for exercising is that people who do so are simply healthier and live longer than those who have a sedentary lifestyle. This is as true for people with arthritis as it is for anyone else.

Many people cite arthritis as a reason for limiting their physical activity, because they fear pain, stiffness and fatigue. But arthritis sufferers who exercise regularly are stronger, fitter and more flexible than those who don’t.

Exercise can be divided into three sorts, each of which will play a role in reducing the pain and disability associated with arthritis.

Stretching or toning exercises: These are low-intensity exercises that should be performed daily to maintain or improve the body’s range of motion. They form the foundation of most therapeutic exercise programmes and also play an important role in recreational or fitness exercise. Building flexibility improves function and reduces the likelihood of injury. Try Tai Chi, yoga or calisthenics.

Muscle conditioning: These exercises are more vigorous and will build strength and endurance when they’re done every other day. They require more from the muscles by requiring them to lift the weight of the limbs or trunk against gravity, or increase resistance using elastic bands or weights. Within a short time, the muscles adapt to the extra load. Try the Pilates programme, playing golf or walking.

Cardio-respiratory or aerobic conditioning: This involves using the large muscles of the body in repetitive, rhythmic movements and results in improved heart, lung and muscle function. It’s also good for controlling your weight and has been shown to improve mood by promoting the release of endorphins, the body’s “feel-good” hormones.

Daily activities such as raking leaves, mowing the lawn or walking the dog are also good aerobic exercise. Remember: exercise causing pain and discomfort is a warning that you're exercising too vigorously or that you're performing the wrong type of exercise.

Research has shown that many people with arthritis can safely take part in a variety of activities that boost their aerobic fitness. Low-impact exercises, such as water aerobics and swimming, are particularly good.

You should start gently (10 minutes 3 times per week), building up slowly as your endurance improves.

The safest intensity for aerobic exercise is moderate exertion, which means you should still be able to speak normally and not be out of breath. Try for at least half an hour of exercise three times a week. If you can’t manage 30 minutes of continual activity, try doing three 10-minute bouts throughout the day.

Why water works
Swimming, water aerobics and other exercises in warm water are particularly beneficial. Here’s why:

• The buoyancy and soothing effect of warm water make it ideal for relieving arthritis pain and stiffness.
• Immersion in warm water raises your body temperature and increases circulation by causing your blood vessels to dilate (relax).
• The buoyancy of water allows gentle non-weight bearing stretching of joints and muscles.
• Water provides enough resistance to build muscle strength, but is unlikely to cause muscle strain if done properly.
• Sitting in a spa bath adds massage to the benefits. Move around until the jet nozzles direct a mixture of air and water to the areas of your body where the muscles feel tight.
• You can do fairly vigorous exercises in a spa bath, but remember that the temperature should be lower than if you’re doing very gentle movements.
• If you own a spa bath, follow the maintenance and safety instructions to the letter.
• Put non-slip surfacing on the areas around the spa bath. The last thing you need is a fall. If you need help getting into the bath, put up handrails.
• If you feel light-headed or nauseous, get out immediately, sit down away from the spa bath and call for help.
• Avoid sitting in a spa bath for long periods of time if you have medical conditions such as lung or heart disease, circulatory problems, high blood pressure, diabetes, multiple sclerosis, skin irritations or any other serious illness.
• If joint swelling, stiffness or pain increase, discontinue the exercise and consult your doctor.
• This goes without saying, but never use a spa bath after drinking alcohol or taking drugs. They can cause drowsiness or changes in blood pressure.
• When you first enter the spa bath, spend a few minutes allowing your muscles to become accustomed to the warmth. Then start your exercise routine. Follow the same procedure afterwards, allowing time for your muscles to relax in the warm water before getting out;

If you’ve been inactive for some time, you should speak to your doctor before starting any new programme.

(Susan Erasmus, Health24)