KEEPING ON THE MOVE

by Arthritis Care

One of the most important things you can do yourself to help your arthritis is to exercise. Exercise protects against joint damage, keeps joints and muscles working, and helps prevent disability.

Even if many of your joints are affected, you still need exercise. Unexercised joints lose muscle strength and can become unstable and painful.

Your doctor will try to reduce inflammation and pain, usually by using drugs; exercise is a way you can prevent loss of joint function. If this has already occurred, it is important to remember that as joint function or mobility was not lost in one day, it cannot be regained in one day either.

Before starting a new exercise programme, talk to your doctor - who may give you advice, a leaflet, or refer you to another health professional such as a physiotherapist. Getting the right balance between exercise and rest is very important.

There are three basic types of exercise. Range of movement (ROM) or stretching exercises, strengthening exercises, and endurance exercises. A good exercise programme will include all three types of exercise.

Stretching exercises

Range of movement or stretching exercises move your joints through their full range of movement and then coax them just a little further without being over zealous. The purpose of these exercises is to maintain joint mobility.

Ideally they should be performed three to ten times a session, twice a day, depending on pain. Even inflamed and painful joints should be gently moved through their range of movement twice a day. Many people find that their joint range is not only maintained but improved over a period of time.

Strengthening exercises

These exercises are useful when you have lost strength in particular joints. They involve contracting the muscle around the affected joint without moving the joint itself. If you need strengthening exercises for specific muscles, ask your doctor or physiotherapist.

When you start you may find you can only do these once a day, and can only contract for one or two seconds. Gradually increase as you are able. Try to hold for a count of six seconds, then relax and repeat four times, twice a day.

The purpose of strengthening exercises is to increase the strength of the muscles which support and protect your joints. These exercises are not a substitute for stretching exercises and they will not increase the range of joint movement.

To make your muscles work harder you can use small weights or small household items such as bags of sugar. Before using weights consult a physiotherapist or your doctor.

Endurance exercises

These are more active forms of exercises, such as running, walking, swimming and cycling, and will help to increase your overall health, maintain a strong heart, increase the strength of your bone, and reduce fatigue. Not everyone with arthritis can run, swim or cycle, although almost everyone can do some endurance exercise. It can be any exercise that causes you to breathe a little faster and increases your heart rate. Aim to exercise for 20 minutes, two to three times a week.

You can find out about suitable sports and dance opportunities in your area from your local council or the Sports Council ( 020-7388 1277)

Exercising in water

It is easier to exercise in water than on dry land. The water helps to take the weight of the body and you will find you can do more with less pain. Because of this, be careful not to over-exercise without realising.

If your local hospital has a hydrotherapy pool, your doctor can refer you to the physiotherapy department for a series of treatments. Alternatively, many leisure centres run exercise classes in water. It is important to have a qualified teacher. There may be a water-based class in your area. Support and encouragement are important. Try to find another person with arthritis or a group, although you can exercise in the water alone.

How much exercise?

Good question. It depends on your general fitness and the severity of your arthritis. Increase your exercise gradually and always warm-up beforehand. Ideally, you should include endurance exercise twice a week and stretching, range of movement exercise every day. Even if you are feeling fatigued, try doing the stretching exercise. You may find that a little endurance exercise, a short walk perhaps, reduces fatigue.

Whatever you decide to do, remember the two-hour pain rule. If you have more pain two hours after the exercises than you did before, do less next time but do not stop. Make exercise part of your daily routine. It is best to exercise when you have the least pain, least stiffness and your medication, is having most effect.