How to reap the benefits of exercise in arthritis?

Dr Biswajit D Baruah
Oct 13, 2014

Exercise is one of the ways to keep your joints active and supple. Let us explore how exercise can help even in arthritic joints

Is exercise harmful for my joints?

A lot of people believe that exercises are harmful to the joint. If wear and tear affect the joints, it is natural to think that using the joint more will exacerbate the arthritis. But that's not true. In fact, its the opposite thats true. Performing exercises is essential to keep the joint healthy. Cartilage is the layer that is affected the most in arthritis. Due to the nature of its structure, cartilage does not have blood supply like the rest of the tissues in the body. It derives its nutrition from the synovial fluid in the joint by a process called diffusion. Moving the joint helps nutrients diffuse into the cartilage and keep it healthy. Surgeons know that keeping a joint immobile for several days is detrimental to the cartilage layer. Thereby keeping the joint mobile and active is one of the secrets to keeping it healthy. And exercises help you achieve that goal. Impact activities or exercises, wherein the joint surfaces hit against each other, like in jumping or any other outdoor sports, can potentially damage the joints. Does that mean we should not run? Certainly not! There are ways to lessen the impact of activities on the joint. Performing exercises under water is excellent for reducing the impact on joint surfaces. Cycling is also beneficial in a similiar fashion. Running without landing on your heels can reduce impact on the joints. Many long distance runners practice running this way. Running outdoors instead of on the treadmill is an excellent way to reduce the effect of landing on your heels affecting your joints. If running is too difficult, then walking is another way to keep the joints active.

Are there any specific exercises for joints affected by arthritis?

Exercises can be broadly divided into three categories:

  • Range of Motion (ROM) exercises
  • Stretching exercises
  • Strengthening exercises

I prefer these terms compared to the technical mumbo jumbo of isotonic and isometric exercises, because the latter do not convey anything on the goal in hand. ROM exercises are important to maintain suppleness in the joint. As the joint becomes arthritic, the joint will develop stiffness and mobility in the joint will reduce. ROM exercises will help regain or at least help retain the movement in the joint. It is important to stay within the pain free range and gently stress against the stiffness. As the joint stiffens, the surrounding soft tissue component of the joint comprising of ligaments and tendons will shorten. Stretching exercises are directed against these ligaments and tendons and help maintain balance of the forces acting on the joint. As the mobility reduces, the muscles around the joint loose their power and become smaller in size (physicians refer to this as atrophy). Strengthening exercises are necessary to maintain the power in the muscles and strong muscles will in turn help maintain range of motion in your joints.

Here's an excellent video from the Singapore General Hospital demostrating the exercises for arthritic joints:

It is a good idea to learn these exercises under the supervision of a physical therapist (physio) at least once, especially if you have not been physically active before.

Physical therapy at home

If the joints are inflamed, you can ice them or soak yourself in cold water.. How do you know they are inflamed? The knee will appear swollen, and feel hot all around but mostly in the front. The cold from the ice will help bring down the inflammation. On the other hand, if the pain in the knee is constant and gnawing, but there is no accompanying heat, then a warm compress will help circulate blood into the tissues around the joint. This will reduce pain and lessen stiffness. Soak yourself in a tub of luke warm water or dip a towel in warm water, wring it to get rid of the water and apply the warm towel around your knee. For those with arthritis affecting the hands or the feet can soak their hands and feet in a bucket of warm water. I will repeat again, do not use warm water if the sking over your joint feels hot or appears flushed.

For those planning surgery

Exercises prior to going in for surgery is immensely helpful in a quick recovery. Familiarity with the exercises helps you get to your feet quicker post surgery. Muscles around your affected joints remain supple and relexive, allowing them to quickly respond to post operative physical therapy. Make it a point to discuss it with your surgeon, and pay a visit to the physical therapy department in the hospital where you are planning your surgery.

Further Reading

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