Exercise, Arthritis and Joint Pain**

You needn't run a marathon or swim like an Olympian to reduce your symptoms of joint pain and arthritis. Even moderate exercise can help ease your pain, boost functional strength and assist in maintaining a healthy body weight. While joint pain or arthritis can threaten to immobilize you, exercise will keep you moving.

Numerous scientific studies support the idea that moderate exercise, when properly performed, is beneficial for people with arthritis.


Australian researchers examining the effects of exercise on joint pain and stiffness reviewed data on over 8,000 middle-aged and senior women who reported their exercise, pain and stiffness levels over a 3-year period.1 They found that if women in their 70's engaged in 75 minutes of moderate physical activity per week, their risk of developing frequent arthritis symptoms fell. And if they exercised moderately for 150 minutes per week, they enjoyed even greater protection.

Swedish researchers investigated the effects of hand exercises on people with rheumatoid arthritis for a 2009 study published in the Journal of Rehabilitation Medicine.2 Just six weeks of hand exercises brought about "A significant improvement in hand force and hand function."

A 2009 article appearing in Current Opinion in Rheumatology reviewed studies on the value of exercise programs for chronic arthritis.3 The author of this paper concluded that, "There is a preponderance of strong scientific evidence that both aerobic and muscle strengthening exercises, alone or in combination, are safe and moderately effective for individuals with chronic arthritis." The benefits included a reduction in symptoms and an improvement in function.

The weight of the evidence supports the argument that regular, consistent exercise helps keep joints supple, restores and preserves flexibility and strength, and protects joints against further damage. It also improves coordination, endurance and the ability to perform daily tasks such as walking or writing.

 

The Goals of an Exercise Program for People with Joint Pain Include:

  • Preservation or restoration of range of motion and flexibility in and around the affected joints
  • Increase in muscle strength and endurance
  • Strengthening of the supporting muscles around affected joints
  • Decrease in health risks associated with a sedentary lifestyle, such as obesity and diabetes.

But whether the best exercise for you is walking, stretching, Tai chi, yoga, aerobics, swimming, golf or whatever - it's important to get started, refrain from overdoing it, and be consistent. One of the wonderful things about regular exercise is that its effects are not merely physical - they also include mood enhancement, a sense of accomplishment and improved self-esteem.

Benefits of Moderate Exercise

While the thought of exercising when your joints hurt may be an anathema to you, physical activity is essential for optimal physical and mental health, and can play a vital role in managing arthritis symptoms.

Benefits of regular exercise.

The amount and form of exercise recommended for each individual varies depending on several factors, including which joints are involved, the level of inflammation, how stable the joints are, and whether the pain is acute or chronic. Doctors and therapists can suggest specific exercises for particularly painful joints. Of course, some exercises may be off-limits for people with a particular type of arthritis, or when joints are swollen and inflamed. But most experts agree that the long-term benefits of a well-designed exercise program are worth any difficulty in getting started.


Should I Exercise When I Have Joint Pain?

The answer is yes... and no.

Although it's often difficult for people experiencing joint pain to be active, proper exercise can actually help control inflammation and pain. It also helps deliver nutrients to joint tissues and rid them of debris. And exercise can help you deal with the psychological stress of dealing with arthritis. This is important, for when you are stressed your body produces more of the stress hormone cortisol, and chronic exposure to cortisol leads to more inflammation.

On the other hand, resting your joints decreases the immediate stress placed on them and helps relieve pain and swelling, at least initially. And your doctor will most likely suggest that you decrease the intensity and/or frequency of the activities that cause you pain. When you experience "flare-ups" - sudden and intense increases in symptoms seen with diseases like rheumatoid arthritis and lupus - it will be important to lessen the intensity of all exercise. However, you should not to quit completely, because exercise does help lubricate your joints. Once the flare-ups recede, gradually work your way back to your optimal level of exercise, rather than exercising at full bore right away.

Health Care Providers Often Overlook the Benefits of Exercise

Although numerous studies have shown the value of careful and moderate exercise, this simple, inexpensive therapy is being underutilized.

A new study funded by the National Institutes of Health, published in Arthritis and Rheumatism, revealed that exercise is underutilized for chronic back and neck pain.4

For this study, researchers from the University of North Carolina at Chapel Hill surveyed almost 700 people with chronic back or neck pain who had seen a physician, chiropractor and/or physical therapist during the previous 12 months. They asked participants whether exercise had been prescribed, and, if so, the type, duration and frequency of the exercise prescribed, and how closely they had been supervised.

Fewer than 50% of the subjects in the study were prescribed exercise. Whether or not they were given the prescription depended quite a bit on which type of health provider they saw. Of those who were told to exercise, 46% were given the prescription by a physical therapist, 29% by a physician and 21% by a chiropractor.

Most of the 700 participants had seen a physician - perhaps along with another health provider - but only 14% of them were instructed by their physicians to exercise. (However, it's likely that some who did not receive an exercise prescription from their physicians were referred to a physical therapist who did prescribe exercise.) Not surprisingly, physical therapists were the most likely to prescribe exercise, although about a third of the patients who saw a physical therapist did not receive an exercise prescription. Physical therapists were also more likely to provide supervision and prescribe stretching and strengthening exercises— practices that typically lead to better outcomes.

Flexibility Training and Arthritis

Whether or not you suffer from joint pain, it's important to devote at least 10 - 15 minutes of every exercise session to general stretches and yoga poses that help strengthen the joints, as they can be crucial to the prevention and management of arthritis. Experts also recommend performing a series of 4 to 8 stretches at least once a day (two or three times a day is even better) to reduce stiffness and improve joint function.

Exercise slowly and gently during acute flare-ups, never pushing past your usual point of discomfort. A warm environment such as a heated yoga room or a heated pool may be helpful, as it will promote elasticity and ease movement. Range of motion exercises, such as shoulder circles, leg swings and knee-to-chest pulls from a lying-down position will help limber up those joints and prevent gradual losses in motion.

Yoga- An Exercise for Everyone

To most people, yoga is a series of physical movements designed to increase flexibility and balance. And while yoga postures do improve flexibility, balance and postural alignment, they also stretch and strengthen the joints. This improves joint range of motion and brings more oxygenated blood and nutrients to joint tissues. Yoga also has a "spiritual side," helping to unite body, mind and spirit through deep breathing, mindfulness and other techniques. This aspect of yoga can do much to relieve stress, which in turn can help reduce the symptoms of arthritis.

People who are in chronic pain are often skeptical about attempting yoga; they tend to think it sounds too difficult and painful. Yet yoga can be customized to any level and can be of help in a wide range of conditions, including arthritis, chronic fatigue syndrome, fibromyalgia and migraines. It's safest to learn the postures from a qualified yoga instructor - and be sure to tell the instructor about your condition, so he or she can modify the poses to suit your needs. Props such as blankets, pillows, belts and blocks help to ensure that anyone can receive the benefits of various yoga poses without straining the body or the joints.

Tai Chi

Although originally one of the martial arts, tai chi is now more of a "moving meditation" based on slow, graceful movements that blend into each other.

A Tufts Medical Center study found that overweight adults with osteoarthritis of the knee gain benefit from tai chi. 5 For this study, one group of volunteers practiced tai chi twice a week for 12 weeks, while the other group spent an equal amount of time doing stretching exercises and receiving wellness education. Those who practiced tai chi enjoyed more relief from pain and depression, plus greater improvements in physical functioning and quality of life. These benefits continued even after the 12-week tai chi sessions had ended.

Experts say that the flowing, meditative, low-impact movements of tai chi tone the muscles surrounding joints, improve alignment and enhance body awareness, which helps reduce risk of injury. Tai chi can also help relieve stress and nurture other healthy habits that can help prevent joint pain and maximize muscle-joint function.

Strength Training and Arthritis

Strength training is just what it sounds like: lifting free weights, using the weight machines at the gym, or even doing a series of push-ups, sit-ups and other exercises that involve the resisting a force.

Numerous studies have shown that strength training can help people manage arthritis and even reduce symptoms. A recent paper published in the Journal of Rheumatology explored the value of simple strength training routines for osteoarthritis of the knee.6 Those participating in a four month-long exercise program consisting of weight-bearing exercises, such as squats and leg extensions, experienced a 43 percent reduction in pain and a 44 percent improvement in physical functioning. The exercisers were able to walk, climb stairs, sit, and stand more easily than their non-exercising counterparts.

The researchers commented that exercise is effective because the muscles act as shock absorbers for the joints, lessening the impact of weight-bearing movement. The better shape the muscles are in, the better they are able to absorb shock.

Another study, published in the British Medical Journal, showed that in people suffering from chronic knee pain a daily strength-training program may help reduce pain, decrease stiffness, and improve physical function.7

In this two-year study, 600 men and women over the age of 45 with knee pain were assigned to different groups that did or did not exercise. The exercise therapy included a series of knee strengthening exercises using graded elastic bands, starting with low resistance and working up to a higher resistance.

Questionnaires measuring pain, stiffness, and physical function were filled out at the start of the study and periodically thereafter.

Compared with the non-exercisers, those who exercised experienced a significant improvement in knee pain. Joint stiffness and physical function were also notably improved.

According to these findings and the results of other studies, people who are self-motivated may be able to manage their arthritis pain with exercise and reduce the need for pain medication. (Helpful as pain pills can be, the do have side effects. And they don't help the body protect the joints like exercise and JoMo Joint Mobility Liquid Glucosamine do.)

Whatever you choose do to for strength training, be sure to ask your physician or physical therapist for help in designing a safe and effective program. Strength training should be performed a maximum of two to three times per week, with a day or two off between sessions to give your muscles time to recover and repair. Don't feel that you have to lift heavy weights or progress rapidly from lighter to heavier weights to get the benefits of strength training. You can gain plenty of benefit from a regular program of very light weight-lifting.

The hallmark of a safe strength-training program is a gradual progression in intensity, difficulty and duration. Patients with arthritis often have lower levels of fitness to begin with, due to pain, stiffness or biomechanical abnormalities. Overdoing it, especially during a flare-up, can result in increased pain, inflammation and damage to the joint. It's best to begin with a few minutes of activity and alternate activity with rest. If you experience joint pain, lower the resistance or substitute another exercise. Take your time and build up gradually.

Depending on the severity of your arthritis, a physician or physical therapist may suggest either isometric or isotonic strengthening exercises. Isometric exercise, such as contracting your thigh muscle while lying on your back with legs extended, involves exercising the muscle without moving the joint. Isotonic exercise, such as performing a leg press or partial chair squat, involves exercising the muscle while moving one or more joints.

Pilates for Strengthening Core Muscles

Early in the 20th century, Joseph Pilates developed a physical fitness system designed to unite body and mind by increasing body awareness, improving posture, toning the body and increasing strength.

Pilates can help people with arthritis in many ways. It reduces joint pain and stiffness by increasing flexibility, muscle strength and endurance. It can also help reduce body weight and contribute to an increased sense of well-being.

Mostly performed on a mat but sometimes using equipment, Pilates takes you through a series of strengthening and flexibility exercises that can help condition the middle muscles of the torso, which helps stabilize the spine and improve posture and alignment. All of this can help reduce pain, especially in the weight-bearing joints.

Cardiovascular Exercise

Although joint pain does not directly harm the cardiovascular system, it is very important to keep this system in good shape. An "in shape" cardiovascular system is better able to pump life-giving blood throughout the body, and less likely to succumb to heart disease and stroke. It also helps reduce the fatigue associated with certain forms of arthritis.

To strengthen the cardiovascular system, you'll need to do a certain amount of aerobic exercise, which is defined as any continuous exercise that maintains the heartbeat in a Target Zone for 20 minutes more. The Target Zone differs for every age group.

Age Target HR Zone
50–85 %
Average Maximum
Heart Rate
100 %
 
20 years 100–170 beats per minute 200 beats per minute
25 years 98–166 beats per minute 195 beats per minute
30 years 95–162 beats per minute 190 beats per minute
35 years 93–157 beats per minute 185 beats per minute
40 years 90–153 beats per minute 180 beats per minute
45 years 88–149 beats per minute 175 beats per minute
50 years 85–145 beats per minute 170 beats per minute
55 years 83–140 beats per minute 165 beats per minute
60 years 80–136 beats per minute 160 beats per minute
65 years 78–132 beats per minute 155 beats per minute
70 years 75–128 beats per minute 150 beats per minute
 

There are a number of aerobic exercises that can keep the heart beating in the Target Zone, including brisk walking, jogging, jumping rope, swimming, aerobics, dancing and bicycling. Some of these exercises, such as jogging and jumping rope, put a great deal of strain on the weight-bearing joints, while others, such as swimming, are easy on the joints. The kinds of exercise best for you depend on the nature and severity of your joint pain, your overall health and your personal preferences.

The best idea is to consult with your physician before beginning or changing your exercise program, to make sure it's right for you. Begin slowly and progress gradually. Depending on your current fitness level, you may start with as little as five minutes of activity three times per day, and work your way up to a single 20-30 minute session five times per week. Listen to your body. If you experience pain that lasts longer than one hour after exercise or notice increased swelling/weakness or decreased range of motion, modify your exercise routine and check with your healthcare provider.

Water Exercises

Water exercise is a gentle way to exercise joints and muscles. Water's buoyancy gives your joints a break from bearing weight, while the resistance it affords can help build muscle strength. If the water is warm it can be soothing and relaxing, and a good way to relieve arthritis pain and stiffness. Hot water (greater than 98.6 degrees) can be even more relaxing to your muscles, and causes your blood vessels to dilate, increasing circulation. However, if you're experiencing any inflammation, hot water can make it worse.

Those who find it beneficial to exercise or just relax in the water may want to consider installing a pool or a spa (hot tub). Both provide the buoyancy that helps you relax and take a load off your joints when exercising. Pools offer more space than hot tubs, allowing for more vigorous exercises, including strengthening and aerobic exercises. But spas have warm-to-hot water, plus jet nozzles that can massage sore muscles. The choice is yours.

Walking

Walking is an endurance exercise, which means it strengthens your heart, helps your lungs work more efficiently and builds stamina, so you won't tire as easily. As a weight-bearing exercise, walking helps strengthen the bones and muscles of the legs, buttocks and core, while reducing the risk of osteoporosis (thinning of the bones) in those same bones. At least some benefits can be gained from anything ranging from a light stroll to a hardcore hike.

Nordic Pole Walking provides low-impact support for the joints while helping you get a good cardiovascular workout.

Elliptical Training

An elliptical trainer is a stationary exercise machine that allows you to enjoy the benefits of walking or running without subjecting your joints to the excessive impact that normally accompanies these activities.

To use an elliptical machine, simply place your feet on the machine's pedals and simulate the act of walking or running in fluid, continuous movements. Some elliptical trainers also come with handles that provide an upper-body workout. You can regulate both the pace of your workout and the amount of resistance the machine offers.

Cycling

Both indoor and outdoor cycling are low-impact exercises, and cycling equipment can be adapted for many of the limitations imposed by arthritis.

Indoor cycling on a machine - which offers less joint stress than outdoor biking - is an excellent way to get a cardiovascular workout without overloading the weight-bearing joints. It's also a good option for people with balance problems, because the cycle remains upright on its own. An interesting outdoor option is the Linear Recumbent Cycle, which allows the rider to adopt a "lying down" position that minimizes back and neck pain.

No matter what kind of cycle you use, a few rules apply:

  • Go easy on the hills (or the resistance, if you're indoor cycling), for going up hill puts a lot of strain on the quadriceps and the patellar tendons in the knee.

  • Downshift your gears or lower the resistance any time you feel discomfort.

  • Try not to hunch your shoulders. When you ride for an extended period of time, your shoulders and neck may become stressed.

  • Take frequent stretching breaks to relieve muscle tension that may be caused by sitting, and by the "hunching over the handle bars" position used on certain bicycles.


Tennis

Although it can be a lot of fun, tennis is a stop-and-go sport that exerts plenty of pressure and twisting on the knee and requires repetitive motions that can inflame the tendons in the elbow joint. Repeated movements of the wrist, especially those meeting resistance, as is the case in a backhand stroke, can make matters worse. If you have arthritis and love playing tennis, see your physician and or physical therapist for tips on how to play safely.

A common ailment see in tennis players is tennis elbow which, although painful, doesn't typically bring about long-term effects. There may be varying degrees of pain, ranging from mild discomfort of the arm with use, to an ache severe enough to interfere with sleep. The pain is made worse by gripping or twisting movements. The outer side of the elbow will feel tender. Rest and ice are commonly recommended and deep tissue massage of the affected area is also helpful. Learn More

Golf

Arthritis can affect any joint in the body but when it strikes the wrists, hands and fingers, it can really affect your golf game. Signs of osteoarthritis common in golfers include joint stiffness, pain upon gripping, swelling and tenderness, enlarged joints, nodules or cysts at the joints.

For avid golfers who want to prevent joint pain or minimize the symptoms of arthritis, it pays to cross-train with various other activities that improve joint health such as stretching, weight training and low-impact cardiovascular exercises. For instance, a good exercise program for a "weekend golfer" might include lifting weights two or three times a week, stretching daily, and performing regular low-impact cardio exercises three times a week to increase endurance and strengthen the muscles supporting the joints. Learn More

Exercise as Part of Weight Management

Being overweight is a leading contributor to arthritis and joint pain, particularly, knee pain. A great deal of research has shown that the knees, hips and ankles bear three to five times the total body weight when walking. However, just losing ten pounds translates to 30 to 50 pounds less stress on the joints when walking. When running, the stress the joints have to bear goes up exponentially - and weight loss affects them even more dramatically. If you've got arthritis, the amount of weight you're carrying can be a crucial factor in determining how much pain and joint damage you experience.

A gentle but regular exercise program that combines stretching, strength training and aerobic activity will also help you maintain a healthy weight and prevent excess wear on your hips and knees.

Recommended Sports and Activities for Joint Pain Sufferers**

Good low-impact or non-impact activities for prevention of arthritis, joint pain relief and weight loss include:

Ballroom dancing or freestyle dance Kayaking and rafting Rowing a boat Swimming Weight Lifting
Biking (indoor and linear recumbent are especially recommended) Race walking Yoga Snowshoe
Water Aerobics
Elliptical Training Scuba diving Snorkeling Tai chi and Chi gong Walking and hiking (especially Nordic Pole walking)

 


**As with any program of diet, exercise, weight loss or therapy, consult your medical practitioner, especially if you have a history of heart disease or other conditions.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease. Individual results vary.

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