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Home » Exercise Programs » Exercise and Arthritis | UW Orthopaedics and Sports …

Last updated: September 23, 2011 Edited by:

Follow our blog http://shoulderarthritis.blogspot.com/ On which we try to provide the best and most current information on shoulder arthritis. Contact If you have questions regarding the ream and run procedure, feel free to email Frederick A. Matsen III M.D. at matsen@uw.edu. If you have questions regarding hip and knee arthritis, feel free to email Seth S. Leopold M.D. at leopold@u.washington.edu.

Part of a treatment program

Bicycling can be great recreational exercise

Exercise is good for almost everyone!

For many years it was thought that people with arthritis should not exercise because it would damage their joints. Now doctors know that when the arthritis is under control, people with arthritis can improve their health and fitness through exercise without hurting their joints.

Exercising for fitness is as important for people with arthritis as for anyone else. It can give you more energy, help you sleep better, control your weight, make your heart stronger, make your bones and muscles stronger, decrease depression, decrease fatigue, improve your self-esteem and sense of well-being, and give you time to socialize with friends.

If you have arthritis, you have more reasons to exercise:

Along with medicines, rest and other parts of your treatment program, regular exercise can help keep your joints in working order so you can continue your daily activities. It may also help prevent further joint damage.

What happens without exercise?

If your joints hurt, you may not feel like exercising. But without exercise, your joints can become even more stiff and painful. This happens because exercise actually keeps your bones muscles and joints healthy.

Because you have arthritis, it is important to keep your muscles as strong as possible. The stronger the muscles and tissues are around your joints, the better they will be able to support and protect those joints--even those that are weak and damaged from arthritis. If you don't exercise, your muscles become smaller and weaker and your bones can become more brittle.

Many people with arthritis keep their joints in a bent position because it's more comfortable. If the joints stay in one position for too long (without movement), they can become stuck in that position. If this happens, you may even lose the use of those joints. Exercise moves these joints and helps keep them as flexible as possible.

Exercise also lifts your spirits. If you're in pain, you may feel depressed. If you feel depressed, you may not feel like exercising. And without exercise, you feel more pain and depression.

Without exercise, you can get caught in a cycle of pain depression and inactivity.

On the other hand, there are some kinds of exercise that are not ideal for patients with certain patterns of arthritis. This article will cover some general recommendations on how patients with arthritis might be able to exercise comfortably and safely.

Types of exercises There are three main types of exercise that can be included in your exercise program: range-of-motion (flexibility), strengthening and fitness.

These types of exercises are discussed in detail later in this article.

Health care professionals

Along with your doctor, there are two other types of health professionals who can help you plan a total fitness program. They can work with you to design a program that meets your specific needs.

Physical and occupational therapists

Physical therapists can show you special exercises to help keep your bones and muscles strong.

Occupational therapists can show you how to do certain activities in ways that will not place extra stress on your joints. They can also provide you with splints or special aids if you need them. Contact your local hospital, county medical clinic or Arthritis Foundation office for more information on how to contact these professionals.

Always check with your doctor, physical therapist or occupational therapist before starting a new exercise program or before changing your current one. They can help you determine the best exercises that meet your needs. If you have had joint replacement surgery also talk with your surgeon.

Therapeutic and recreational exercise

People with arthritis often follow a therapeutic exercise program and also take part in active leisure or recreational exercise. Therapeutic exercise is exercise recommended by your doctor physical therapist or occupational therapist. It includes specific exercises designed to meet your individual needs and achieve specific goals. Recreational exercise is done for fun and general fitness. It includes activities you can enjoy by yourself or with family and friends such as walking, bicycling, swimming and exercise classes. It is not designed specifically for you by your doctor but it is a good idea to discuss your recreational exercise plans with your doctor or therapists.

Don't work too hard

The most common risk to exercise is working your joints or muscles too much. This can happen if you exercise too long or too hard--especially when you're first beginning your exercise program.

Remember: exercise is only one part of your treatment program. Other parts of your program should include:

For more information about arthritis of particular joints, see our articles on hip arthritis, knee arthritis and shoulder arthritis. For more information about joint replacements for arthritic joints, see our articles about hip replacement, minimally-invasive knee replacement and shoulder replacement.

About these exercises

These exercises reduce stiffness and help keep your joints flexible. The "range-of-motion" is the normal amount your joints can be moved in certain directions. If your joints are very painful and swollen, move them gently through their range of motion.

Exercise tips

These exercises can help keep your joints moving. Follow these tips to get the most benefit.

If you have arthritis, you should try to move your joints through their full range of motion every day. Daily activities such as housework, climbing stairs, dressing, bathing, cooking, lifting or bending DO NOT usually move your joints through their full range of motion. They should NOT replace the therapeutic exercises your therapist recommends for you.

Instructions for viewing movies

Below are some range-of-motion exercises for people with arthritis. Although these exercises were selected for their safety and effectiveness, the UW Department of Ortheopedics is not responsible for any injuries resulting from these exercises.

Some of these exercises are illustrated with movies.

Range of motion exercises

Neck

Breathe with the movements, breathing out when your head moves down, breathing in when it moves up. Don't let your shoulders or torso (upper body) sway to the side. Don't do movements that your doctors or therapists have advised against.

Arms

Fingers

Chest and torso

Legs

Click to play Ankle range of motionClick to play Gastroc stretchClick to play Soleus stretch

Click to play Pelvic tiltClick to play Hip liftClick to play Lower back rotationClick to play Double leg pullClick to play Single leg pullClick to play PushClick to play Back pressClick to play Back releaseClick to play Arm reach

Click to play Elbow bendingClick to play Elbow straighteningClick to play Turning palm upClick to play Turning palm downClick to play Stretch for tennis elbow

Click to play Table topClick to play Finger curlsClick to play Finger tip touchClick to play Finger spread

Click to play Hamstring stretchClick to play Hip flexor stretch

Click to play Getting the arm up overhead while lying downClick to play Getting the arm up overhead while sittingClick to play Getting the arm up overhead with a pulleyClick to play Getting the arm up to rotate while lying downClick to play Getting the arm to rotate while standingClick to play Getting the arm up the backClick to play Getting the arm across the body

Click to play Thumb slideClick to play In and outClick to play Thumb roll

Click to play Wrist flexion and extensionClick to play Moving the wrist side to side

About these exercises

These exercises help maintain or increase muscle strength. Strong muscles help keep your joints stable and more comfortable.

Common exercises

Two common strengthening exercises for people with arthritis are:

Do these exercises daily or every other day. On days when you have more joint pain and swelling, you can adapt your program by leaving out or decreasing the strengthening exercises. Ask your therapist or doctor about ways to do this.

Specific strengthening exercises can be done for different joints. These should ONLY be done if they are comfortable. If you have questions about whether you should be doing these exercises, contact your physician.

Instructions for viewing movies

Below are some strengthening exercises for people with arthritis. Although these exercises were selected for their safety and effectiveness, the UW Department of Orthopaedics is not responsible for any injuries resulting from these exercises.

Some of these exercises are illustrated with movies.

Strengthening exercises

Back

Chest and torso

Legs

Calf and Ankle

Click to play Calf strengthening IClick to play Calf strengthening IIClick to play Posterior tibial strengthClick to play Toe flexor strengthClick to play Peroneal Strength WeightsClick to play Peroneal Strength Tubing

Knee

Click to play Quad setsClick to play Straight leg raisesClick to play Short arcsClick to play Wall sitsClick to play Mini squatsClick to play Hamstring strengthening

Click to play Shoulder shrugClick to play Table push upsClick to play BalanceClick to play Stiff arm pullClick to play FliesClick to play Two hand catch

Click to play RhomboidsClick to play Internal Rotation IsometricsClick to play Internal Rotation TubingClick to play Internal Rotation Free weightClick to play External Rotation Free weightClick to play External Rotation IsometricsClick to play Supine Press Two handsClick to play Supine Press One handClick to play Supine Inclined pressClick to play Supine Sitting press

Click to enlarge Figure 1 - Isometric exerciseClick to enlarge Figure 2 - Isotonic exerciseClick to enlarge Figure 3 - Pelvic tiltClick to enlarge Figure 4 - Back erector

Click to enlarge Figure 5 - Angry cat stretchClick to enlarge Figure 6 - Double knee pullClick to enlarge Figure 7 - Half sit-upClick to enlarge Figure 8 - Hip kicker

Fitness exercise is endurance exercise. This means it helps make your heart and lungs stronger and gives you more stamina. It also helps keep your joints flexible and your muscles strong. Fitness exercise also helps you get more quality sleep, control your weight and feel better overall both mentally and physically.

Fitness exercises for arthritis

Some of the best fitness exercises for people with arthritis are walking, water exercise and bicycling.

Walking

Walking is better than running for people with arthritis because it doesn't put as much stress on your joints. It doesn't require any special skill and it doesn't cost a lot. You can walk almost any time and anywhere. If you have severe hip, knee, ankle or foot problems, talk to your doctor: walking may not be for you...but even in that case there are other choices - see water exercise and bicycling below.

Water exercise

Swimming and exercise in water are especially good for stiff sore joints. Warm water helps relax your muscles and decrease pain. The water should be between 83 and 90 degrees. Water helps support your body while you move your joints through their full range of motion. With the water holding you up, there is less stress on your hips, knees and spine. You can do warm-water exercises while standing in shoulder-height water or while sitting in shallow water. In deeper water, use an inflatable tube life vest or ski belt to keep you afloat while you move your arms and legs. Many public pools (as well as private fitness clubs) conduct water exercise and/or water aerobics programs for arthritis patients.

Exercise in the water whether swimming, water aerobics, water walking or water jogging is particularly handy for patients with arthritis of the legs (hips, knees, ankles, feet) for whom a walking program is painful.

Bicycling

Bicycling, especially on an indoor stationary bicycle, is a good way to improve your fitness without putting too much stress on your hips knees and feet. Adjust the seat height so your knee is as straight as possible when the pedal is at the lowest point. The recommended cadence (number of pedal strokes per minute you can count each time your right foot reaches the lowest point as "one") is about 60 per minute. Add resistance only after you have warmed up for five minutes. Don't add so much resistance that you have trouble pedaling.

Gradually build up your fitness exercises to 20 to 30 minutes per day at least three times per week. Fitness exercises should be only one part of your total exercise program. DO NOT substitute fitness exercises for the therapeutic exercises your health professionals recommend.

Communicate with your doctor

Talk with your doctor or therapist to decide what types of exercises are best for you. Your decision will be based on what type of arthritis you have, which joints are affected, what you like to do where you live and other factors.

If you find a program on your own and you have serious joint problems, show a copy of the exercises to your doctor or therapist. They may suggest ways to modify the exercises to protect your joints or may suggest other exercises to add to the program.

When to exercise

In general it is best to exercise:

Here are a few more tips about exercise times:

Before exercising

Massage the stiff or sore areas or apply heat and/or cold treatments to the area. Heat relaxes your joints and muscles and helps relieve pain. Cold also reduces pain for some people. Here are some ways you can apply heat or cold:

In general use warmth before exercise and ice afterwards.

Be sure to apply the heat correctly! Mild heat will give you results. It should feel soothing and comfortable, not hot. Apply it for about 20 minutes at a time. Use cold for 10 to 15 minutes at a time.

Warm up first. Do gentle range-of-motion and strengthening exercises at least 10 to 15 minutes before more vigorous exercise. Begin your activity at a slow pace and gradually work to a faster pace. This helps avoid injuries.

Wear comfortable clothes and shoes. Your clothes should be loose and in layers so you can adapt to changes in temperature and activity. Your shoes should provide good support and the soles should be made from non-slip, shock-absorbent material. Shock-absorbent insoles can also make your shoes more comfortable.

During exercise

Don't hurry. Exercise at a comfortable steady pace and give your muscles time to relax between each repetition. For range-of-motion and flexibility, it is better to do each exercise slowly and completely rather than to do many repetitions at a fast pace. You can gradually increase the number of repetitions as you get into shape.

Breathe while you exercise. Don't hold your breath. Counting out loud during the exercise will help you breathe deeply and regularly.

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