Exercise and Arthritis

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Exercise and Arthritis

The importance of exercise in the management of rheumatic diseases is often

not taken as seriously as it should be. Inflammation in muscles and joints

could potentially result in the loss of joint range of motion, muscle

strength, and bone density. The normal reaction when there is pain in a

joint is to stop using the affected joint. The build up of fluid inside a

joint can also decrease movement. Inflamed joints are generally more

comfortable in a slightly bent position because of a decrease in pressure.

As a result of not using the affected joint, the joint space may tighten and

permanent joint contrcacture could possibly occur. Furthermore, without use

the tendons and muscles surrounding the joint could possibly shorten.

Exercise can increase joint range of motion, strength, endurance,

coordination, as well as improve joint stability. There are exercises that

target one specific joint and exercises that could help with overall

cardiovascular fitness and endurance. In rheumatoid arthritis and

osteoarthritis, aerobic and resistive exercises can decrease disability by

improving function while decreasing pain.

These types of exercises can be classified into three groups: range of

motion or stretching, strengthening (resistive exercises), and aerobic

(endurance). In general, an exercise program progresses through different

levels. With passive exercises, the joint is moved without the patient

exerting any effort. With active exercise, the patient is assisted in

exerting some muscle contraction in attempting joint movement to achieve the

desired range. In resistive exercises, which are known as strengthening

exercises, a force is applied in opposition to the attempted movement.

Inflamed joints should be exercised frequently. Usually, passive exercise is

suggested with range of motion exercises to allow for bending and extending.

Stretching may be more effective after the application of heat to the area.

As with all exercise programs, it is advised that a physician be consulted

to make sure the exercise is appropriate for the condition.

Compliance in an exercise program is improved by having an individual join a

group. This produces a structured exercise program. Another suggestion to

increase compliance is to have the patient keep an exercise diary, which

should be reviewed at each visit.

The physician and health care professional should also provide positive

feedback and frequent encouragement. Usually exercises with a high level of

impact, such as tennis and racquetball, are avoided because of the stress

that is placed on the joints and ligaments.