Some people with arthritis avoid exercise because of joint pain. However, a group of exercises called isometrics are designed to strengthen targeted muscle groups without bending painful joints. Isometrics involve no joint movement, but rather strengthen muscle groups by using an alternating series of isolated muscle flexes and periods of relaxation.
Another group of exercises called isotonics are similar to range-of-motion exercises because they involve joint mobility. However, this group of exercises is more intensive, achieving strength development through increased repetitions or speed of repetitions, or by introducing light-weight resistance with small dumbbells or stretch bands.
A physical therapist or fitness instructor (preferably one with experience working with arthritis patients) can provide you with instruction on how to correctly and effectively perform isometric and isotonic exercises.
Hydrotherapy or aquatherapy (water therapy), is a program of exercises performed in a large pool. Aquatherapy may be easier on painful joints because the water takes some of the weight off of the affected areas while providing resistance training.
The foundation of endurance training is aerobic exercise, which includes any activity that uses large muscle groups, can be maintained continuously for a long period of time and is rhythmic in nature. Aerobic activity conditions the heart, lungs and cardiovascular system to:
- Use oxygen more efficiently
- Supply the entire body with larger amounts of oxygen-rich blood
- Build stronger muscle tissue
When paired with a healthy diet, aerobic activity also is fundamental for weight control (which reduces excess pressure on affected joints) and improving overall general health.
The Cleveland Clinic Foundation suggests that people with arthritis should perform about 15 minutes of aerobic activity (called the duration of the exercise) at least three times a week (called the frequency of the exercise) at first, then gradually build up to 30 minutes daily. The activity also should include at least 5 to 10 minutes of warm up plus 5 to 10 minutes of cool down. While peak benefits are achieved when an aerobic activity is performed continuously for at least 30 minutes, aerobic exercise can be spread out in smaller segments of time throughout the day to suit your comfort level, without overexerting yourself. Aerobic exercise should be performed at a comfortable, steady pace that allows you to talk normally and easily during the activity. Ask your therapist what intensity of exercise is appropriate for your fitness level.
Intensity is how hard you are exercising. During exercise, your heart's "training range" or training heart rate should be closely monitored. To improve your body's aerobic condition, you need to exercise at an intensity between 60 and 80 percent of your maximum heart rate.
Examples of aerobic activities include walking, swimming, low-impact aerobic dance, and biking, and may even include such daily activities as mowing the lawn, raking leaves or playing golf. Walking is one of the easiest aerobic exercise programs to begin because it requires no special skills or equipment other than a good pair of supportive walking shoes, and it's less stressful on joints than running or jogging. Biking also may be more beneficial to people with arthritis than other aerobic activities because it places less stress on knee, foot and ankle joints.
Appropriate recreational exercise, including sports, can be helpful to most people with arthritis, but only if it is preceded by a program of range-of-motion, strength and aerobic exercise to reduce the chance of injury.
Beginning a New Exercise Program
Regardless of your condition, discuss exercise options with a physician before beginning any exercise program. Also, begin new exercise programs under the supervision of a physical or occupational therapist, preferably one with experience working with arthritis patients.
People with arthritis who are beginning a new exercise program should spend some time conditioning using a program that consists only of range-of-motion and strengthening exercises, depending on their physical and athletic condition. Endurance exercises should be added gradually, and only after you feel comfortable with your current fitness level.
As with any change in lifestyle, your body will have to take time to adapt to your new program. During the first few weeks, you may notice changes in the way your muscles feel, changes in your sleep patterns or different energy levels. These changes are to be expected with increased activity levels. However, improper exercise levels or programs may be harmful, making symptoms of arthritis worse. Consult your physician or therapist and adjust your program if you experience any of the following: