Exercise and Arthritis

Have you ever felt discomfort or stiffness around a joint area? Ever wondered if those feelings mean you have arthritis? According to the Arthritis Foundation, more than 28 million Americans suffer from arthritis. The two most common types are Osteoarthritis (OA) and Rheumatoid Arthritis (RA). Although a cure has not yet been discovered, there are a number of risk factors and preventive strategies to be aware of that may help delay the onset or reduce the severity of the disease.

Osteoarthritis is a chronic condition resulting in the breakdown of cartilage. The Arthritis Foundation states in their Osteoarthritis fact sheet that the most common symptoms of OA are pain or stiffness in joints, a catching sensation during movement and “bony growths at the margins of affected joints.” The American College of Sports Medicine’s (ACSM) Resource Manual for Exercise Testing and Prescription (RMETP) states that the most common weight-bearing joints affected by Osteoarthritis are the knees and hips. This often causes the quadriceps muscles to atrophy with the progression of the disease (RMETP 652).

Most people grow up thinking that arthritis is caused by one’s genes, general aging and extreme wear and tear on joints. While these do largely influence Osteoarthritis cases, recent research has uncovered additional risk factors to be aware of. Other symptoms include previous joint injuries, joint misalignment, nerve injury, obesity and high levels of cytokines in the blood—meaning muscle inflammation (ACSM’s RMETP, 652-653). These factors can increase anyone’s chances of suffering from OA. Given this knowledge, it is crucial that everyone make the time to address their health issues and prevent any weaknesses increasing susceptibility to arthritis. For example, make sure to receive treatment or at least a doctor’s recommendation for any joint or nerve injury or pain in a timely manner. In general, try to maintain a healthy body composition and live a healthy lifestyle.

RA is similar to OA, but far more debilitating. While OA does not have any visible character traits, RA leads to such results as red, swollen, curled-in hands as sometimes seen on elderly patients. RA is a chronic inflammatory disease affecting the lining of joints. Rheumatoid arthritis can strike at any age. Risk factors include family history, aging, hormonal imbalances, infection, smoking and obesity (RMGETP, 659). Sadly, there is no cure, but treatments do exist

According to the Arthritis Foundation, it has three stages. The first is swelling of the synovial lining; the second is a rapid growing of cells, which thickens the lining. The final stage is when the inflamed cells actually begin eating away at bone and cartilage. RA symptoms include pain, warmth, stiffness, redness, swelling and eventually loss of movement and misshapen joints due to bone loss.

Many people fear that exercising suffering joints will cause increased swelling and pain. Fortunately, this worry is completely unfounded, and in fact, quite the opposite is true! Both the Arthritis Foundation and the American College of Sports Medicine recommend indoor cycling as an ideal cardiovascular exercise. In a study done by cycling enthusiast and Ph.D., Greg Marchetti, and rheumatologist Kelly Krohn, M.D., they exemplified the benefits of incorporating an indoor cycling program into one’s exercise regimen. When comparing individuals who participated in a cycling class specifically designed for their condition to a control group who continued their regular exercise routine, the cycling group had greater improvements in walking performance and less pain with symptom-related disabilities. The physical motion utilized in cycling targets thigh and hip regions, strengthening the muscles and joints and in effect, easing the pain. This, in combination with the motivating class structure, make cycling classes a wonderful exercise option for those struggling with arthritis.

The ideal exercise program for arthritis patients incorporates three main components: flexibility routines, strength training and aerobic workouts. First, most arthritics find it beneficial to start out each morning with a 10–15 minute range of motion flexibility routine to loosen up stiff joints.

The second component, strength training, should occur 2–3 times per week, preferably incorporating mostly isometric contractions as opposed to isotonic exercises. Isometric contractions eliminate strained, repetitious joint actions and instead focus on contracting muscles without actually moving. For example, instead of performing bicep curls (isotonic), one could contract the muscles by pushing the hands together in a prayer position (isometric). This prevents unnecessary movement and increased inflammation.

The third element of aerobic workouts, such as cycling, should occur 3–5 times per week, for 20–30 minutes. Arthritics, especially those suffering in their knees, should keep to three core movements: Seated Flats, Seated Climbs and limited Standing Flats for saddle relief. It is important to avoid Jumps, Jumps on a Hill and Sprints to reduce weight on the knees and reduce the risk of hyperextension of the knee joint. Cadence ranges should remain between 80–100 RPM on flats and 70–80 RPM on hills with a light to moderate resistance to avoid undue stress. The goal of an exercise routine for arthritics is to maintain a wide range of motion, reduce pain and slow the progression of their chronic condition.

No matter one’s health condition, exercise has significant benefits for everyone. Especially as an arthritic, spending ample time warming up and cooling down is crucial. Though it may seem insignificant, incorporating range of motion exercises for all areas of the body, even if one is just performing an exercise targeting a specific body part, helps arthritics resist stiffness and increasing pain. Arthritis is a very difficult disease to fight. Incorporating the three main exercise components addressed above is one simple way to help overcome the struggles.

Fitness Focus, September 2009