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Physical Activity: The Arthritis Pain Reliever

December 08, 2014, 10:00 AM
Physical Activity: The Arthritis Pain Reliever
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Tips for starting and maintaining a physical activity program if you have arthritis.

Safe, enjoyable physical activity is possible for most every adult with arthritis. The most important thing to remember is to find out what works best for you. At first glance, 150 minutes of activity per week sounds like a lot, but if you pay attention to the following tips you will be well on your way to getting the recommended amount of activity in no time!

Studies show that some increase in pain, stiffness, and swelling is normal when starting an activity program. If you have increased swelling or pain that does not get better with rest then talk to your health care provider. It may take 6–8 weeks for your joints to accommodate to your increased activity level, but sticking with your activity program will result in long-term pain relief.

Here is an easy way to remember these tips: Make S.M.A.R.T choices!

Start low, and go slow

Many adults with arthritis are inactive, even though their doctor may have told them being active will help their arthritis. You may want to be more active but just don’t know where to start or how much to do. You may be worried that using your joints and muscles may make your arthritis worse. The good news is that the opposite is true, physical activity will help your arthritis! The first key to starting activity safely is to start low. This may mean you can only walk 5 minutes at a time every other day. The second key is to go slow. People with arthritis may take more time for their body to adjust to a new level of activity. For example, healthy children can usually increase the amount of activity a little each week, while older adults and those with chronic conditions may take 3–4 weeks to adjust to a new activity level. You should add activity in small amounts, at least 10 minutes at a time, and allow enough time for your body to adjust to the new level before adding more activity. Click here for examples of how to progress activity levels safely.

Modify activity as needed.

Remember, any activity is better than none. Your arthritis symptoms, such as pain, stiffness and fatigue, may come and go and you may have good days and bad days. You may want to stop activity completely when your arthritis symptoms increase. It is important that you first try to modify your activity to stay as active as possible without making your symptoms worse. Here are some ways you can do this:

  • Decrease the number of days per week you do activity — walk on 2 days instead of 4 days.
  • Decrease the time you are active each day — walk 15 minutes each day instead of 30 minutes.
  • Change the type of activity — instead of walking, ride a bicycle or take a water exercise class.

When your symptoms have returned to normal, slowly increase your activity back to your starting level.

Activities should be "joint friendly."

People with arthritis can do many types of moderate or vigorous intensity activities, some people with arthritis can even run marathons! If you are unsure of what types of activity are best for you, a general rule is to do activities that are easy on the joints like walking, bicycling, water aerobics, or dancing. These activities have a low risk of injury and do not twist or "pound" the joints too much. It is also important to pick a variety of activities that you enjoy, this will help keep you from getting bored and make it easier to stick with your activity plan.

Recognize safe places and ways to be active.

Safety is important for starting and maintaining your activity plan. If you are currently inactive or do not have confidence in planning your own physical activity, a class designed just for people with arthritis may be a good option for you. Some people with arthritis feel safer by starting an activity program in a class with a trained instructor and get support from and gain confidence by participating with the other people with arthritis. Local chapters of the Arthritis Foundation offer 2 classes, the Arthritis Foundation Exercise Program and the Arthritis Foundation Aquatics Program, in many communities. For a list of more exercise programs, click here.

If you currently do some activity or feel confident that you can safely plan your own activity program, you should look for safe places to be physically active. For example, if you walk in your neighborhood or a local park make sure the sidewalks or pathways are level and free of obstructions, are well-lighted, and are separated from heavy traffic.

Talk to a health professional.

You should already be under the care of a health care professional for your arthritis, who is a good source of information about physical activity. Health care professionals and certified exercise professionals can answer your questions about how much and what types of activity match your abilities and health goals.

Real life examples of how to start and stay active with arthritis

I don’t do any activity now, how do I start?

Meet Jean, a 48-year-old grandmother.

Jean is 48 years old and has rheumatoid arthritis. Her doctor has told her to increase her physical activity because it will help her arthritis. Jean wants to be able to walk to and from the park and play with her grandchildren. Right now, she does not have the stamina to walk to the park which is only a 15 minute walk from her house. Jean is also not very confident she knows how to safely start and increase her activity level. She is worried she will make her arthritis symptoms worse.

Start low.

The nurse in Jean’s doctor’s office told her about group exercise programs that are just for people with arthritis. There are classes every week at the community center close to Jean’s neighborhood. Jean works full-time but doesn’t have to start work until 10:00AM. She found out one of the classes, the Arthritis Foundation Aquatics Program (AFAP), meets at 8:00AM on Mondays, Wednesdays and Fridays. The class lasts for 60 minutes, which allows her enough time to shower, dress, and get to work on time. Jean went to the community center to sign up but was concerned she may not be able to do 60 minutes of activity at one time. The instructor assured her that the exercises can be modified and the instructors are trained to help each person work at their own level.

Go slow.

For the next 4 months, Jean attends the AFAP class 3 days per week. The first 4 weeks she cannot do all the exercises and has to take a lot of breaks, so she was working at a moderate effort for about 10–15 minutes each class (30–45 minutes of aerobic activity per week). By the 7th week, she can do 20 minutes per class and by the 3rd month she is up to 30 minutes (90 minutes of aerobic activity per week). Jean feels great and can tell she has more stamina. Over the next 4 weeks Jean slowly increases the time she is working at a moderate effort each class until she can do the entire 60 minute class without stopping (180 minutes of moderate aerobic activity per week).

Get advice.

Although Jean feels the AFAP has helped strengthen her muscles and given her more stamina, she now feels she should do more muscle strengthening exercises. For Christmas, her children gave her a gift certificate for 4 free sessions with a certified exercise specialist at a local fitness center. At her first session, she asked for instructions on how she can do muscle strengthening exercises at home. The fitness professional gave her some elastic resistance bands and showed her how to use them to strengthen all the major muscle groups of the body. Jean is now using the resistance bands 2 days per week in addition to her aquatics classes.

I do some activity now, how can I safely increase my activity to gain more health benefits?

Meet Steve, an active 69-year-old retiree.

Steve is a 69-year old-retired accountant who has been physically active all his life but has been diagnosed with osteoarthritis in his knee. Now that he is retired, Steve has the time to increase his activity level even more. Steve’s goal is to increase his total activity per week and to do some vigorous intensity activity because he knows it is good for his heart and may reduce his risk of getting some cancers. Steve currently does 180 minutes of moderate intensity activity each week including—

  • Mowing the grass and other moderate yard work = 30 minutes.
  • Plays 9 holes of golf 1 day per week walking without a cart = 60 minutes.
  • Uses a stationary bicycle at home 3 days per week for 30 minutes = 90 minutes.
  • Lifts weights at a local fitness center 2 days per week.

Adding more activity.

Steve wants to increase his total activity to at least 300 minutes per week of moderate intensity activity. He decides that without too much trouble he can easily add 1 more day of golf, adding 60 minutes of moderate intensity activity each week. Steve’s wife recently joined a local senior’s tennis league and has been bugging him to play tennis with her. Steve hasn’t played tennis in a long time so he signed up for 4 weeks of tennis lessons at the parks and recreation department in his town. After the lessons, he and his wife started playing doubles tennis 2 days per week for an hour each time (60 minutes of moderate intensity activity, 120 minutes per week). He continues to lift weights 2 days per week. Steve has successfully added 180 minutes of moderate intensity activity and now gets a total of 360 minutes per week.

Trading up to vigorous activity.

After doing this level of activity for 4 months, Steve wants to trade some of the moderate intensity activity he does for vigorous intensity activity. He decides that on 2 of the 3 days he uses the stationary bicycle at home, he will instead use the stair climber or elliptical machines at his fitness center. Because 1 minute of vigorous intensity activity equals about 2 minutes of moderate intensity, Steve plans to do 20 minutes on 2 days each week when he is at the gym. Steve’s activity program now includes—

  • 300 minutes per week of moderate intensity activity.
    • Mowing the grass and other moderate yard work = 30 minutes.
    • Plays 9 holes of golf 2 days per week walking with out a cart = 120 minutes.
    • Uses a stationary bicycle at home 1 day per week for 30 minutes = 30 minutes.
    • Plays doubles tennis 2 days per week = 120 minutes.
  • 40 minutes of vigorous intensity activity (equal to 80 minutes of moderate intensity).
    • Stair climber or elliptical machines 2 days per week = 40 minutes.
  • Lifts weights at a local fitness center 2 days per week.

What should I do if I have pain when I exercise?

Some soreness or aching in joints and surrounding muscles during and after exercise is normal for people with arthritis. This is especially true in the first 4 to 6 weeks of starting an exercise program. However, most people with arthritis find if they stick with exercise they will have significant long-term pain relief. Here are some tips to help you manage pain during and after exercise:

  • Modify your exercise program by reducing the frequency (days per week) or duration (amount of time each session) until pain improves.
  • Changing the type of exercise to reduce impact on the joints – for example switch from walking to water aerobics.
  • Do proper warm-up and cool-down before and after exercise.
  • Exercise at a comfortable pace – you should be able to carry on a conversation while exercising.
  • Make sure you have good fitting, comfortable shoes.

Signs you should see your health care provider:

  • Pain is sharp, stabbing, and constant.
  • Pain that causes you to limp.
  • Pain that lasts more than 2 hours after exercise or gets worse at night.
  • Pain is not relieved by rest, medication, or hot/cold packs.
  • Large increases in swelling or your joints feel “hot” or are red.
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