Arthritis can be managed through many different modalities which include exercise and a physically active lifestyle. However, the modality employed depends on the type and state of the condition.
The process of understanding arthritis is multi-layered and includes getting an idea about what the condition entails, what are pathological changes that happen in the joints and how a history of injury can cause arthritis. This highlights the importance of consulting a specialist before starting an exercise routine while managing arthritis.
Arthritis must be controlled at the initial stage before getting into physical activities or exercises. Diet and exercise alone cannot control inflammatory arthritis, say experts. Medical treatment is an essential part of treating arthritis along with physiotherapy and exercises, or even small things such as a change of footwear.
Types of exercises for arthritis
Arthritis pain can limit people from working out which presents a huge roadblock. “If there is an active arthritis in a particular joint, we advise them not to overuse that joint,” says Dr Madeshwaran Mani, consultant rheumatologist, Royal Care Super Speciality Hospital, Coimbatore, Tamil Nadu. “Once the inflammation subsides, we inform them to use the joint to maximise the range of movement,” he adds.
Various exercises are recommended for both upper and lower limbs. For those with osteoarthritis, assisted exercises, resistance exercises, isometric exercises, swing and warmup-based exercises and yoga are advised.
Exercising with the different types of equipment should be done under supervision. These include lifting light weights (ranging from 0.5 kg to 5kg), resistance bands, and lightweight kettlebells, which can be used for swinging exercises. Stationary cycling, elliptical cross trainers and resistance rowing machines are useful too.
“Exercising 30 minutes a day is a good target,” says Dr Pavan Chebbi, senior consultant orthopaedic surgeon at Amber Clinic and Apollo Spectra Hospital, Bengaluru. “People with arthritis can start a 10-minute walk twice a day and if the pain does not bother them much, then they can increase to up to 30 minutes. They can also go up to an hour with enough breaks in between which can be helpful in painful conditions.”
Exercises for lower limbs include calf stretches, hamstring stretches, straight leg raise, quad set, seated hip march, pillow squeeze (this move helps strengthen the inside of your legs to help support your knees), heel raises, side leg raises, sit to stand, balancing on one leg, step ups (to strengthen your legs for climbing steps), walking (even if you have stiff or sore knees, walking may be a great exercise). Other exercises that are easy on the knees include cycling, swimming, and water aerobics.
Exercises for the upper limbs (upper arm, forearm, and hand) include shoulder rotation, rotator-cuff strengthening exercise, elbow flexion-extension (pronation/supination), hand and wrist isometric and small muscle exercises.
Benefits of exercising with arthritis
- Stretching improves flexibility and the range of motion or how far one can move the joints in certain directions. It also helps to lower the odds of pain and injuries.
- Working out builds muscle strength to help support weak joints.
- It helps to strengthen the hips and thigh muscles and can help with daily activities like walking or standing up.
Arthritis and diet
Anti-inflammatory diet is important in managing arthritis as they are less likely to trigger the immune system.
“Anti-inflammatory diet includes fibre-rich foods, an oily fish like sardines for omega fatty acids, olive oil and turmeric,” says Dr Mani. “People with arthritis should avoid inflammatory foods such as red meat, refined carbohydrates, refined sugars, and white flour (maida).”
Arthritis and yoga
“Yoga helps individuals focus on their inner self, inner peace and mental stability and helps to deal with the condition better,” adds Dr Mani. “Yoga does not have a direct effect on the control of inflammation, but it helps keep the mind calm.”
While doing yoga people should be mindful of the condition and the areas/joints where the pain exists. Asanas that exert pressure on the affected joints should be avoided. If a particular joint is under stress, it is best to avoid that exercise altogether or avoid holding that posture for long durations.
Arthritis and exercising: Points to be careful about
People with arthritis should stay active. Not mobilising enough can lead to weight gain and muscle stiffness around the joints.
“While staying active, prevention of falls and fractures becomes important, especially for those in their 60s who have fragile bones,” adds Dr Mani. “One must be careful to avoid injuries and fractures while lifting weights, and get their bone mineral density tested.”
It is advised to walk on a flat surface, especially for those with knee and hip issues. It is better to avoid uneven surfaces and staircases. Regular assessment by a physio or a musculoskeletal specialist is essential to monitor the strength and mobility of the joints.
- Arthritis must be controlled at the initial stage of the medical treatment before starting an exercise programme.
- Diet and exercise alone cannot control inflammatory arthritis.
- Not mobilising enough can lead to muscle stiffness and weakness around the joints.