Arthritis affects over 4.6 million Canadians and causes muscle weakness, fatigue, pain, stiffness, and swelling in joints, muscles, tendons, ligaments, and/or bones. Although arthritis cannot be cured, it can be improved by engaging in regular exercise.
Why Exercise is Important
Exercise can help you improve your health and fitness without hurting your joints. Along with your current treatment program, exercise can:
- Strengthen the muscles around your joints
- Help you maintain bone strength
- Give you more strength and energy to get through the day
- Make it easier to get a good night's sleep
- Help you control your weight
- Make you feel better about yourself and improve your sense of well-being
Though you might think exercise will aggravate your joint pain and stiffness, that's not the case. Lack of exercise actually can make your joints even more painful and stiff. That's because keeping your muscles and surrounding tissue strong is crucial to maintaining support for your bones. Not exercising weakens those supporting muscles, creating more stress on your joints.
Types of Exercise for Arthritis
Cardiorespiratory endurance (a.k.a. cardio or aerobic) is the ability of the heart and lungs to deliver oxygen and fuel to the muscles of the body. Cardiovascular exercises should initially be performed in short bouts (about 10 minutes). Add 5 minutes per session to up 30 minutes and progress with duration versus intensity. Intensity should be moderate (you should be able to say a few words between breaths). If you use a heart rate monitor this would be at about 60-70% maximum heart rate. You can try out our “target heart rate calculator” found under “activities” à “tools and trackers” to determine what your heart rate should be at. Low-impact activities such as swimming, walking, and cycling are preferred and they are easier on the joints.
Resistance training is any exercise that causes the muscles to contract against an applied force with the expectation of increases in strength, tone, size, and/or endurance. Weight training is an example of resistance training and is beneficial for anyone with arthritis because building strong muscles helps to support and protect your joints. One set of 8-10 exercises for the major muscle groups of the body 2-3 times a week is recommended. Older individuals may find that 10-15 repetitions with less resistance are more appropriate. The resistance or weight needs to be of sufficient intensity to challenge the muscles without increasing joint pain. Resistance can take the form of lifting a limb against gravity, using hand-held weights or elastic bands, or pushing/pulling against resistance using a weight machine. Even movement against water can provide resistance when done at faster speeds. Gradually increase the amount or form of resistance for ongoing improvements in strength. Make sure to give 48 to 72 hours between resistance training sessions to allow the muscles to recover.
Flexibility is the range of motion of the joints and the mobility of the muscles to allow full range of the joints. Flexibility exercises are important for anyone with arthritis because they relieve stiffness, improve posture, reduce risk of injuries, and improve everyday functionality. Range of motion exercises should be performed 2 to 10 times daily. Performing range of motion exercises in the evening may help reduce joint stiffness the next morning. It is recommended that stretching exercises be done at least 3 days per week with each stretch being held for about 30 seconds. Recreational activities such as yoga and tai chi incorporate both range of motion and stretching movements into their routines and are recommended for all abilities.
When to Exercise?
Finding the right time of day to exercise will help you establish a routine and obtain the greatest benefits. For those with a lot of morning stiffness, gentle range of motion exercises may be helpful, but getting to a fitness class may be too difficult. If fatigue is a problem, breaking up the exercise program into several short bouts during the day may be more manageable. Trouble sleeping at night? Avoid doing aerobic exercises within 2 hours of bedtime; however, stretching and relaxation exercises may help with sleep. It is important to be aware of any changes in your arthritis symptoms such as periods of more joint pain and stiffness. You may need more rest and less exercise during these times.
Tips to Protect your Joints
Start slowly to ease your joints into exercise if you haven't been active for a while. If you push yourself too hard, you can overwork your muscles. This can worsen your joint pain.
Consider these tips as you get started:
- Apply heat. Heat can relax your joints and muscles and relieve any pain you have before you begin. Heat treatments — warm towels, hot packs or a shower — should be warm, not painfully hot, and should be applied for about 20 minutes.
- Move gently. Move your joints gently at first to warm up. You might begin with range-of-motion exercises for five to 10 minutes before you move on to strengthening or aerobic exercises.
- Go slowly. Exercise with slow and easy movements. If you start noticing pain, take a break. Sharp pain and pain that is stronger than your usual joint pain might indicate something is wrong. Slow down if you notice inflammation or redness in your joints.
- Ice afterward. Apply ice to your joints as needed after activity, especially after activity that causes any joint swelling.
- Take it easy and slowly work your exercise length and intensity up as you progress. Don’t exert more energy than you think your joints can handle.
- Avoid exercise during arthritic flare-ups or only perform range of motion exercises.
- Some pain after exercise is normal, but if your pain lasts longer than two hours after you exercise, you were probably exercising too strenuously. Talk to your doctor about what pain is normal and what pain is a sign of something more serious.