When their joints are feeling stiff and painful, people with osteoarthritis may find the idea of heading out for a walk or a bike ride daunting. But the benefits of physical activity for those with the disease are far-reaching. Exercise reduces joint pain, boosts energy, increases strength and flexibility, and improves mood.
“Many people with arthritis are skeptical or fearful of exercise,” says physiotherapist Gregory Noonan, physiotherapy practice coordinator at Vancouver General Hospital’s Mary Pack Arthritis Program. “They may be concerned it will increase their pain and further damage their joints.
“In fact, the opposite is true,” Noonan says. “Exercise has been shown to be safe with all types of arthritis and certainly osteoarthritis, which is the most common form. Although exercise is ideal, any physical activity confers significant benefits, especially for those who tend to be more sedentary. Simply doing some gardening, playing a round or golf, or even just getting off the couch are great ways to start. Even the smallest step is a step in the right direction.”
Other benefits of regular physical activity include increased range of motion of the joints, improved balance, reduced risk of falls, stronger bones, healthier body weight, better sleep, and improved functional ability.
Be sure to talk to your doctor and other members of your health-care team before starting or changing an exercise routine. And progress gradually in terms of duration and intensity. Not only will this reduce the risk of injury, Noonan says, but it will also make it more likely that you’ll stick with a program.
The Canadian Physical Activity Guidelines recommend adults accumulate at least 150 minutes of moderate to vigorous exercise per week in bouts of 10 minutes or more to build endurance. “For those individuals who are more sedentary, lesser amounts can still confer significant health benefits,” Mr. Noonan notes.
Strengthening exercises that use all the major muscle groups are also vital when it comes to managing arthritis. Also called resistance activities, these are recommended two to four days a week, as they enhance the muscles’ ability to support and stabilize joints.
Stretching is important as well to maintain and develop flexibility and improve joint function.
The top three low-impact endurance exercises for arthritis
Endurance activities improve circulation and help you increase your stamina so you can work out for longer periods without tiring as quickly. Low-impact activities, which don’t stress musculoskeletal tissues, are easiest on the joints.
Walking
Walking puts far less stress on the joints than running and is considered much safer for those with arthritis. It also enables the stretching the muscles and joints of the back and legs that can become stiff from sitting for long periods.
A major advantage of walking is that it can be done virtually anywhere, indoors or out, at any time of day. Many Canadians take to mall-walking in the winter.
“There’s no cost and no training; it’s the most accessible type of exercise there is,” Noonan says.
For those who feel unsteady on their feet, walking poles (also known as Nordic walking or trekking poles) have become popular. There are even groups and classes geared specifically to those with arthritis. If you have hip, knee, ankle, or foot problems, the Arthritis Society recommends checking with your health-care provider to ensure that walking is an appropriate activity for you.
Cycling
Whether you’re cruising around a beautiful park or using a stationary bike at home or at your local gym, cycling is a terrific cardiovascular workout that strengthens leg muscles.
“It’s a very natural, smooth motion,” Noonan says. “It has less impact on the hips and knees than walking.”
Be sure to have a knowledgeable fitness or health professional adjust the seat and handlebars so that you have proper posture and don’t end up overstretching muscles.
Those with back pain may want to consider a recumbent bike, which allows you to sit up while cycling. The Arthritis Society cautions that people with knee problems should start slowly and use the least amount of resistance possible by ensuring the gears are at the lowest setting.
Swimming
The water adds resistance, boosting muscle strength and endurance without putting joints under strain. The water’s buoyancy, meanwhile, helps relieve pain and stiffness, especially if the water is warm.
Contrary to popular thinking, you don’t have to be a good swimmer to exercise in the pool. You can stay in the shallow end, hold onto the side, or use a floatation device like a buoyancy belt, which is commonly used for deep-water running.
“Swimming is very popular for those with significant arthritis,” Noonan says. “The cushioning effect of the water makes the exercise or motion much more comfortable. It can be traditional swimming, a modified exercise class at the local rec centre, or even walking in the pool.”
What to do if you’re having a flare-up
If a joint is hot, painful, or swollen, overuse may aggravate the inflammation. Here’s where things can get tricky: vigorous activity should be avoided, but you need to continue moving your joints to keep them healthy.
When a flare-up occurs, the Arthritis Society recommends doing any range-of-motion exercises that you’ve been prescribed, moving each joint slowly and gently. Three repetitions done daily within your pain-free range may even shorten the flare-up. As the flare-up subsides, you can gradually get back to normal activities but start out slowly and decrease intensity.
General stretches for arthritis
“People with painful joints often adopt certain postures that can help reduce stress or tension upon their joints, which generally means less pain,” Mr. Noonan notes. “But because people favour these positions for extended periods, certain muscle groups can become tight over time.”
Stretches are most effective when they’re done when muscles are warm, such as after exercise (following your walk, bike ride, or swim, for instance), or after a shower.
The ideal duration is a total of 60 seconds per muscle group during a session. Stretch at least two to three times a week, though the greatest benefits come with daily repetition. “A stretch should be held at the point of tightness or slight discomfort,” Mr. Noonan says.
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Hip flexor stretches: Tight hip-flexor muscles can cause pain in the hips. The most important consideration in this stretch is to protect your back by tightening or drawing in your stomach muscles. Also, be sure to avoid any rotation of the spine or pelvis.
Lie on your back on a flat surface such as a bed. Gently pull one leg up toward your chest, with your hands behind the back of the leg, and let the other leg extend and drop to the floor.
Hamstring stretch: Often, pain in the knees results from tight hamstrings.
You can do this sitting in a chair or on the side of a bed. Extend one leg out in front of you and point the toes up toward your nose. Hinge at the waist to bend forward while keeping your leg and your back as possible. (Avoid bending the knee if possible, and don’t round the back.)
Wrist stretches: Flexing and extending the wrist can help relieve pain and stiffness. To flex your wrist, lift fingers up toward the ceiling; you can use the other hand to help keep the fingers up. Hold before extending your wrist by pointing your fingers toward the floor.
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