Arthritis affects many older adults and is one of the most common conditions seen in classes for them. This article is designed to address the most frequently asked questions about exercise and arthritis. This material was the result of a question and answer session at a recent FEOAA (Fitness Educators of Older Adults Association) Special Population Workshop.
Q. Are there some guidelines that would be useful for a fitness professional working with someone with arthritis?
- First and foremost, exercise must be FUN and enjoyable. The best-designed therapeutic exercise program is of no use if it remains inside a desk drawer.
- Teach your client to listen to their body and DO what it tells them to do! Always remember the two-hour rule. If you hurt more 2 hours post-exercise than you did before you exercised, back off.
- Remind the client that it took them a long time to get into their current condition, and it will take awhile to improve. Help your client to set himself or herself up to succeed rather than fail.
- Never place other joints at risk while doing the exercise routine. Be mindful of the knees, hips, neck and low back regions.
- Lastly, keep in mind the benefit-to-risk ratio regarding every exercise. With this population, knowing and avoiding contraindicated exercises is a must.
What should be the goal of an exercise program for the person with osteo-arthritis?
Joint protection is always important in conjunction with avoiding pain. Flexibility is the key, in addition to a program of sensible strength training to lessen the load on the effected joint. Work toward improving functional fitness; that is, to be fit enough to do whatever your client wants whenever she wants.
For the person with arthritis, when is it appropriate to exercise and when isn't it? Do you have any fitness tips that we could share with our clients?
Most experts agree that rest is most prudent when a person is having a flare-up. However, if the therapist and doctor agree, gentle range-of-motion activities are acceptable. Otherwise, exercise needs to be part of the client's daily routine, just like good nutrition and proper usage of medication.
Fitness Tips For Clients With Arthritis:
- Exercise when you are having the least amount of pain.
- Exercise when you are not fatigued.
- Exercise when medication is having maximum effect, which DOES NOT MEAN USING MEDICATION TO MASK PAIN!
What exercises/activities should a person with arthritis avoid?
Much like the old joke—when the patient tells the doctor it hurts when I laugh, and the doctor says then don't laugh. No exercise should increase pain. It is generally believed that activities that place a heavy load on a joint are ill advised. Jogging on hard surfaces, full squats, overhead presses with heavy weights, biking with heavy resistance and even walking or water exercise without proper shoes can increase pain.
Why should someone who has arthritis exercise? Won't it wear out the joint even more?
It is important to keep in mind the many benefits of exercise. The following is a list of a few specific to arthritis:
- Proper exercise brings nutrients to the joint.
- Proper exercise helps protect the joint by improving the stability through increased strength of the muscles; this ultimately reduces the load on the joint.
- Proper exercise will improve range of motion.
- Proper exercise will assist to burn calories that may lead to fat loss that will decrease the load on the joint.
- Proper exercise may increase bone density, or at least retard its loss.
- Lastly, and maybe most importantly, proper exercise increases a person's feeling of self-efficacy which is very important to older adults.
Could you recommend any books or videos that discuss exercise and arthritis?
When looking for books and videos, always look at the credentials of the person and the advisory board. Time Life Medical has released an Arthritis Exercise Video and an excellent book, The Arthritis Helpbook by Dr. Lorig and Dr. Fries, which is currently available.
Time Life Medical Can Be Reached By Writing To:
Time Life Medical
1271 6th Ave.
New York NY 10020
The Arthritis Help Book is published by Addison Wesley Publishing and can be found at Amazon.com.