by Zareen Afridi | 07 OCT 2017
Arthritis is a common problem in India that involves pain, swelling, inflammation or deformity in joints. Arthritis has various forms depending upon the severity, such as Rheumatoid Arthritis, Osteoarthritis, Reactive Arthritis, Calcium Deposit Arthritis, etc. Person suffering from Arthritis experiences joint and muscle pain, weakness and fatigue due to which exercising becomes difficult and hence avoided. But this further worsens the situation and leads to stiffness of joints and muscles. Over time, joint movement is totally hindered and causes permanent deformity.
In an interview with Dr. Madhuri, Consultant Rheumatologist, CARE Hospitals, Hi-tech City :
Q. How is exercising beneficial for Arthritis patients?
A. Exercising has tremendous benefits to the body in general. The benefits of exercising are enumerated as
Excellent pain reliever
Increases strength, endurance and motor skills
Improves balance of the body
Reduces pain, disability and joint damage
Improves mood and quality of life
Physically active person has less chances of developing Arthritis
Regular exercise lowers risk of hypertension, Osteoporosis, Obesity, Type 2 diabetes and cardiovascular diseases.
Q. What are the prerequisites before exercising?
A. Following some rules before you hit the exercising regime can prove beneficial in gaining maximum output from the energy and time invested:
Stay positive and motivated at all times
Exercise should be done on a regular basis and continued for a long term
You can set modest, achievable goals that can help you stay on track
Set the right time for exercising, weather early morning or evening
Always exercise with an empty to moderately filled stomach
Group exercising is another fun-filled way of exercising and recreation
Q. What are the types of exercise programs?
A. Exercise can be broadly divided into four sub heads, namely flexibility, strengthening, aerobic and balance exercises.
Flexibility exercises are used to improve flexibility of the body. It involves stretching of joints that decrease rigidity / stiffness of joints and improve posture. This is usually the first step in exercising for those who have been inactive, have restricted joint motion or are in the recovering phase of joint replacement surgery.
Strengthening exercises are endurance exercises especially beneficial for Arthritis patients. They are for empowering the muscles that alleviate the pressure on joints. Pushing or pulling against weight machines are some of strengthening exercises. It is advised to follow these exercises twice a week along with aerobic exercises. Resistance can be added gradually, depending upon the progress.
Aerobic exercises aim to benefit heart and lung functions as they involve quick and rapid breathing. For Arthritis patients, aerobic exercise can help in weight control, mood improvement and excellent sleep. Walking, cycling, swimming or house work are best forms of aerobic exercise.
Balance exercises are helpful in maintaining good posture, joint position sense (proprioception), coordination and relaxation. If you have an unstable joint, weakness or are prone to falls, you must focus on balance exercises. Examples of balancing exercises are Yoga and Tai Chi. Other easy to do balance exercises are backward walking, walking on heels / toes, maintaining balance on single foot and so on.
Q. What are some of the other informal ways one can exercise?
A. For most Arthritis patients, joining a regular exercise program is not possible. Hence some changes can be brought about in the daily routine that can better the problem of joints in Arthritis patients.
Use stairs instead of elevator
Walk to the local grocery store instead of driving
Vouch for longer route while walking from one place to another
Park your vehicle further away from where you normally do
Don't stop while talking on the phone, keep walking but keep a watchful eye.
Q. How much exercise is necessary?
A. On an average, 30 - 40 minutes must be secluded for exercising. If exercising at a stretch of 30 minutes is not possible, it can be divided into smaller segments. Moderate exercises that can be done within 30 to 40 minutes include walking, cycling, swimming, doubles tennis, social dance, Tai Chi / yoga. Those who do not have inflammatory Arthritis can go for Vigorous intensity exercises like jogging / running, singles tennis, swimming, jumping rope, aerobic dance, etc.
Q. Should the patients with Arthritis exercise?
A. Yes, even though it may feel uncomfortable and painful initially, regular and dedicated exercising in the long run has been helpful in alleviating joint pain, improved sleep and better day today jobs.
Q. What steps to take before beginning an exercise regimen?
A. First and foremost, consult with your Rheumatologist whether exercising is safe for you or not. Ask for specific sports / exercises that are to be avoided initially. Your exercise sessions should take place in the supervision of a Physiotherapist to prevent accidents. And lastly, brace yourself for some pain and discomfort because the muscles will feel a new environment. Later in the long run, this pain and discomfort will subside.
Q. How can safe exercising be ensured for Arthritis patients?
A. Exercising under supervision assures and encourages the patients to perform better and also boosts their confidence. Sensibly planned exercises are not harmful and its benefits far outweigh the cons of inactivity.
Warm up before you begin exercising. Cool down in the last 5 minutes of exercise
Wear proper shoes of right size and stability If you have hip, knee, ankle or foot problems, start by walking on leveled surfaces
Avoid sudden and jerky movements and high impact exercises
To decrease the impact on joints, aquatic exercise can be opted
Wear splints and braces for joint protection
Q. What if a flare erupts?
A. Acute flare is when an increased, sudden pain erupts that may tempt to abolish the exercise completely. In such a situation, decrease the intensity of exercise. Exercise at sitting position can be done. Range of movement exercises can be done as per the tolerance capacity. Duration can also be minimised. Take rest after the exercise session. Ice pack can be applied to the swollen areas. Pay more attention to joint protection gear. You can also change or modify your exercising regimen if pain persists. Also check if you are exercising the right way.
Q. What are red flags?
A. These are danger signs that indicate exercise should be stopped completely. Consult your doctor immediately if one of the following happens:
A sudden, severe and shooting pain rises that does not subside
If joint becomes severely painful or inflamed after a particular exercise
If pain, congestion and pressure develops in chest or arms
Sense of vomiting, dizziness, fainting or palpitations occur
For Appointments : Dr. Madhuri, Consultant Rheumatologist, CARE Hospitals, Hi-tech City.
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