Exercise and losing weight are the most important things an arthritis patient can do, says Bernard Rubin, DO, director of the rheumatology fellowship at the University of North Texas Health Science Center in Fort Worth. But he finds most of his patients don't see getting in shape as part of their treatment plan.
"The problem is that people are very harried, work aggressively, and run around taking care of family. They confuse that with exercise," says Dr. Rubin, "which it's not."
Lessening your load and strengthening your joints
For every unneeded pound of body weight, a knee joint, for example, bears an extra three pounds of pressure. "Losing 10 pounds will take 30 pounds off your joints," says Dr. Rubin. "So what people need to understand is that if they're overweight by 50 or 100 pounds, losing 10 or 15 pounds will make a difference."
Exercise is one way to lose weight, but it has other benefits. Stretching, done carefully, can be a good pain reliever. Increased strength can affect the progression of the disease and the intensity of the pain.
"It's good for improving the mobility of the joint," says Honolulu-based rheumatologist James McKoy, MD, chief of the pain service division at Kaiser Permanente in Hawaii. "The stronger the ligament and muscles are around the joint, the less instability, the less pain, and eventually, as time goes on, less deformity."
How to start when it hurts
Not all osteoarthritis sufferers can tolerate much exercise. For many, the onset of the disease has meant cutting back on physical activities.
"When we first moved to Fort Lauderdale we'd go ride our bikes and take long walks," remembers Judy Street, 67. "But after a while I just couldn't do it. I couldn't jump, and I couldn't run. I could maybe walk three blocks but it would hurt. And when I stepped wrong it was like a knife right below my knee."
Dr. McKoy admits many patients are discouraged. "Patients with arthritis of the back, hip, or knee will say 'No, I can't exercise. It'll cause too much pain.'"
"But those people can do exercise in a pool, for example, preferably a warm-water pool, which we call aqua therapy," says Dr. McKoy. "Or they can be taught sometimes by physical therapists how to do exercises sitting in a chair, to do just stretching exercises, or strengthening exercises."
The first steps
Here are Dr. Rubin's rules for safe and effective arthritis exercise.
- Look at exercise like a prescription.
- Find a controlled, prescribed time period for appropriate exercise.
- Start with short and gentle exercise routines that may seem minimal at first.
- A journey starts with small steps.
- "Do a little bit, but do it well."
Ultimately Dr. Rubin sees benefits far beyond physiology. "I think people who exercise have increased endorphins, a better self-image, and a sense of accomplishment. The pain is not consuming their life, they don't blame the arthritis. It's a psychological shift from being a pain patient to being a patient or person who happens to have some pain."