Exercise was once thought to increase pain and inflammation associated with arthritis. Specific exercise is now known to help reduce overall pain with no negative effects on disease activity or inflammation.
Benefits of Exercise
When exercise is done properly it can help to decrease pain, improve joint nutrition, and maintain mobility of the joints.
Exercise helps to improve muscle strength, joint stability, and maintain bone strength.
Exercise will also increase your fitness level, help you to lose weight, make you feel better about yourself, reduce stress and anxiety, and improve sleep.
How to Exercise Safely and Maximize Benefit
Just as medication is specifically prescribed for your individual issues, you should only do exercises that are appropriate for you. We recommend working with a physiotherapist to create a program that is safe and effective for you and your arthritis.
Be smart when doing your exercises: allow a warm up and cool down period, don’t over do it (start slowly), respect your pain, and use good posture.
If you experience mild pain use ice, heat, or time your medications to help you through your exercise period. Don’t forget to breathe on exertion during your exercise and monitor your joints for overuse or stress.
Don’t over-do it
Exercise should be enjoyable and pain free. If you feel pain or discomfort lasting more than 2 hours after exercising it is a warning that you have done too much and you should modify your program.
Other warning signs that you are doing too much include increased joint swelling, decreased range of motion, increased muscle weakness, and fatigue. Talk to your doctor or physiotherapist if you experience any of these problems.
See our article Exercising in a Flare for tips on how to safely exercise during a flare.
Make the most of it
It is always good to start with an exercise plan. Your physiotherapist can help you develop a plan which is specific and measurable. Your exercise program should be achievable and realistic and done within a set time.
Some people find the support of a partner beneficial to help keep motivated.
Choose a variety of activities so you don’t get bored and keep a diary of your progress. Above all, exercise should be fun; reward yourself for a job well done!
Types of Exercise
Range of Motion (ROM)
These types of exercises are intended to maintain full movement of your joints. They can also be helpful for reducing stiffness and pain.
To perform these exercises, move the joint through its full, available range and then return to the neutral position. For example, for the knee, extend your leg out straight and then bend your knee as far as it will comfortably go. There is no need to hold these.
Repeat these exercises 5–10 times for problem joints. Decrease this to 3–5 times if the joint is hot, swollen, or painful. These slow and gentle exercises are safe to do every day, especially on stiff joints. They will help to prevent joint contractures and alleviate morning stiffness.
These exercises help to build and tone your muscles surrounding the joints. Strong muscles help to absorb shock that is transmitted through your joint when doing activities keeping the joint stable.
Strengthening exercises can be progressed by either increasing the number of times they are done (repetitions), or increasing the resistance/weight. It’s important to only make one change at a time.
Strengthening exercises should be done 3–4 times per week to build muscle and 2–3 times per week to maintain the muscle. For power: Do higher weight, and low repetitions i.e. 6–8 repetitions. For endurance: Do lower weight, and higher repetitions i.e. 12–15 .
Start slowly, we generally recommend 1 set of 10 repetitions, 3–4 times per week. To progress build up to 2 sets of 10 reps, and then 3 sets of 10 reps.
When this becomes easy talk to your physiotherapist about adding weights, changing positions, or doing a more difficult exercise. Remember to have fun!
Stretching exercises help to increase flexibility of your joints. Flexibility refers to the amount of elasticity in the muscles and tendons.
A stiff or shortened muscle can interfere with the range of motion of a joint. A lengthened muscle can cause instability in the underlying joint. Ideally you want a balance between muscle tension and elasticity.
Always stretch after doing strengthening exercises. Stretches should be held for approximately 30 seconds and repeated 3–4 times, at least 3 times per week.
Aerobic exercise is aimed to improve the health of your heart and lungs.
Use the FITT principle:
- FREQUENCY: 3- 4 times/week of moderate intensity exercise.
- INTENSITY: Low to moderate intensity.
- TIME: Accumulation of 120 minutes/week in minimum of 10 minute bouts
- TYPE: Any dynamic, rhythmical activity that uses the large muscle groups and can be sustained for a minimum of 10 minutes i.e. walking, biking, swimming.
To monitor your heart rate, your target is roughly: 220 – age x 55-70% (the 55-70% range depends on if you are a beginner or advanced – a beginner would start at 220 – age x 55%, someone more advanced would use 220 – age x 70%). Watch for the level where you are able to speak normally while exercising.
Hydrotherapy refers to exercise performed in water. Water can be used for support, assistance and resistance. Water reduces the force on weight bearing joints such as hips and knees. General mobility is improved as there is less compression of the joints, less pain, and less muscle activity required with the buoyancy of the water.
Therapeutic pools are usually warmed to a temperature of 92-96 degrees Fahrenheit.
Benefits include: general relaxation, decrease in muscle tone and spasm, decrease in pain, and increase in flexibility of soft tissue.
Talk to your doctor to find out if exercising in warm water is safe for you. In warm water water it is difficult for the body to get rid of excess heat. Blood pressure may decrease and heart rate may increase. Vigorous exercise in warm water can increase the risk of working the heart beyond a safe margin.
Balance exercises are used for muscle coordination and body awareness. Repetitions will depend on the type of balance exercise you are doing.
Core stability exercises are designed to help re–educate the muscles responsible for stabilizing your “core”. The core of your body can be likened to the core of an apple. It is the inner most muscles responsible for stabilizing your back, pelvis and the rest of your body. They are recruited prior to doing any movement.