Fit & Proper: Exercises that help deal with arthritis

Many people use the term "arthritis" to refer to all rheumatic diseases. However, arthritis literally means joint inflammation - that is, swelling, redness, heat, and pain caused by tissue injury or disease in the joints and other supporting structures of the body such as muscles, tendons, ligaments and bones.

Exercise reduces joint pain and stiffness and increases flexibility, muscle strength, cardiac fitness and endurance. It also helps with weight reduction and contributes to an improved sense of well-being. Exercise is one part of a comprehensive arthritis treatment plan. Treatment plans may also include rest and relaxation, proper diet, medication and instruction about proper use of joints and pain-relief methods.

Researchers have found that people who do moderate, regular running have low, if any, risk of developing osteoarthritis. However, studies show that people who participate in sport involving high-intensity, direct joint impact are at risk of the disease. Sport involving repeated joint impact and twisting (such as baseball and soccer) also increase osteoarthritis risk. Early diagnosis, effective treatment and complete rehabilitation decrease the risk.

Three types of exercise are best for people with arthritis:

Range-of-motion (stretching) exercises help maintain normal joint movement, relieve stiffness and improve the flexibility of the muscles around the joint. Put the joints gently through their full range of motion once a day, with periods of rest, during acute systemic flares or local joint flares. Patients can talk to their trainer about how much rest is best during general or joint flares.

Strengthening exercises (like weight training) help maintain or increase muscle strength. Strong muscles help support and protect joints affected by arthritis. These exercises should be done every day. Strength training can be done with small free weights, exercise machines, isometrics, elastic bands and resistive water exercises.

Correct positioning is critical, else strengthening exercises can cause muscle tear, more pain and joint swelling.

Aerobic or endurance exercises improve cardiovascular fitness, help control weight and improve overall function. Weight control can be important for people who have arthritis. Some studies show that aerobic exercise can reduce inflammation in some joints. These should be done for 20 to 30 minutes three times a week - unless you have severe pain or swelling in your joints.

Discuss the exercise options with your doctor and wellness trainer. It is best to find a trainer who has experience of working with people with arthritis. The trainer will design an appropriate exercise programme.

QUICK TIPS

* Apply heat to sore joints to start the exercise programme.

* Stretch and warm up with range-of-motion exercises.

* Start strengthening exercises slowly with small weights. Progress slowly.

* Use cold packs after exercising.

* Add aerobic exercise. Consider appropriate recreational exercise.

* Ease off if joints become painful, inflamed, or red, and work with your doctor to find and eliminate the cause.

* Choose the exercise programme you enjoy the most.

* Work with the fitness trainer to adjust the exercise programme when you notice any of the following signs:

• Unusual or persistent fatigue
• Increased weakness
• Decreased range of motion
• Increased joint swelling
• Continuing pain (pain that lasts for more than one hour after exercising).

* "Too much, too fast, too soon" is not always the best policy. Remember, you are not competing with anyone but yourself. Work at your own pace and listen to your body.

Kiran Sawhney
Founder, Fitnesolution and New Delhi Tango School, New Delhi