Arthritis Awareness Month: Don’t Fear Exercise

Living with arthritis is a challenge, so I want to give you my perspective as a physical therapist and a patient. Information related to the benefits of exercise and weight loss for people with arthritis is easy to find on the internet, same for medical management; however, support for living a full life with the disease is not as readily available.

My perspective comes from active family members and friends of all ages with various forms of inflammatory arthritis. I was a competitive swimmer through college and have had osteoarthritis (hips, hands, feet) since my 30’s. My daughter, now in her 30’s, was a competitive Nordic ski racer in high school and college and carries a diagnosis of rheumatoid arthritis. She is gradually working her way back to Nordic skiing for recreation. My husband with inflammatory osteoarthritis competes in in-line skate marathons and has a winter routine that includes near-daily 5 to 15-kilometer Nordic ski loops. My young friend was diagnosed with ankylosing spondylitis at age 15. At 21, she decided to ignore recommendations to avoid sports and in her 30’s, continues to play soccer.

Many of us with arthritis are told to cut back on activity and increase rest to protect the joints. Instead, the message should be to increase your activity level and exercise at an intensity that increases strength to support your joints. Start with a physical therapist to guide your plan and assure proper neuromotor control and form to avoid injury. The evidence is there to support exercise and muscle strengthening, along with adequate sleep for improved function and life satisfaction.¹ The exercise dose (how often, how long, how intense) will depend on the type and severity of your arthritis.

My family members and friend with arthritis include 2 physical therapists, an occupational therapist and a family physician with a sports medicine specialty. We negotiate an active lifestyle by avoiding the fear of exercise-induced joint deterioration. Studies have shown no evidence of accelerated osteoarthritis from most forms of exercise.² This knowledge allows us to be as active as we can and want to be. Functional ability on the day following exercise should guide your exercise dose, not necessarily pain. Build up your activity level slowly, cutting it in half and rebuilding if you have an exacerbation or experience trouble carrying out your daily routine on the day after an exercise session. There is no hurry.

For me, regular weight lifting, 3 to 5-mile walks, and yoga generally keep arthritis stiffness and pain at a manageable level and allow me to downhill ski and hike. I am not embarrassed to use hiking poles to allow me to go farther faster. My husband and I have 1 knee and 3 hip replacements between us. The fear of making the decision to have surgery before we recognized a decline in activity level was highlighted by our daughter, a physical therapist specializing in mobility and pain, who said, “You’ll only be a year weaker, Dad.”

Lynn Millar, PT, Ph.D., FACSM in an article written for the American College of Sports Medicine says

“If you have arthritis, you may think that exercise will increase your joint pain or speed the joint breakdown; however, regular exercise is actually beneficial for the person with arthritis. Often the joint pain and stiffness that are the primary symptoms of arthritis cause us to reduce our activity. Unfortunately, this actually will lead to an increase in symptoms and loss of normal function, and may even speed the breakdown within the joint”.³

I recommend that you read the rest of this article as it discusses findings that those with arthritis exercising regularly have fewer joint replacements, and it discusses guidelines for exercise type and frequency for people with arthritis.

The “take home” message is keep moving, especially if you have arthritis since moving is essential to life. Everyone has a drive to maintain activity, whether it is cooking, gardening, biking or downhill skiing. While it is certainly easier to remain active when you don’t have arthritis, some level of activity makes life worthwhile and improves health

Deb Roberts, PT

Deb Roberts, PT, has practiced physical therapy for 44 years and her current interests focus on decreasing pain and improving mobility in the pediatric population. She lives with arthritis while working to maintain an active lifestyle that includes mountain hiking, adventure travel, and skiing. To help her and hopefully others with this journey, she has recently begun blogging about overcoming barriers to an active lifestyle. Please feel free to contact her at debroberts2@gmail.com or through her blog, www.agingactivelytips.com

References
1 Bherer, Louis, et al. A Review of the Effects of Physical Activity and Exercise on Cognitive and Brain Functions in Older Adults. Journal of Aging Research, vol. 2013, 2013, pp. 1–8., https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3786463/. Accessed 17 May 2018.

2Bosomworth, Neil J. Exercise and Knee Osteoarthritis: Benefit or Hazard? Can Fam Physician, vol. 55, no. 9, 2009, pp. 871–878., www.ncbi.nlm.nih.gov/pmc/articles/PMC2743580/. Accessed 17 May 2018.

3Exercise and Arthritis. American College of Sports Medicine, 7 Oct. 2016, www.acsm.org/public-information/articles/2016/10/07/exercise-and-arthritis. Accessed 17 May 2018.