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Osteoarthritis: Exercising With Arthritis

Table of Contents

Osteoarthritis: Exercising With ArthritisAppendixTopic Images

Hand Exercises for ArthritisKnee Exercises for Osteoarthritis

Osteoarthritis: Exercising With Arthritis

Exercise may make you feel better, reduce your joint pain, and make it easier for you to doyour daily tasks.A common symptom of osteoarthritis is pain after activity, which may make you not want toexercise. But you can use heat and cold therapy or take pain medicines to help relieve painand make it easier for you to exercise and stay active.Exercise should be balanced with rest and joint care. If your joints hurt or you have redness orswelling, rest your joints, then try a little exercise. You might also think about using assistivedevices, such as splints or braces, for a short time to protect your joints.Sharp or unusual pain may be a sign of injury. Talk to your doctor if you have new pain or ifyour pain is a lot worse.Always check with your doctor before you start an exercise program.

How to exercise if you have osteoarthritis

How to exercise if you have osteoarthritis

There are several types of exercises that you can do to help keep your muscles strong and reducejoint pain and stiffness:

Aerobic activity strengthens your heart and lungs and builds your endurance. For aerobic

exercise, you can:Walk outdoors through your neighborhood or on city paths. Or you can walk indoors ona treadmill or at the mall.

Do water aerobics. You might try walking in water that is up to your waist or your chest(if walking outdoors or indoors isn't comfortable for you). The water helps take theweight off painful joints. And it provides some resistance.Swim at your local health club, YMCA, or neighborhood pool. Many locations offerclasses designed for people with arthritis. Swimming is a great choice for people whohave hip or knee arthritis, because water takes weight off the joints while also providingsome resistance.Bike outdoors or inside on an indoor bike.Be more active in your daily routine. Vacuuming, housework, gardening, or yard workcan all be aerobic.

Note: Start slowly. For example, do 10 minutes of activity at a time, 1 or 2 times a day. Then

work your way up to where you can do it for a longer time. Aim for at least 2½ hours ofmoderate activity a week. One way to do this is to be active 30 minutes a day, at least 5 daysa week.Strength exercises improve and keep the muscles in your body strong. Strength exercises

include:Lifting light weights or dumbbells or using elastic tubing. You can use these at yourlocal health club, or you can buy them to use at home.Using an exercise machine at home or weight machines at your local health club.

Note: Before you start to do strength exercises, ask a physical therapist or your doctor whichexercises would be best for you. And ask how to do strength exercises safely so you don'tget hurt. Exercise books and videotapes can also show you how to do strength exercises theright way.Range-of-motion exercises help keep you flexible and prevent more damage to your

joints. Range-of-motion exercises include:Moving each joint through its full motion. Move each joint as far as you can in eachdirection without causing pain, 8 to 12 times each day. Remember to do all the littlejoints, such as those in your fingers.Long, slow stretches to keep the soft tissues around the joints flexible. For example,stretches for the legs include calf stretch, quadriceps (thigh) stretch, and hamstring(tendons in the back of the knee) stretch.Exercises that target a certain joint such as the knee in order to improve motion in thatjoint and prevent more damage. An example of this is a quadriceps stretch to keepyour knees flexible.

Note: Exercises that stretch and strengthen the muscles and joints can help older adultskeep their balance, which can help prevent falls.

Several types of exercises can help you stretch and strengthen your hands (See figure in appendix)and reduce knee pain and stiffness (See figure in appendix) .

If you have arthritis of the knee, you may be able to reduce the stress on your knee by wearing theright shoes or by adding insoles to your shoes. Talk to your doctor or physical therapist about thefootwear that would be best for you.

Taping the kneecap in a certain position may also help reduce pain. If you and your doctor find thattaping helps you, you can learn how to put the tape on by yourself.

If an activity makes you feel sore, try something else. You can also change how you do the activity.

Here are some things you can try:

Rest between each exercise or activity.Decrease your speed.If you like to walk or swim, go a shorter distance. You might take two or three short walks in aday rather than one long walk.Do a shorter workout, then rest and do a little more later.Lift less weight.

Ask your physical therapist or doctor

Talk to your physical therapist or doctor before you start an exercise program. Ask what kind ofexercise is best for you. He or she can help you learn the right way to do the exercise. Also ask:

How to exercise if a joint is sore or if a joint is swollen.Whether you should take nonsteroidal anti-inflammatory drugs (NSAIDs) to make it easier foryou to exercise or use ice after you're done exercising. Be safe with medicines. Read andfollow all instructions on the label.

For more information, see:

Quick Tips: Exercising Safely With Arthritis.

What to do when your joints hurt

If your joints hurt, try to rest them. Use assistive devices that can help you do your daily activitieswith less stress on your joints. Your doctor may suggest over-the-counter medicines to help reducepain in your joints.

Other steps to help get rid of pain and stiffness include heat or cold therapy. You can use heat andcold therapies before or after exercise. It just depends on what works better for you.

For heat therapy, you can:

Put a warm towel on the joint that hurts.Put a hot pack on the joint that hurts.Take a warm bath or shower.Get water therapy in a heated pool or whirlpool.

Cold therapy may relieve pain or numb an area. Use a cold pack (such as a bag of ice or frozenvegetables wrapped in a thin towel).

It's still important to try to exercise a little, after your pain is relieved. Walking is a great way to stayactive. If you have pain when you walk, or if you want to switch back and forth between walking andother exercises, try walking in waist- or chest-deep water, swimming, or riding an indoor bike.

References

Other Works Consulted

Stitik TP, et al. (2010). Osteoarthritis. In WR Frontera et al., eds., DeLisa'sPhysical Medicine and Rehabilitation: Principles and Practice, 5th ed., vol. 1, pp.781–809. Philadelphia: Lippincott Williams and Wilkins.

Credits for Osteoarthritis: Exercising With Arthritis

By Healthwise Staff

Anne C. Poinier, MD - Internal Medicine

Joan Rigg, PT, OCS - Physical Therapy

Last Revised May 9, 2013

Appendix

Topic Images

These exercises can help stretch and strengthen the muscles in your hands and fingers and reducepain and stiffness. Before you try any of these exercises, talk to your doctor or physical therapist.He or she can help design an exercise plan that is best for you.

If you feel pain when you do these exercises, stop. Ask your doctor or physical therapist if there areother exercises that you can do to keep your muscles flexible and strong.

Figure 1

Tendon glides for hands

This exercise is a gentle way to move the joints and tendons in your hands. Dothese movements until you feel a mild stretch. Never push to a strong stretch.

In this exercise, the steps follow one another to a make a continuous movement.

1. Hold your hand straight with your fingers and thumb pointing up. Your wristshould be relaxed, following the line of your fingers and thumb.

2. Curl your fingers so that the top two joints in them are bent, and your fingerswrap down. Your fingertips should touch or be near the base of your fingers.Your fingers will look like a hook.

3. Make a fist by bending your knuckles. Your thumb can gently rest against yourindex (pointing) finger.

4. Unwind your fingers slightly so that your fingertips can touch the base of yourpalm. Your thumb can rest against your index finger.

5. Move back to your starting position, with your fingers and thumb pointing up.

Repeat the series of motions 10 times with each hand.

Figure 2

Alternating finger touch for hands

This exercise is a gentle way to move the joints and tendons in your hands. Dothese movements until you feel a mild stretch. Never push to a strong stretch.

1. Hold your hand with your fingers and thumb spread out, facing upward. Yourwrist should be lined up with your fingers and thumb.

2. Holding your hand in its spread-out position, take your first finger and thumb,and curl them until their tips touch. This will look like an "okay" sign, but try tokeep your other fingers straight and pointing upward as much as you can.

3. Repeat the exercise with your second finger and thumb. Again, your fingersthat aren't being used should point upward.

4. Repeat with your third and fourth fingers.

Do this exercise 10 times with each hand. Each exercise includes all fingers.

These exercises can help stretch and strengthen your leg muscles and reduce knee pain andstiffness. Before you try any of these exercises, talk to your doctor or physical therapist. He or shecan help design an exercise plan that is best for you.

If you feel pain when you do these exercises, stop. Ask your doctor or physical therapist if there areother exercises that you can do to keep your muscles flexible and strong.

Figure 3

Knee flexion with heel slide

1. Lie on your back with your knees bent.2. Slide your heel back by bending your affected knee as far as you can. Then

hook your other foot around your ankle to help pull your heel even fartherback.

3. Hold for about 6 seconds, then rest for up to 10 seconds.4. Repeat 8 to 12 times.5. Switch legs and repeat steps 1 through 4, even if only one knee is sore.

Figure 4

Quad sets

1. Sit with your affected leg straight and supported on the floor or a firm bed.

Place a small, rolled-up towel under your knee. Your other leg should be bent,with that foot flat on the floor.

2. Tighten the thigh muscles of your affected leg by pressing the back of yourknee down into the towel.

3. Hold for about 6 seconds, then rest for up to 10 seconds.4. Repeat 8 to 12 times.5. Switch legs and repeat steps 1 through 4, even if only one knee is sore.

Figure 5

Straight-leg raises to the front

1. Lie on your back with your good knee bent so that your foot rests flat on thefloor. Your affected leg should be straight. Make sure that your low back has anormal curve. You should be able to slip your hand in between the floor andthe small of your back, with your palm touching the floor and your backtouching the back of your hand.

2. Tighten the thigh muscles in your affected leg by pressing the back of yourknee flat down to the floor. Hold your knee straight.

3. Keeping the thigh muscles tight and your leg straight, lift your affected leg upso that your heel is about 12 in. (30 cm) off the floor. Hold for about 6seconds, then lower slowly.

4. Relax for up to 10 seconds between repetitions.5. Repeat 8 to 12 times.6. Switch legs and repeat steps 1 through 5, even if only one knee is sore.

Figure 6

Active knee flexion

1. Lie on your stomach with your knees straight. If your kneecap isuncomfortable, roll up a washcloth and put it under your leg just above yourkneecap.

2. Lift the foot of your affected leg by bending the knee so that you bring the footup toward your buttock. If this motion hurts, try it without bending your kneequite as far. This may help you avoid any painful motion.

3. Slowly move your leg up and down.4. Repeat 8 to 12 times.5. Switch legs and repeat steps 1 through 4, even if only one knee is sore.

Figure 7

Quadricep stretch (facedown)

1. Lie flat on your stomach, and rest your face on the floor.2. Wrap a towel or belt strap around the lower part of your affected leg. Then

use the towel or belt strap to slowly pull your heel toward your buttock until youfeel a stretch.

3. Hold for about 15 to 30 seconds, then relax your leg against the towel or beltstrap.

4. Repeat 2 to 4 times.5. Switch legs and repeat steps 1 through 4, even if only one knee is sore.

Figure 8

Stationary exercise bike

If you do not have a stationary exercise bike at home, you can find one to ride atyour local health club or community center.

1. Adjust the height of the bike seat so that your knee is slightly bent when yourleg is extended downward. If your knee hurts when the pedal reaches the top,you can raise the seat so that your knee does not bend as much.

2. Start slowly. At first, try to do 5 to 10 minutes of cycling with little to noresistance. Then increase your time and the resistance bit by bit until you cando 20 to 30 minutes without pain.

3. If you start to have pain, rest your knee until your pain gets back to the levelthat is normal for you. Or cycle for less time or with less effort.

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