Exercise and Rheumatic Diseases

improving through moving

Jennifer Horonjeff, MS, PhD CandidateErgonomic Consultant, Certified Pilates Instructor

jhoronjeff@gmail.comProgram of Ergonomics and Biomechanics

Occupational & Industrial Orthopaedic CenterNew York University

Some Considerations

What are your complaints about the disease?

What are your excuses for not to exercising?

Do you feel comfortable talking about exercise with your doctor?

A little bit of history….

Bone

Responds to physical demand

Bone mineral density improves with exercise

Cartilage

Cyclical loading shown to have anti-inflammatory properties and may dampen cartilage destruction

Muscle

Rheumatic diseases affect muscles too!

Motor Control

• Reaction Time

• Muscle activation strategies

• Proprioception

• Balance

THE BODY CAN REWIRE!

People with inflammatory arthritis and fibromyalgia who exercise regularly, complain of less pain and fatigue!

Pain and Fatigue

Inactivity Cycle

Lack of Physical Activity

•Deconditioning of muscles•Increase weight•Activities require greater effort•Increase chance for injury•Increase in pain

Physical Activity Recommendations

Centers for Disease Control and Prevention and American College of Sports Medicine

Accumulate at least 30 minutes of moderate intensity physical activity on most, if not all days of the week.

30 MIN DOES NOT NEED TO BE CONSECUTIVE!

Start slow

Listen to your body

Find range where you feel good without over-doing it and you’ll be

more likely to stick with it!

No one program is right for everyone

Is it safe?

Types of Exercise

Strength-conditioningAlone not able to bolster bone mineral density

Dynamic high-intensity exerciseReduction of disease activity greater than usual care

Non-weight bearing exercises Best when baseline radiologic damage exists

HydrotherapySome people have experienced feeling better than did with land

exercises

Enjoy it!

MUST BE ENJOYABLE!

Fitness programs with social or self-efficacy component had greater compliance

Goals

During a flare: PRESERVE!

When under control: Improve fitness and participation in activities

Stretching

Aids in release of tightened muscle bands and provides pain relief

Stretch to point of resistance and hold stretch•Allows Golgi tendon to signal muscle fibers to relax

DO NOT stretch to point of increased pain—causes muscle fibers to contract and have opposite effect.

NO BOUNCING!

Physical Benefits

•Weight loss

•Improve aerobic capacity

•Improve cardiovascular health

•Improve range-of-motion

•Reduction in pain

Overall Benefits•Improve functional abilities

•Improve quality of life

•Improve sense of well-being

•Improve quality of sleep

•Increase energy

•Reduce anxiety and depression

•Stimulate endorphins

What is your excuse not to exercise?

“The design of work in relation to the capabilities of people”

People

ErgonomicsErgonomics

Ergonomic Risk Factors

Ergonomics InjuriesMusculoskeletal DisordersMusculoskeletal Disorders

• Acute Trauma Disorders (ATD’s)Acute Trauma Disorders (ATD’s)• Injuries which occur instantaneously due to

a known cause

• Cumulative Trauma Disorders (CTD’s)Cumulative Trauma Disorders (CTD’s)• Injuries occurring over time due to

repeated exposure to various risk factors

Identify the Issues

Copyright 2008 © United States Ergonomics

Normal and Maximum Working Area

Work Envelope and Work Envelope and ReachReach

Keyboard & MouseThe Neutral Wrist Position = StraightThe Neutral Wrist Position = Straight

AVOID Wrist AVOID Wrist bending bending

Hand Stress vs. posture

Shoulder Posture vs. Shoulder Posture vs. Strength Strength

Shoulder Abduction

Line of sight

April 13, 2023

• The viewing angle will determine the head/neck posture

Neck Posture

Headset Preferred Not as Effective

Forces on the Spine

Spine Stress

Vs.

Lifting Posture

Poor Good

Pressure on spinal discs

Around the house

Be kind to your feet!

Footwear

So, get up…

…and get moving!