• Even if joints are painful, there are ways to start an exercise program without causing more pain.  If your muscles are weak, a good first step is to buy a joint fitting elastic support.  Products like ACE knee brace or even KT tape (Kinesiology tape) can provide a joint with solid structural support.  A wide variety of elastic knee or elbow support devices exist and can give you a bit more confidence in getting back in motion.

    The key to exercise when you have joint discomfort is to find low-impact activities, including cycling, swimming, and water aerobics. These activities can raise your heart rate to boost cardiovascular fitness, while not placing demands on your joints.

    Why Exercise is Important

    Moving your joints throughout the day strengthens the surrounding muscles and helps keep the tendons and ligaments flexible. Joint movement is the primary way nutrients are transported into and waste products removed from the cartilage, the material which protects and cushions the ends of the bones. Since cartilage does not have blood vessels, it is the squeezing action caused by joint movement that pushes nourishing vitamins, minerals, and blood inside the cartilage.

    Exercise Guidelines:

    • Exercise regularly for optimal benefits. If you exercise only two days a week you won’t build up the strength that you could by exercising daily. Be consistent, set a specific time to exercise each day.  Know what time of day you feel your best and try to target that time for 30-60 minutes of movement. Find an exercise buddy to help you be accountable for going daily!
    • Low intensity exercises should not be intimidating and instead should be the type that produces very little impact on your joints. These are usually the exercises that are relaxing, don’t leave you breathless, and can be used as the basis for helping you build strength in your joint area.
    • Exercise timing: The best time to exercise is when pain and stiffness are at a minimum. Some people with arthritis prefer exercising after morning stiffness subsides. Others dislike afternoon exercise sessions because their energy levels are lower as the day progresses. It’s a matter of personal preference. Exercise when it fits into your schedule, but program it into your calendar to assure yourself that you WILL do it!
    • Don’t overdo it, remember that the old adage, “no pain no gain” is a myth. Many strengthening and range-of-motion exercise programs suggest performing the exercises in sets of three to 10 repetitions, with each set repeated one to four times. No set number works for everyone. Your mantra should be 10 repetitions and see how you feel.

    Range-of-motion Exercises

    Range-of-motion exercises are gentle stretching exercises that aim to move each joint through their normal range of motion. An example of a good range of motion exercise would be arm circles. Rotating your arms in large full circles gives you the “full range of motion “ of your shoulders and arms. Go slow! There is no benefit from rushing through range of motion exercises.  Ankle rotations, shoulder rotations, wrist rotations are all examples of giving you full range of motion of that joint. Once you pick a joint and engage in the range of motion exercise, reverse the movement. Try to do the exercise 10 times.

    Strengthening Exercises

    Strengthening exercises are those movements designed to increase muscle strength for joint support, making them more stable and helping you move with less pain. The two types of strengthening exercises are isometric and isotonic.

    • Isometric exercises involve tightening the muscles, without moving the joints. An example of an isometric exercise would be to stand in a doorway and put your hands on either side of the entrance and push out. To begin, you can simply stand with your arms outstretched at your sides (you should look like a “T”) and push out.  The joint doesn’t move but you’re getting an excellent stretch while strengthening the joint that helps keep your arms in that position.
    • Isotonic exercises involve strengthening the muscles by moving the joints.  An example of an isotonic exercise is walking up and down stairs or simply sitting in a chair, raising your knee and extending your leg.

    Exercise Choices

    Your doctor should always be consulted before starting an exercise program. The amount and form of exercise you choose can include a wide variety.  You don’t have to do the same thing every day.  What’s important is that you do something daily!

    Here are some exercise options that are low impact and should be gentle on your joints:

    • Walking:  An aerobic activity, walking helps build strength, improves cardiovascular fitness, maintains joint flexibility, aids in strengthening bones to reduce the risk of osteoporosis.  The only thing you need is comfortable walking shoes.  Head out the door, look at your watch and walk for 15 minutes when you’re just getting started. Turn around and walk back to your starting point.  Gradually increase the distance over time.  Always walk at a pace that feels comfortable.
    • Tai Chi is a gentle martial arts exercise with origins in ancient China. While performing fluid and flowing circular movements, you can relax, maintain mobility, and improve range of motion and balance.  Again, the only thing you need are comfortable shoes and loose fitting clothes that let you move easily.

    Yoga can provide pain relief, relax stiff muscles, and ease sore joints. With controlled movements, stretches, and deep breathing, yoga can improve range of motion and strengthen muscles.  Do only what you can  – special yoga positions do not have been the key focus for you.  Talk to your yoga teacher about your joint discomfort so they know how to assist you.

    • Warm water exercise is an excellent way to build up strength and sooth stiff joints and muscles.   Some water programs offer an aerobic component or use stretchy bands and other equipment to work on muscle strength. By participating in the aerobic movements you’re increasing cardiovascular fitness while strengthening muscles and bone.
    • Bicycling outside or spinning indoors provides a solid low impact aerobic exercise option.  Excellent for cardiovascular    fitness as well as strengthening primarily the lower muscles and bones, cycling can be a fun social activity with friends or family.  Consider finding a Rails to Trails route near your home.  These trails made from old rail road beds offer soft bike paths that are usually flat and scenically beautiful.

    Most joint injuries occur when someone pushes themselves too hard or engages in physical activity that pounds the body against the pavement.  Avoiding combat sports or activities, heavy weight lifting, running, or activities that twist joints such as tennis, skiing, or racquetball will protect your joints.  Speaking of joint health, there’s a new iPhone and iPad app created by legendary quarterback Joe Montana and his partner, Joint Juice called “Throw with Joe,” designed for fun but also with a serious mission of raising funds for the non-profit Arthritis Foundation. Check it out and support arthritis research!

    There are plenty of activities to enjoy, so find some that appeal and start slowly.

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    Article by: Dr. Kristine Clark

    Dr. Kristine Clark is the Director of Sports Nutrition and Assistant Professor of Nutritional Sciences at Penn State University. She advises coaches, MD’s, athletic trainers, and administrators on policies regarding weight loss & gain, food and beverage choice, eating disorders, and supplement use in college athletes. She is an active member and Fellow in the American College of Sports Medicine and a member of the USOC’s Sports Medicine Advisory Board.

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