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Joint Efforts-Exercise and Arthritis: 
What Caregivers Need to Know

Exercise is beneficial to everyone and exercise is especially vital to patients who have arthritis. Over 40 million Americans (1 in 7) have arthritis. Chances are you tend to be an arthritic individual or will in be the future. Let's explore the role of exercise in regards to caring for the arthritic population.

Years ago, doctors and therapists believed exercise would exacerbate the already painful joints of the arthritic patient. New research is now yielding a much different picture. Exercise helps get stiff joints moving, strengthens surrounding muscles for joint integrity, improves circulation, flexibility, builds stronger bones and cartilage and provides more strength for daily chores. Exercise also provides greater self-esteem, a component lacking by many suffers of arthritis. Many patients feel controlled by the disease instead of them controlling the condition. Dependence on other people to help with daily chores can lead to frustration. Combined with daily pain, that can lead to stress and fatigue. Depression and anger often follow which can place strain on relationships with friends and family. As caregivers, we need to be encouraging and empathetic towards our clients loved ones. Exercise can be an effective way to help them regain control. 

Exercise programming for this population should begin with involving the primary care doctor and/or rhumatoligist, along with the therapist and caregiver. With over 100 different forms of arthritis, exercise programs need to be tailored to each individual as the implications for exercise varies greatly based on the form and severity of the disease. The focus of the program should be to improve the overall quality of the person's life. This is achieved through: Increasing overall health and fitness (reducing stress, increasing flexibility, etc.), improving self-esteem and aiding in pain management. 

Exercise protocols that have proved beneficial for managing arthritis have been stretching and range of motion exercises. The aim of range-of-motion exercise is to move a joint as far as comfortable and then stretch it a little more. This helps maintain joint mobility along with improving joint function. Range of motion work also helps to minimize joint pain. "Use it or lose it" certainly applies here. Performing light stretches, even several times per day, is acceptable and beneficial with most patients.

Low-impact exercises such as walking, bicycling and swimming also have their place in arthritis programming. As mentioned earlier, recent studies have shown low-impact activities aid greatly in this population. The benefits of this cardiovascular work include: strengthening the heart, lungs, weight management, and reducing stress to name only a few. Aim for 30 minutes of low-impact activity done at a comfortable pace. This can be done every day and even broken down into three, 10-minute sessions in the beginning. 

Finally, strengthening exercises help to increase muscle and connective tissue strength, stabilize joints, and improve overall tone. Strength training can come in the form of weights, elastic bands or simply one's body weight against gravity. Resistance training is also a key component for increasing bone density, which is of special concern to women. Strength training should only be performed every other day, allowing a day of rest in between. 

By incorporating exercise and activity into part of the treatment plan for people with arthritis, successful pain management, conditioning and an enhanced lifestyle can become possible.

Sean M. Kenny, CPT, is a certified trainer, author and consultant to the medical community. Visit his website at anythingfitness.com

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