Arthritis and exercise

Arthritis is a general term for many different conditions that affect the muscles, bones and joints. A more accurate name for this group of conditions is ‘musculoskeletal conditions’.

Your musculoskeletal system#

To understand how arthritis and other musculoskeletal conditions work, it helps to know a little about the parts that make up your musculoskeletal system.

• A joint is a structure that allows movement where two bones meet.
• Cartilage is a firm cushion that covers the ends of the bones, absorbing shock and letting the bones glide smoothly over each other.
• The joint is wrapped inside a tough capsule filled with synovial fluid, which lubricates the cartilage and other structures and keeps them moving smoothly.
• Ligaments hold the joint together by joining one bone to another.
• Muscles are attached to the bones by tendons. As muscles contract, they pull on the bones to make the joint move.

Arthritis and other musculoskeletal conditions affect the normal functioning of the joints, muscles, bones and surrounding structures. How this happens depends on the condition you have. Arthritis can cause pain, stiffness and often inflammation in one or more joints or muscles.

The benefits of exercise for arthritis#

Regular exercise can reduce some of the symptoms of arthritis and improve your joint mobility and strength. It has many benefits and can:

• Aid joint lubrication and nourishment.
• Ease joint pain and stiffness.
• Improve flexibility.
• Build muscular strength.
• Improve your balance.
• Help you sleep better.
• Improve posture.
• Improve or maintain the density of your bones.
• Help you maintain a healthy body weight.
• Improve overall health and fitness.
• Lower stress levels and improve your mood.

There are many forms of exercise to choose from#

The type that is best for you depends on your personal preference, the severity of your symptoms, and whether you have other musculoskeletal conditions or health issues. If you are not sure which exercises are suitable, be guided by your doctor or another health professional, such as a physiotherapist or exercise physiologist.

Aim to do some form of exercise every day. Ideally, the exercises you choose should help with:

• Flexibility – stretching and range-of-movement exercises help maintain or improve the flexibility of your joints and nearby muscles, keeping them moving properly and easing stiffness.
• Strength – to build muscle strength, provide stability to your joints and improve your ability to perform daily tasks.
• Overall fitness – exercise that gets you moving and raises your heart rate (such as walking, swimming and cycling) improves the health of your heart and lungs and can help with endurance, weight management and the prevention of other health problems (such as diabetes). This is also called aerobic or cardiovascular exercise.

Many activities help with flexibility, strength and overall fitness at the same time, including swimming or water exercise classes, tai chi, walking or Nordic walking, chair exercises, low-impact aerobics, strength training and dancing.

The exercise you choose should be something you enjoy and will stick with. If you find it hard to stay motivated, consider exercising with friends or in a group or team.

Finding the right balance of rest and exercise#

Sometimes it can be difficult to exercise because of pain. An inflamed, hot or painful joint needs rest, but too little exercise can cause muscle weakness, pain and stiffness. It is important to find the right balance. If you are not sure what that balance is for you, talk with your doctor, physiotherapist or exercise physiologist.

Arthritis and water exercise#

Warm water exercise is particularly helpful if you have arthritis or another musculoskeletal condition, because your body is supported while the resistance of moving through water builds muscle strength and endurance. It involves exercising in a pool, usually heated, and may also be called ‘hydrotherapy’.

The most suitable type of water exercise for you depends on factors such as:

• Your personal preferences.
• The type of arthritis you have and how it affects you.
• Your fitness level.
• Your confidence in the water.

Some options include individual programs tailored to your condition, gentle water exercise classes suitable for older adults or people with conditions such as arthritis, and swimming laps at your local pool.

Starting a water exercise program

Recreation centers, fitness centers and public swimming pools may run warm water exercise classes. Before you choose a class:

• Talk with your doctor, physiotherapist or exercise physiologist about whether it is right for you.
• Contact venues in your area to find out what classes are offered, and ask about the qualifications of the person running them.
• Check that the venue is suitable – for example, is the pool easy to access, are the change rooms accessible and comfortable, and is it close enough to attend regularly?
• Make sure the class suits your level of fitness and ability. If you like, watch a class or two from the sidelines before joining.

Another option is to use the pool facilities with a water exercise program designed for you by a physiotherapist or exercise physiologist and exercise on your own, either instead of or as well as joining a class.

Pool safety

Once at the pool, safety suggestions include:

• Warm up – a good way is to swim gently or walk through the water.
• Be guided by your instructor or by the exercise program designed for you.
• Take care when moving in wet areas around the pool, including change rooms, to avoid slipping and falls.
• Keep the body part you are exercising under the water; this may require you to squat or bob down at times.
• Perform each movement as gracefully and smoothly as you can.
• If you feel light-headed, sick or dizzy at any stage, get out of the water.

Arthritis and tai chi#

There is good evidence supporting the effectiveness of tai chi for people with arthritis and other musculoskeletal conditions. There are many styles, and most are suitable for people with arthritis. The benefits of tai chi include:

• It is relaxing and enjoyable.
• It can be practiced by people of all ages and fitness levels.
• It promotes correct body posture and balance.
• It is a low-impact exercise.
• It can help relieve joint pain and stiffness.
• It integrates the body and mind.
• It uses gentle, circular movements.

You can learn tai chi from books and DVDs, but most people find it easier to learn from a qualified instructor, using books and DVDs to practice between classes. Before starting a tai chi class, talk with your doctor about whether it is suitable for you, and make sure your instructor is qualified and takes special care of people with arthritis.

General exercise cautions and suggestions#

Your doctor or exercise professional can give you advice specific to your condition and situation. General suggestions for exercising safely include:

• See your doctor before starting any new exercise program.
• If you have had a joint replaced, ask your surgeon or health professional which movements you should limit or avoid.
• Consider pre-exercise screening, which helps identify people with medical conditions that may put them at higher risk during physical activity. It acts as a safety net to weigh the benefits of exercise against the risks for you.
• Don’t exercise a painful, inflamed or hot joint. Instead, gently move it through its range of movement to reduce stiffness and improve circulation.
• Start gently and increase the intensity gradually over weeks or months.
• Warm up thoroughly beforehand, and cool down afterwards with gentle, sustained movements.
• Pay attention to good technique and try to move smoothly. Don’t force a joint beyond a comfortable range of movement.
• Don’t try to do too much too soon. If you feel out of breath, slow down.
• If a joint feels particularly painful afterwards (for longer than two hours after a session), reduce the intensity of your next session. If an activity causes pain or increases your pain beyond what is normal, stop it.
• Drink plenty of fluids during and after exercising.
• Wear appropriate clothing and footwear.
• Increase incidental activity in your life – for example, walk to nearby shops instead of driving.

Key points#

• Arthritis can cause pain, stiffness and often inflammation in one or more joints or muscles.
• Regular exercise can reduce some of the symptoms of arthritis and improve your joint mobility and strength.
• Exercise can help you maintain a healthy body weight, among many other benefits.
• An inflamed, hot or painful joint needs rest, but too little exercise can cause muscle weakness, pain and stiffness.
• It is important to find the right balance of rest and exercise.

Where to get help#