Prescription #3 for Joint Health: Exercise

Exercise plays a critical role in the non-operative treatment of arthritis. Strong muscles act as shock absorbers for the joints, reduce stiffness and help keep your joints flexible and stable.

While exercise can help you build strong bones and slow bone loss, you’ll gain the most benefits if you start exercising regularly when you’re young and continue to exercise throughout your life. That said, it’s never too late to start. Studies have shown that even people in their eighties and nineties, when put on a sensible weight-training regimen, exhibit significant gains in flexibility, mobility, balance and strength. 

We’d like to caution you that by exercise,we don’t mean just pounding out 30 minutes on the Stair Master. A good program will include a combination of range of motion exercises, strength training, and aerobic activities.

Unfortunately, many people fail to appreciate the importance of a diverse exercise regimen, and especially the value of strength training in extending joint health. Researchers who have looked at the effects of muscle strength on the development of osteoarthritis have found that strengthening the quadriceps muscles, for example, can reduce knee pain and disability associated with osteoarthritis. One study shows that even a relatively small increase in strength (20-25 percent) can lead to a 20-30 percent decrease in the chance of developing knee osteoarthritis. And a recent 12-year study showed that strengthening the low-back muscles had an 80 percent success rate in eliminating or alleviating low-back pain.

Strengthening the muscles around your joints actually allows them to pull the joints apart and reduces the grinding that can lead to further joint deterioration and pain. Strength training also builds stronger connective tissues, improves bone density, and increases joint stability.  This acts as reinforcement for the joints and helps prevent injury.  

Suggestions for a well-rounded exercise regimen

A well-designed program of resistance training using moderate free weights and machines is more effective than aerobic training in increasing bone mass and density. This is an especially significant fact for postmenopausal women who are vulnerable to osteoporosis.

If you’re new to the gym, or unfamiliar with weight training, speak with one of the trainers about developing a safe and effective exercise program that preserves muscle tone and maintains range of motion. The key to success with these repetitive weight-training exercises is knowing which muscles need to be strengthened and how to perform the exercises without overstressing your joints.

Range of motion exercises and stretching will reduce the stiffness in joints and help make them more flexible. Mild weight-bearing exercises and isometric exercises—in which you tighten your muscles but don’t move your joints—should constitute the strength portion of your workout; they’ll increase muscle strength, which in turn will stabilize weak joints.

Finally, aerobic or endurance exercises that you do for 20 to 30 minutes three times a week will improve cardiovascular fitness, help control weight, improve overall function, and can even reduce inflammation in some joints. It is important to exercise consistently, because the more inactive a person it, the more pain and stiffness they’ll suffer.

Non-impact activities: Start your exercise plan with non-impact activities that give you a cardiovascular workout and keep your joints moving through their normal range of motion. This will keep the cartilage in your joints lubricated and pain-free. Cycling and swimming are great options. Both of these activities use big muscle groups for an aerobic workout without impact on your joints.

Swimming deserves special mention for those of you with advanced arthritis or injuries, and those recovering from illness or surgery. The benefit of water-based workouts is that water offers resistance, which strengthens your muscles as you push against it, while the water’s buoyancy supports your weight and significantly reduces stress on your weight-bearing joints, bones and muscles. For those with injuries, the pressure of the water also reduces swelling, and if the water is warm, the heat will relax your muscles and ease joint stiffness. Bicycling, especially on an indoor, stationary bicycle, can help you become more fit without putting too much stress on your hips, knees, and feet.

Low-impact cardio equipment: Elliptical trainers and recumbent bikes are excellent machines that are kinder on the knees than a treadmill. If you’re experiencing joint pain, we suggest you avoid the “old-fashioned” stair master. If your knees are already hurting, you’d do well to remember that, pound for pound, few things put more stress on your joints than running.

Exercises to Avoid: The seated leg extension machine would be one to avoid, as it places undue stress on the knee joint; lunges are a better alternative for maintaining quad strength, as long as you’re careful not to bend the knees more than 90 degrees.

It’s important to realize that certain exercises can be a double-edged sword. Remember, arthritis is often a problem of “wear and tear” on the joint, so anything that further stresses the joint, like vigorous exercise or lifting excessively large weights, may actually do more harm than good.  Too much exercise can amplify the joint force about the hip or knee and cause increased pain and more rapid deterioration of the joint.  Lifting very heavy weights is also problematic. As you get older and continue to lift significant weights, you can injure your muscle-tendon junctions and joint surfaces.  That’s because the new muscle becomes stronger than the aging tendons, in particular the patella, quadriceps, biceps and Achilles tendons. 

The best prevention as you pass through middle age is to maintain flexibility, and keep the weight training geared toward lower weights and multiple reps. The shoulder is a special case; it’s imperative that you keep the shoulder joints flexible and maintain rotator cuff strength with basic exercises, especially if you want to continue activities that involve overhead arm motions, like golf.

It also goes without saying that you need to pay attention to your body’s signals.  If, after your workout, you feel unusual or persistent fatigue, increased weakness, decreased range of motion, increased joint swelling, or continuing pain that lasts more than one hour after exercising, your exercise program may be too strenuous and should be adjusted.