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Managing Arthritis with Exercise
by Eric Durak

The Arthritis Foundation states that there are over 100 types of arthritis that afflict persons today. Most of us are familiar with the two most prevalent types - osteoarthritis, which usually attacks one or more bones in the body, and rheuamtoid arthritis, which is an autoimmune disease that, like Lupus, is an inflammatory disease that occurs eight times more frequently in women. Recent reports state that hormonal and mineral imbalances play a role in the deterioration of he immune protection process - and thus accelerate the disease itself.

The goal of managing arthritis is to keep the joints in good working order, relieve pain (through proper nutritional support and anti-inflammatory medications), and to reduce depression - which is one of the most crippling aspects of arthritis.

Exercise training can affect all aspects of arthritis management. Chronic exercise helps to maintain levels of synovial fluid in the joint capsule - the lubricating substance in all joints. Exercise also helps overall circulation of both blood and lymph systems. The lymph system is misunderstood by most people, but it acts to clear most waste products from the circulatory system out of the body. One of those are excess mineral deposits that may be cleared during exercise. Training also allows arthritis sufferers to move their joints through a wider range of motion that at rest - which helps in breaking up adhesions that occur during lack of movement. Exercise also helps to show patients that they CAN participate in regular programs and reduce some of their pain and inflammation.

One of the most common exercise programs for arthritis is called the PACE program, which incorporates aerobic and resistive exercise in its components. PACE (People with Arthritis Can Exercise) helps its participants maintain joint range of motion - a main benefit of this type of exercise program. PACE uses total body conditioning sessions at lease twice per day - many days they incorporate three or more mini sessions. These sessions increase muscle tone and responsiveness to external workloads (decreasing the fibromyalgia component to a minimum), and finally, this uses exercise as a social interaction to guard against depression - one of the major reasons for the health deterioration in arthritis patients.

TYPES OF EXERCISE
There are many types of exercise that are beneficial in reducing the inflammatory process and pain in arthritis. Aerobic conditioning and strength training were mentioned above, and basic programs of each do wonders for arthritis. A sample program is listed below:

PHASE I -

Type of exercise                     Days per week                 Intensity                       Sets/reps

Aerobics                                           2-3                          Light to Moderate      10-20 min.
Walking  treadmills
or Biking stationary bicycles

 Strength training                              1-2                                  Light to Moderate              strength equipment          

Lateral raises                                                                                                    1 X 10 Bicep curls                                                                                                                  1 X 10 Tricep extensions                                                                                                        1 X 10   Leg extensions                                                                                                        1 X 15   Leg curls                                                                                                                  1 X 15   Calf raises                                                                                                                1 X 15 Abdominal crunches                                                                                                    1 X 15

Water Aerobics                              1-2                                  Moderate                     10-20 min. aqua products         

Stretching program                        3-4                                  Gentle                                  stretching and yoga

PHASE II-

Type of exercise                   Days per week                      Intensity                      Sets/reps

Aerobics or                                     3-5                                 Moderate                     20-30 min.  Water Aerobics                              1-2                                 Moderate                     10-20 min.

Strength training                             1-2                                 Moderate                   Lateral raises                                                                                                              1 X 10 Bicep curls                                                                                                                   1 X 10 Tricep extensions                                                                                                        1 X 10   Leg extensions                                                                                                            1 X 15   Leg curls                                                                                                                       1 X 15   Calf raises                                                                                                                    1 X 15 Abdominal crunches                                                                                                   1 X 15

Stretching program or                    3-4                                 Gentle                         Water strength training                   2-3                                 Moderate                     10-15 min.

Persons who have high levels of pain should consult their physician about their exercise, medication status, or both. No matter what type of exercise you choose, any type of conditioning program helps reduce pain status, improve quality of life status, and lubricate joints - plus the added benefit of improving cardiovascular risk factors. With information from the PACE program (now over 10 years old), we are learning of the tremendous benefits of regular exercise for arthritis sufferers. The best news is that whether it's weight training, water therapy, or low impact aerobics, each has benefits in helping patients lead more normal lives.



References
Gecht MR; Connell KJ; Sinacore JM; Prohaska TR . A survey of exercise beliefs and exercise habits among people with arthritis. Arthritis Care Res, 9(2):82-8 1996.

Neuberger GB; Press AN; Lindsley HB; Hinton R; Cagle PE; Carlson K; Scott S; Dahl J; Kramer B. Effects of exercise on fatigue, aerobic fitness, and disease activity measures in persons with rheumatoid arthritis. Res Nurs Health, 20(3):195-204 1997 Jun

Spencer AC; Kinne S; Belza BL; Ramsey S; Patrick DL . Recruiting adults with osteoarthritis into an aquatic exercise class: strategies for a statewide intervention. Arthritis Care Res, 11(6):455-62 1998

Ettinger WH Jr; Burns R; Messier SP; Applegate W; Rejeski WJ; Morgan T; Shumaker S; Berry MJ; O'Toole M; Monu J; Craven T . A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). JAMA, 277(1):25-31 1997

Rejeski WJ; Ettinger WH Jr; Martin K; Morgan T . Treating disability in knee osteoarthritis with exercise therapy: a central role for self-efficacy and pain. Arthritis Care Res, 11(2):94-101 1998


Bio
My name is Eric Durak, and for the past 15 years I have been training, writing, and lecturing on exercise programs for persons with special needs. I am now producing articles with bodytrends.com to help people understand how to use exercise to improve their lifestyles. The bodytrends.com newsletter enables us to inform you about information on the benefits of exercise training for persons with specific medical conditions. We have known for many years that exercise is beneficial for conditions such as diabetes and heart disease, but we are finding out that regular exercise may improve the prognosis for almost every diagnosed disease! A pretty powerful tool. With that in mind, it's our intent to make sure that you understand something about exercise as it relates to your condition - that you can talk about your exercise plans with your doctor, and that you select and USE the most appropriate exercise products to fit your needs. If you have any questions, please let us know. And by all means, . . . read on.