“I Shouldn’t do exercise because of my Arthritis” – that was what a client said to me in clinic this week. Have you ever thought that? “I have been told I have arthritic knees and I shouldn’t do exercise because it will make my Arthritis worse” this is another one we hear regularly in clinic.
This really frustrates me not only as a clinician but also as a semi keen exercise taker!
My question back to the client in question was “ok who told you that?” their response – “I read it somewhere”. My next question was ok “when you have ever heard a doctor or health professional tell someone that exercise is bad for them?” – the answer is NEVER.
Please don’t think I’m being rude here, I understand I really do, but I think we need to break this down a little, so we can take a look at the evidence and the common sense as to why NOT exercising because of your Arthritis is such a Ludicrous idea!
So Firstly, what is Arthritis?
Arthritis is a very commonly used broad term to describe inflammation and stiffness in the joints of the body – there are over 100 different types of arthritis and related conditions. Arthritis does not discriminate, it can and does affect men, women, old and young alike. It is also worth remembering that not all Arthritis is made equal, one persons arthritis is not the same as the next.
We are going to focus on specifically Degenerative Arthritis or Osteoarthritis – this is the most common – run of the mill Arthritis, the type almost all of us will unfortunately develop if we live long enough.
It is common to occur in Knees, Hips, Shoulders less so but possible, Spine and fingers and or toes – essentially if there is a joint it is possible to get arthritic changes in it – more so in the weight bearing joints. It occurs because the smooth cartilage that surrounds and protects the ends of the joints starts to degrade and break down. This is entirely normal and natural process and shouldn’t cause any great concern. Why It affects some more vigorously than others, is something in truth we do not know the answer to, the same reason why some people go bald and others don’t – it probably has something to do with genetics, but will also have a lot to do with external factors such as lifestyle, work environment and even stress levels.
As you can see in this picture the normal knee on the left has nice smooth joint surfaces - the Arthritic joint on the right , well not so much.
Ok so we have established what Arthritis is and who it affects…….Now let's look at why people think exercise may make this worse.
When I put this to my client they said they thought it would "cause more pain and inflammation and therefore was a bad thing". I’m not really sure how or why this has come about, my best guess is that society as a whole has developed a BIG misunderstanding of what PAIN actually means. Pain in most cases does not equal damage or destruction, just read that again and let it sink in for a second.
“Pain in most cases does not equal damage or destruction” This is Super important to understand and if you only take one thing from this blog let it be that.
Most people that suffer with Arthritis will have or do experience a certain level of discomfort due to the mechanical changes that have happened to the joint surface – this is inevitable – unfortunately most people then manage this with painkillers and carry on doing the exact same things they have been doing that led them down that path in the first place.
So let's look at the benefits of exercise specifically Strength training.
Any form of exercise is good for you – this is FACT. Regular exercise helps to reduce the risks of heart disease, diabetes and also helps with mental health and wellness. Strength training – also called resistance or weightlifting has been demonstrated to significantly decrease pain and stiffness in adults diagnosed with Arthritis while increasing lower limb function by over 30%. So this basically means you have stronger muscles that are able to cope better with the demands put on them.
Not only are you stronger and fitter, you also have less pain and more function or ability to do the things you enjoy. Sounding good so far to me….
Oh and there is the added benefit that strength training helps you to lose weight (along with a balanced diet obviously) this will in turn put less stress on your joints and help decrease pain further.
What’s that I hear you cry ….”sign me up, I’m in?!” Great news here’s a few tips to get you started!
1. See a Physiotherapist or certified Personal trainer to design a program for you – this will ensure you do the right exercises in the right way for the right amount of time.
2. Strength training should be performed at least twice per week but three times is ideal. About 30 minutes each time should do the trick. Remember to warm up and cool down and make sure you include some stretching – DON’T skip it.
3. Train at a time of day when your symptoms are at their best – no point in training first thing when you are at your stiffest.
4. A gym is great, but don’t feel you have to join one – lots of exercises can be done at home with little or no equipment – for ideas check out our YouTube channel
5. Muscle soreness or DOMS as its known is perfectly acceptable following training. Sharp pain is not – if you experience sharp pain stop and discuss with your Physiotherapist.
So there you have it reasons why you definitely SHOULD be exercising especially if you have Arthritis.
In the words of Vince Lombardi “Perfection is not attainable, but if we chase perfection we can catch excellence” Dave Out.