At this time of year, many of us resolve to do a bit more exercise but for people with arthritis, this is especially important. Many people with arthritis worry that exercise can harm the joints but in fact the opposite is true.
Even if exercise is slightly painful, using the joints cannot cause more damage and exercise can have huge benefits in terms of reducing pain and stiffness, increasing flexibility and mobility and improving function and sleep. If anything, it is lack of exercise which can contribute to joint damage. Being less active means that muscles become weak, weaker muscles cannot support the joints as well so the joints may feel unstable, and then joints can hurt even more when we try to exercise them again. Weaker thigh muscles can even contribute to an increased risk of knee osteoarthritis.
Exercise can also have emotional benefits. Exercise causes the body to produce endorphins which are the body's natural painkillers that are similar to morphine. It can help calm the mind and improve sleep quality. It improves balance leading to reduced risks of falling. Exercise can also have social benefits such as meeting similar people, making friends and reducing isolation.
There are different types of exercise with different benefits. Ideally you should try to do a variety of exercises for the best results. Aerobic (cardiovascular) exercise gets your heart beating faster and improves overall fitness and stamina. You don't have to go to a gym to do aerobic exercise - any activity which makes you breathe deeper and faster can be aerobic including walking, housework, dancing, swimming, gardening, climbing stairs and cycling.
Muscle-building (resistance training) exercise improves strength and balance as it involves exercising your muscles against resistance. Examples of this type of exercise include strengthening exercises for the knee and weight training. Even if you have inflammatory arthritis such as rheumatoid arthritis, training with weights will not harm your joints; in fact weight training can significantly help improve joint pain and function.
Flexibility exercises including stretching, yoga and Pilates can help reduce joint stiffness and muscular pain and may help improve balance.
After Christmas and New Year's, many people try to lose some weight and some join a gym, often trying very hard for a few weeks only to give up soon after because of boredom or frustration at limited results. Exercise on its own will not lead to weight loss but it can be very effective for weight control if combined with sensible eating.
Most of us are not doing enough exercise. Department of Health Guidelines suggest that for health benefits, adults should all be doing 150 minutes per week of moderate intensity exercise or 30 minutes on 5 days per week. An example of moderate intensity exercise is brisk walking. Alternatively 2 sessions of vigorous activity for 75 minutes will have the same benefits. These guidelines also suggest that adults should also exercise to improve muscle strength on at least two days a week and should minimise the amount of time spent being sedentary (sitting). Adults over 65 should do all this too, plus exercises to help prevent falls if they are at risk of falling.
These exercise targets seem very challenging for many people and most of us have a very long way to go before reaching these levels of activity. For those with arthritis the challenges may be even harder so don't feel guilty if you are less active than the guidelines suggest.
The good news is that even small increases in your level of activity can have a large benefit on health and wellbeing. You don't have to go to a gym to feel the benefits and can break down your exercise into 10 minute chunks on activities such as brisk walking or gardening.
You can also become more active by trying simple things like standing up a bit more by turning off the television for an hour every evening, moving around to music when you do the housework or dancing whilst waiting for the kettle to boil. Try parking the car further away from the entrance to shops and try to stand up from sitting without using your hands. If you find this difficult, practice standing from a high chair and work towards several repetitions. This exercise is excellent for strengthening the thigh muscles and can help with knee pain.
You are much more likely to keep exercise going if it is fun so try to find an activity that is fun or exercise with a friend. Even gentle stretching or Tai Chi can improve balance and help keep the joints moving and simple walking can dramatically improve fitness and reduce joint pain. You should talk to your GP or Healthcare professional before starting a new exercise to make sure that you can exercise safely.
UK charity Arthritis Action encourages people with arthritis to exercise regularly as it not only helps to strengthen the muscles that protect and support the joints, but it also has multiple physical and psychological benefits, therefore helping people living with arthritis to live more active lives, free from arthritis pain.
Wendy is a Consultant Rheumatologist at North Hampshire Hospitals NHS Foundation Trust and UK Charity Arthritis Action's Medical Advisor.