Strength training and arthritis.

About two in ten Americans have been diagnosed with some form of arthritis. Although the degrees (mild to severe) and types of arthritis (osteoarthritis and rheumatoid arthritis) vary widely, it commonly produces a significant reduction in joint range of motion and, of course, a significant increase in joint pain. For this reason, most individuals with this condition feel that they cannot participate in any type of resistance exercise and, indeed, many are advised by their health care providers to avoid resistance exercise. The fact of the matter is that if stronger muscles surround a joint, it becomes more stable and can greatly contribute to increased mobility and actually assist in reducing pain levels.

One of the problems associated with arthritic joints is, as stated, a lack of flexibility or what is known as range of motion. So how do you get strength increases, at least initially, with little or no range of motion? Well, one of the old stand-bys of resistance training can help. It’s called isometric resistance training. Basically, it means that the individual will perform resistance training against an object—any object—that provides resistance but cannot be moved easily. A good example would be thick resistance bands, a stationary weighted bar or a selectorized machine. In this manner, resistance is provided to the muscle without the pain associated with movement. The resistance is moved only as far as is possible and then held for a brief period of time (about 5 or 6 seconds) and then “

released”. The resistance “movement” is then followed by a rest period of about 15 to 20 seconds and, if necessary or desired, the process is repeated for up to a total of three “sets” for each muscle group. A longer rest period (about a minute) in between each muscle group and/or exercise is recommended. The amount of time in actual contraction should not exceed 5 or 6 seconds and the recommended amount of “rest time” in between “sets” should be adjusted according to factors such as pain level, significantly elevated heart rate and perceived exertion. Similarly, the time in between the training of each muscle group and/or exercise may have to be adjusted based upon the same factors.

In any case, range of motion can be gradually increased, if possible, and general joint movement can and will improve as strength levels increase over time. As always, a training session should begin, where possible, with some simple and slow range of motion exercises that will allow the muscles and joints to “warm-up” before resistance training begins. A cool-down activity (similar to the warm-up) should also follow each strength training routine. In this way, even those that suffer from arthritis can reap the benefits of strength training. When and if pain free full joint range of motion is accomplished, strength training can be done through the new expanded range of motion using a slow and controlled movement pattern. And if you have arthritis, ALWAYS check with your doctor or health care provider before beginning any strength training program.

I’m Dr. Paul Kennedy and that’s the “Be Fit, Stay Fit” Topic of the Week. Good luck with YOUR program. I KNOW you can do it!

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