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Exercise Away the Aches

When people have arthritis it often hurts to move, so many people with arthritis limit their movement. But inactivity can be crippling -- literally -- for people with any form of this ubiquitous disease.

Whereas a generation or so ago, people with arthritis were sent to bed in an effort to "save their joints," Mitchell W. Krucoff, MD, coauthor of Healing Moves: How to Cure, Relieve and Prevent Common Ailments with Exercise (Harmony), on how exercise can help cure and prevent common ailments such as arthritis, told me scientific evidence now refutes that. "Study after study has shown that people with arthritis who exercise regularly report less pain and joint swelling, improved functioning and increased strength, endurance and flexibility -- without harming their joints," he says.

The psychological benefits are also dramatic. "The mind and body are not separate," added coauthor and yoga instructor Carol Krucoff. "Exercisers experience less depression and anxiety, and greater feelings of control. When you can't function, it's very depressing. You can't walk stairs, or go places. And for seniors, the idea that they might fall down and not be able to get up is very frightening." Basic exercises give seniors a sense of control and the ability to do the functions of daily living. "They feel better about themselves and feel more capable," said Carol.

This is all well and good, but it still hurts to exercise with achy joints. So, what kinds of exercise do the Krucoffs recommend for arthritis sufferers?

1. Range of motion exercises. These are exercises that help reduce stiffness and keep the joints flexible. Dr. Krucoff explained that range of motion simply means the normal distance your joints can move in all directions. There are five primary movements he recommends...

Shoulders. Slow easy arm circles. Starting with your arms at your sides, bring them all the way up toward the ceiling and then as far behind the body as comfortable in a huge circle. Repeat several times. Hips. Lie on your back with knees bent, feet on the floor and arms down along your sides. Bring one knee to the chest and rotate the knee in an easy gentle circle. Repeat with other knee. Wrists. Make circles with your wrists, rotating hands in both directions. Ankles. Draw big circles in the air with your big toe in both clockwise and counterclockwise motion. Knee. Lie on your back and bring one knee to the chest. Straighten your leg, pointing your foot toward the ceiling and bend a few times. Repeat with the other leg.

2. Endurance exercise (aerobics). "Like anyone interested in good health, people with arthritis need to accumulate 30 minutes a day of cardio activity," Dr. Krucoff told me. He added that for people with arthritis it's especially important to strengthen large muscles, such as those of the legs, allowing more gentle and consistent compression of the sore joints, which in turn stimulates the healing process in the cartilage. When choosing an exercise, it's important to pick something that doesn't exacerbate arthritis. Here's what the Krucoffs suggest...

Walk on a flat even surface. Good choice: A school track, using good supportive shoes. Or a mall or a sidewalk. Avoid bumpy fields or gravel roads. Water exercise. "For people who can't tolerate walking, water exercise is the gold standard," said Carol. "When you're in the water, it supports the body so there's less stress on hips and spine and knees. The Arthritis Foundation runs classes at YMCAs called PACE classes -- People with Arthritis Can Exercise. These classes are great because they keep you in warm water at chest level. And they take you through a good range of motion and aerobic conditioning."

3. Strengthening exercises. The idea of people with arthritis pumping iron is very new. "There are some very good studies showing that weight training for people with arthritis is very helpful," said Carol, "particularly for those with rheumatoid arthritis." Important: Check with your physician before starting this or any exercise program.

When starting, it's best to begin with light weights or even no weights and work up from there. "Your goal is to work out with a weight you can lift at least 10 times without being too tired," said Carol. "If you can't, it's too heavy."

Chair extensions. Sit straight in a chair, knees bent 90 degrees, feet flat on floor. Then extend your leg straight out and bend it back down to starting position. "Do several of these leg extensions for each leg to strengthen the quadriceps muscle," said Carol. "When you can do eight to 12 repetitions, you can strap on light ankle weights." Toe raises. Work the calves by standing and raising your body up on your tiptoes and back down. Do eight to 10 repetitions.

Chair squats. "These are probably the most useful exercises of all," said Carol. "You sit in a chair and practice standing straight up and sitting back down again, using the muscles of your legs. It strengthens the legs and gives you confidence that you can perform a basic daily task."

The number-one cause of nursing home admissions is not heart disease or Alzheimer's disease or diabetes. "It's weak joints and muscles," said Dr. Krucoff. These people can't do the activities of daily life. They can't get up or down, can't go to the bathroom. "You can prevent these problems with a good exercise program," said Dr. Krucoff. "And the time to start is right now." (After you get approval from your treating physician, of course.)

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