Arthritis is a general term used for the different conditions that affect the bones, joints, and muscles.
There are many types of arthritis affecting anyone including children and adolescents, namely, Rheumatoid arthritis, Osteoarthritis, Juvenile arthritis, Gout, etc. [1].
Most common symptoms or complaints irrespective of the type of arthritis are of pain, inflammation, swelling, redness, and stiffness of joints.
The conventional treatments to manage these symptoms include painkillers along with lifestyle modifications like diet and exercise regimen.
Conventional medical treatments (CAM) are most effective, physical therapy and exercise training remain an important part of arthritis management. Research shows that exercise and arthritis go hand in hand as it benefits the symptoms of arthritis.
What is Resistance Exercise?
Resistance training is any form physical activity or exercise that causes the skeletal muscles to contract against an external force (resistance) with the prospect of increase in strength, tone, mass, and/or endurance of muscles.
The external resistance can be heavyweights like dumbbells, your own body weight, bricks, bottles of water, resistance bands, or any other object that causes muscular contractions.
Resistance exercises can be categorized into three basic styles depending on the means of resistance or external force used;
- Bodyweight Using one’s own bodyweight to create resistance example; push-up, bench press, squats, etc.
- Free weights Lifting heavy free weights like the barbell, dumbbells, kettlebells etc. along with some other unconventional heavyweights like water bottles, bricks, another human being, etc.
- Weight Machines Nowadays every gym has weight or resistance machines installed these are less effective as free weights but are a safer alternative for those new to resistance training.
Benefits of Resistance Exercise for Arthritis Patients
Every arthritis has joint degradation which often leads to deformities and muscle atrophy (wasting), which dramatically affect its treatment and management.
This weakening in muscle strength along with stiffness of joints negatively impacts a patient’s quality of life as well as an increase in health care cost.
Traditional therapies include the use of anti-inflammatory and pain-killer medications and sometimes surgery that have potentially serious long‐term side effects [2] [3].
Subsequently, the need for a safe and effective treatment for arthritis treatment has never been more apparent.
There are several studies and meta-analysis data that suggests that resistance exercise has a positive impact on both functional capacity and disability proven to be clinically relevant.
It helped decrease disability and impairment of joints irrespective of the heterogenicity of the study groups [4] [5].
In a clinical trial to investigate the effects of resistance exercise with respect to the pain, disease activity, and physical functioning in active rheumatoid arthritis patients showed that a short-term resistance exercise regimen is more effective and safe in improving muscle strength than a conservative exercise [6] .
In another computerized literature analysis of 11 randomized clinical trials on exercise therapy for osteoarthritis (OA) of knee and hip, indicated small‐to‐moderate beneficial effects of exercise therapy on pain, both disability outcome measures, and moderate‐to‐great beneficial effects to patient's quality of life according to the global assessment of effect [7].
There is convincing evidence that obesity is closely associated with knee and hip osteoarthritis and weight loss have a positive impact on this degenerative joint disease [8] [9] [10].
Therefore, both the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) recommend weight loss and exercise for obese patients with knee OA.
Interestingly most of the studies suggest that the combination of diet and exercise is superior to either treatment alone in improving the symptoms of arthritis.
And hence dietary intervention alone does not show any improvement in the management and care of arthritis.
Five most effective resistance Exercises for Arthritis
1. Water Work-out/Aerobics
It is difficult to move let alone exercise when one is sore and stiff due to swelling and inflammation in joints and muscle tissue. Hence, water exercise is the best bet for people suffering from arthritis due to following reasons;
- The buoyancy of water supports the body so there is less impact on joints and muscles.
- Exercising in a heated pool gives an added benefit of warmth, which helps soothe sore joints.
- Moving in water provides natural resistance giving the muscles a good workout without the need for weights.
Every arthritis is different from another and has a different impact on the individual person. Hence, before starting a water workout, one should always consult their physical therapist for a safe and effective routine.
Start slow and easy in the beginning steadily increasing the pace of movements. It is important to keep in mind to not over-do or stress your already sore joints and muscles.
Here is the link to a beginner’s guide for water aerobics for people with arthritis -
2. Bodyweight Exercises
Bodyweight exercises also are known as calisthenics it’s a simple, effective way to improve strength, balance, flexibility, and endurance with minimal or no equipment.
Some of the most common exercises in this category are sit-ups, push-ups, pull-ups, crunches, planks, jumping jacks, lunges and squats, and their variations.
These exercises can be modified according to your needs and your arthritis, it can be made harder or easier depending on your fitness level best part they can be done anywhere.
As with every exercise start with lower repetition and slowly increasing the intensity and sets of your choice of exercise.
Bodyweight exercises require strong core muscle strength as these exercises affect a lot of muscle groups at once, making them hard but effective.
Here is a link to start off with bodyweight training with arthritis -
3. Free Weightlifting
Weightlifting sounds scary for people suffering from arthritis but it is achievable if practiced under proper guidance and preparation.
Weightlifting too can be practiced and modified depending on the targeted area.
On the contrary to the old belief that weightlifting is only for the young and fit, experts suggest that weightlifting should be practiced by everyone irrespective of their age and gender.
Lifting weight too have its right ways and wrong ways especially for the people suffering from arthritis as oppose to their healthy counterparts.
Always consult your doctor for proper guidance, get professional help, practice slow and steady methods as sudden jerks and pull can do more harm than good.
And most important of all pay attention to your body if you push too hard, your body will react hard too.
4. Cycling
Cycling is a powerful, low-impact exercise suitable for everyone. It not only helps strengthen the leg muscles, but it is a good cardiovascular exercise.
The repetitive knee motion is especially good for arthritic knees since it encourages fluid production, lubricating it and flushing away the waste products.
Again, before starting cycling weather indoors or outdoor one must always consult their doctors to assess their fitness level.
One can make modifications and variations in their cycling regimen depending on the severity of their diagnosis.
Some of the basic tips to remember are, always wear helmets while cycling outdoors, using a recumbent bicycle can help people with arthritis.
Mounting and dismounting can be tricky for some patients in such cases getting a custom-tailored cycle to one’s height and posture is also advisable.
Slowly and progressively increase the distance, frequency, and speed of your rides. Since just cycling while seating does not do much to help promote bone-density, experts advise a weight bearing device once you have reached an optimal level of competency.
Many experts suggest that cycling on a regular basis can help prevent muscle atrophy thus delaying the onset of arthritis.
Here’s a video link that helps explain the benefits of cycling with arthritis
5. Stretching Exercises
Many healthcare professionals recommend stretching for arthritis sufferers.
Dr. Philip Conwisar, an orthopedic surgeon in California suggests doing some stretches first thing in the morning and take a stretch break instead of a coffee break.
While many others recommend finger curling, mild wrist bending, and thumb stretching as well. Some of the best practices for stretching exercises are yoga poses, tai-chi, using resistance bands, etc.
These have been proved to be extremely helpful in relieving the symptoms like back pain, stiffness, and inflammation.
People with milder disease and who don’t have significant stiffness can do more yoga and tai-chi poses than someone who has advanced arthritis.
Yoga if practiced properly can offer gentle stretching and flexibility apt for arthritis sufferers. People need to practice mindfully and listen to their own bodies if any pose causes pain in any way, it should not be practiced.
Start slowly and preferably with a certified yoga instructor after getting consent from your doctor. Apart from stretching yoga breathing exercises also offers a range of benefits.
Tai-chi originated thousands of years ago in China as a martial art when practiced regularly is comparable to resistance training and brisk walking and is said to improve both lower-body and upper-body strength.
There are many studies that show Tai chi can significantly lower the pain and physical impairment in people suffering from arthritis especially knee osteoarthritis [11].
Apart from relieving pain and improving balance and flexibility the slow and graceful movements of Tai chi also help reduce stress and anxiety [12].
Resistance bands or tubes are very popular in various physical therapies and rehabilitation for patients with arthritis.
They are used extensively for isotonic exercises wherein the band is gently stretched through the range of motion of the joint.
Almost all the band exercises can be performed with minimal modifications to better suit the patient and the severity of the pain.
The resistance bands are an excellent way to begin strength training.
Like every other exercise or physical therapy always consult your doctor or an expert for proper guidance and counseling.
Here are few links to practice yoga, Tai chi, and resistance bands as an aid to arthritis.
A Short Video on Yoga For Arthritis -
Conclusion
Everyone especially those with arthritis, benefit from exercise and/or physical therapy for flexibility, strengthening, and endurance.
Resistance exercises provide resistance/external force to all muscle groups thus, decreasing pain and help improve joint stability.
Exercises like bodyweight, water aerobics, and cycling help build up strength and increase flexibility whereas, tai-chi and yoga help do the same along with other added benefits like help reduce stress and anxiety.
All these activity needs strict supervision and modification to better suit the patients with arthritis since most of these involve jerk and pull movements that can do more harm than benefit if not performed with care and proper guidance.
Hence, it is imperative that one should always consult a doctor and practice these exercises with the help of a certified physical trainer.