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So what's the best exercise for arthritis?


Hey guys, I hope you all are staying active, even as cool weather begins and college football consumes more and more of your (and my) time! I'm going to start a series of blog posts about questions I get with some regularity because it's become apparent that these questions are what most people want to know! The first question I want to answer is "what is the best exercise for arthritis?" The glib but true answer is the best exercise is whatever you'll do regularly. Though that is the truth, it's less than helpful for those athletes looking for something more concrete. I'll have to answer this the long way because all things worth knowing are worth knowing why.

First, most kinds of exercise which use a particular joint will benefit that joint but really won't do much for other joints. For example, cycling is great for your knees and hips but really doesn't help your shoulders or elbows. So, if you're performing exercise for health maintenance, it's fine to do whichever exercises get your heart rate up and build some strength; however, if you're looking to improve pain and function in arthritic joints, then you have to use those joints.

*Point one: Improvement is joint specific

Next, most people with arthritis want improved pain control of the affected joint. Who doesn't? So for improvements in pain, what's better: heavy weight or light weight? In 2009 physicians in a hospital in New Jersey undertook this very question. I've provided a link here.

They examined elderly osteoarthritis patients who underweight resistance training for 8 week, 3 times weekly. The participants were divided into three groups: no exercise, light weight exercise, and heavy weight exercise. At the end of eight weeks, the light exercise and heavy exercise group had similar reductions in pain scores for their knee arthritis, a little bit more than 40% for both groups. Two things stand out from this; one is that performing exercise cut pain scores by almost half! The second takeaway from this study is that whatever intensity of exercise you prefer, you can see pain improvement! It's also important to point out, however, that the volume of exercise performed between groups was similar. In other words, while the high-weight group lifted heavier weights, they did fewer repetitions than the low weight group.

*Point two: Pain is similarly improved with both higher-weight and low-weight exercises

**As a caveat, I would limit the weight of any particular exercise to about 75% of what you can maximally perform once. So if I can squat ~200 lbs, then I probably should keep my working weight to 150 lbs or less.


Third, the larger the range of motion, typically, the better the exercise; this is true for both your joints as well as your muscles and other soft tissues. This is one reason I really like body weight exercises: lunges, body-weight squats, push-ups, pull-ups. With these exercises, you can go through the full or nearly full range of motion without being constrained by the limitations of how a machine was built. Whatever you decide to do, try to pick something that has a full range of motion. So walking isn't what we're looking for but a stair-master or bike would be great!

*Point three: Joints benefit from using their full range of motion

Having written about these three things, you'll rightly notice that I haven't actually listed a particular set of exercises that are "good" for your joints. This is mostly because I don't want you to feel artificially constrained by my personal set of favorites. That being said, if you're looking for a good beginner set of exercises, here are a few that I personally feel are beneficial.


-Squats

-Lunges

-Spinning or cycling (note that recumbent cycling is, in my opinion, not nearly as healthful as spinning or upright cycling)

-Push-ups

-Pull-ups or rows

-Supermans

-Sit-ups

-Lap swimming

-Shoulder dumbbell press

-Yoga and Pilates

-Tai Chi

Keep moving!

TDS

Selected reading:

http://acsm.org/docs/default-source/fit-society-page/acsm-fsp-16-5.pdf?sfvrsn=0


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