Article written by: Jim Storhok DPT, ATC
This month we are going to be discussing the benefits of strengthening and stretching for arthritic conditions. It seems that arthritis is a type a diagnosis that affects many Americans, and can affect patients young and old. It seems that people may become affected in their early 30s and the frequency seems to progress as they age. Weight-bearing joints are typically affected more than non weight-bearing joints including hips, knees, and the low back. Although the bony surfaces cannot be changed by your physical therapist, there are some things that can be done in order to manage the progression of arthritic changes in these areas.
Strengthening is a great way to decrease stresses a cross an arthritic joint. Exercises to improve strength should be done through range of motion which fatigues the muscle, although does not irritate the joint. It would seem almost counterintuitive to perform a squat if you had arthritic knees, although this is a very good exercise done to increase strength in both the glute muscles and thigh muscles, which in turn will decrease stress across the arthritic joint. The exercise just needs to be done through a range of motion which is comfortable for the patient. This is also a very functional exercise as most people engage in some sort of a squat throughout their day.
Another good exercise is a forward step up. This exercise is valuable as it is also another activity which mimics a common activity of daily living, and strengthens the same muscle groups of the glute and thigh muscles. This activity can be progressed by either adding height to the step, or adding a weight to the patient to hold onto. The exercise can be modified by modifying the step height, or using upper body assistance. Again, all exercises should be performed in a range of motion which is pain free.
Upper extremity joints can also become arthritic, however the frequency is less. We do tend to see patients with arthritis in their shoulders as well as both the neck and low back. Shoulder exercises need to be done in a range of motion which does not exacerbate pain or cause catching, clicking or popping. The lower back and neck posture is vitally important during all exercises as to not exacerbate any pain in the area. There are different core exercises including pelvic tilting and activities on therapy balls which are very effective at improving muscular stability around the spine.
Maintaining proper muscle flexibility is the last point to be made as it is also just as important to have good muscle length and combination with good muscle strength in order to remain good balance around arthritic joints. If there is poor flexibility, that may provide increased stress through the joint and could cause difficulties and more pain. Flexibility exercises should be performed to a moderate intensity and are typically recommended 30 second holds for 3 to 5 repetitions per side. There should never be any tingling or numbness experienced in either the upper or lower extremities during stretching exercises and there should also be no sense of burning.
If you have any other specific questions regarding your condition, please see her physician or physical therapist.