Arthritis: Exercise to Treat Arthritis

What Is Hydrotherapy?

Hydrotherapy, also called "aqua therapy" (water therapy), is a program of exercises performed in a large pool. Aqua therapy may be easier on painful joints because the water takes some of the weight off the painful areas while providing resistance training.

What Are Endurance Exercises?

The foundation of endurance training is aerobic exercise, which includes any activity that increases the heart rate for a prolonged period of time. Aerobic activity conditions the heart and lungs to:

• Use oxygen to more efficiently supply the entire body with larger amounts of oxygen-rich blood
• Build stronger muscles

When paired with a healthy diet, aerobic activity also is fundamental for controlling weight (which is important for people with arthritis since it reduces excess pressure on affected joints) and for improving overall general health.

At first, people with arthritis should perform about 15 to 20 minutes of aerobic activity at least three times a week, and then gradually build up to 30 minutes daily. The activity also should include at least 5 to 10 minutes of warm-up plus 5 to 10 minutes of cool-down.

Although peak benefits are achieved when an aerobic activity is performed continuously for at least 30 minutes, aerobic exercise can be spread out in smaller segments of time throughout the day to suit your comfort level, without overexerting yourself. Aerobic exercise should be performed at a comfortable, steady pace that allows you to talk normally and easily during the activity. Ask your therapist what intensity of exercise is appropriate for your fitness level.

During exercise, your heart's "training range," or target heart rate, should be closely monitored. To improve your body's aerobic condition, you should calculate your maximum heart rate-220 minus your age-and exercise at a level of intensity between 60% and 80% of your maximum heart rate.

Examples of aerobic activities include walking, swimming, low-impact aerobic dance, skiing, and biking, and may even include such daily activities as mowing the lawn, raking leaves, or playing golf. Walking is one of the easiest aerobic exercise programs to begin because it requires no special skills or equipment other than a good pair of supportive walking shoes, and it's less stressful on joints than running or jogging.

Biking is another good choice for people with arthritis, because it places less stress on knee, foot, and ankle joints. Swimming is also often recommended because there is minimal pressure on joints.

Appropriate recreational exercise, including sports, can be helpful to most people with arthritis. But only if the activity is preceded by a program of range-of-motion and strength exercises to reduce the chance of injury.

How Do I Begin?

Regardless of your condition, discuss exercise options with a doctor before beginning any new exercise program.

People with arthritis who are beginning a new exercise program should spend some time conditioning with a program that consists of only range-of-motion and strengthening exercises, depending on their physical condition and level of fitness. Endurance exercises should be added gradually, and only after you feel comfortable with your current fitness level.

As with any change in lifestyle, your body will need time to adapt to your new program. During the first few weeks, you may notice changes in the way your muscles feel, your sleep patterns, or energy levels. These changes are to be expected with increased activity levels. However, improper exercise levels or programs may be harmful, making symptoms of arthritis worse. Check with your doctor and adjust your program if you experience any of the following:

• Unusual or persistent fatigue
• Sharp or increased pain
• Increased weakness
• Decreased range of motion
• Increased joint swelling
• Continuing pain

Regardless of the exercise program you select, it's important to begin slowly and choose a program you enjoy so that you maintain it. Make exercise part of your daily routine so that it becomes a lifetime habit.

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