Osteoarthritis: Exercising with arthritis

Exercises that will help you if you have osteoarthritis include:

• Aerobic activity that gets your heart beating faster and makes you breathe harder, such as walking, biking, swimming, and water aerobics. You can also get some aerobic activity by being more active in your daily routine. Vacuuming, house work, gardening, and yard work can all be aerobic.
• Strength exercises, such as lifting light weights or dumbbells or using elastic tubing, at home or in a gym.
• Range-of-motion exercises that help keep you flexible, such as stretching or exercises that target a certain joint.

Exercises to avoid

Don't do exercises that put a lot of stress on the joint that hurts. For example, if you have arthritis in your hands, try not to do exercises or sports that need a tight grip, such as biking. If you have arthritis in your knees, try not to do exercises that put stress on your knees, such as playing tennis.

Be careful not to exercise too much. Joint pain that lasts longer than 2 hours after exercise may be a sign that you did too much.¹

Continue to Why?

Exercise can help keep your joints and muscles from getting stiff and weak. And it will help you feel better and help you stay at a healthy weight. Weak muscles and extra weight can put added stress on your joints and can cause your arthritis to get worse faster.

Exercising won't "wear out" a damaged joint.² But if your joint is very loose or doesn't line up the way it's supposed to, some kinds of exercise may not work well or may even make your arthritis worse.³ Your doctor or physical therapist can help you find an exercise that is best for you.

Exercises that stretch the muscles can help prevent stiffness and injury. Exercises that strengthen the muscles and ligaments around a joint can help protect and reduce stress on the joint. For example, stronger thigh muscles can help reduce stress on the knees and hips.

Several studies show that exercise can help to:

• Improve how well the hip and knee joints work and move.²
• Improve how well a person with knee arthritis can move, and may delay or prevent the need for surgery.⁴
• Improve posture and balance in older adults with arthritis, which can help prevent falls.⁵

Motivation to exercise

Sometimes it's hard to get motivated to exercise, even though we know how good it is for us to do. Here are some ways to get started and stay active:

• Finda friend to exercise with you, or join a support group. People are more likely to stay with their exercise program if they exercise with a friend. And people with arthritis who attend classes or support groups have less pain and depression and have joints that work better than people who don't join a class or support group.⁶
• Try a class at your local health club or with your local arthritis chapter that is designed for people with arthritis. People who take part in an exercise class and who also exercise at home have less pain and feel better. And they are more likely to keep doing their exercise even after the class ends.⁷
• Record your efforts. Some people are motivated by seeing their progress written down.
• Reward your efforts. When you reach a step toward your goal, reward yourself by doing a special activity or buying something.

You don't have to spend a lot of money at a health club or on equipment to exercise. You can do many exercises, such as walking, almost anywhere at no cost. At a local health club such as the YMCA, you can enroll in a class (rather than pay for a complete membership) that doesn't cost a lot and is designed for people with arthritis.

Continue to How?

There are several types of exercises that you can do to help keep your muscles strong and reduce joint pain and stiffness:

• Aerobic activity strengthens your heart and lungs and builds your endurance. For aerobic exercise, you can:
  • Walk outdoors through your neighborhood or on city paths. Or you can walk indoors on a treadmill or at the mall.
  • Do water aerobics. You might try walking in water that is up to your waist or your chest (if walking outdoors or indoors isn't comfortable for you). The water helps take the weight off painful joints. And it provides some resistance.
  • Swim at your local health club, YMCA, or neighborhood pool. Many locations offer classes designed for people with arthritis. Swimming is a great choice for people with hip or knee arthritis, because water takes weight off the joints while also providing some resistance.
  • Bike outdoors or inside on an indoor bike.
  • Be more active in your daily routine. Vacuuming, house work, gardening, or yard work can all be aerobic.
  Note: Start slowly. For example, do 10 minutes of activity at a time, 1 or 2 times a day. Then work your way up to where you can do it for a longer time. Aim for at least 2½ hours of moderate activity a week. One way to do this is to be active 30 minutes a day, at least 5 days a week.
• Strength exercises improve and keep the muscles in your body strong. Strength exercises include:
  • Lifting light weights or dumbbells or using elastic tubing. You can use these at your local health club, or you can buy them to use at home.
  • Using an exercise machine at home or weight machines at your local health club.
  Note: Before you start to do strength exercises, ask a physical therapist, a trainer from a health club, or your doctor which exercises would be best for you. And ask how to do strength exercises safely so you don't get hurt. Exercise books and videotapes can also show you how to do strength exercises the right way.
• Range-of-motion exercises help keep you flexible and prevent more damage to your joints. Range-of-motion exercises include:
  • Stretches that move your joints through their entire range of motion. For example, stretches for the legs include calf stretch, quadriceps (thigh) stretch, and hamstring (tendons in the back of the knee) stretch.
  • Exercises that target a certain joint such as the knee in order to improve motion in that joint and prevent more damage. An example of this is a quadriceps stretch to keep your knees flexible.
  Note: Exercises that stretch and strengthen the muscles and joints can help older adults keep their balance, which can help prevent falls.

To learn specific exercises that can help stretch and strengthen your hands and knees, see:

• Hand exercises for osteoarthritis.
• Knee exercises for osteoarthritis.

If you have arthritis of the knee, you can try wearing shock-absorbing shoes, wedged insoles, or cushioned shoes to help reduce stress on the joint by shifting weight off of it. Taping the kneecap in a certain position may also help reduce pain. If you and your doctor find that taping helps you, you can learn how to put the tape on by yourself.

If an activity makes you feel sore, try something else. You can also change how you do the activity. Here are some things you can try:

• Rest between each exercise or activity.
• Decrease your speed.
• If you like to walk or swim, go a shorter distance. You might take two or three short walks in a day rather than one long walk.
• Do a shorter workout, then rest and do a little more later.
• Lift less weight.

Ask your physical therapist or doctor

Talk to your physical therapist or doctor before you start an exercise program. Ask what kind of exercise is best for you. He or she can help you learn the right way to do the exercise. Also ask:

• How to exercise if a joint is sore or if a joint is swollen.
• Whether you should take nonsteroidal anti-inflammatory drugs (NSAIDs) to make it easier for you to exercise or use ice after you're done exercising.

For more information, see:

• Quick Tips: Exercising Safely With Arthritis.

What to do when your joints hurt

If your joints hurt, try to rest them. Use assistive devices that can help you do your daily activities with less stress on your joints. Your doctor may suggest over-the-counter medicines to help reduce pain in your joints.

Other steps to help get rid of pain and stiffness include heat or cold therapy. You can use heat and cold therapies before or after exercise. It just depends on what works better for you.

For heat therapy, you can:

• Put a warm towel on the joint that hurts.
• Put a hot pack on the joint that hurts.
• Take a warm bath or shower.
• Get water therapy in a heated pool or whirlpool.

Cold therapy may relieve pain or numb an area. Use a cold pack (such as a bag of ice or frozen vegetables wrapped in a towel).

Transcutaneous electrical nerve stimulation (TENS) and ultrasound are two other types of physical therapy. These may help relieve joint stiffness and pain and allow you to exercise.

It's still important to try to exercise a little, after your pain is relieved. Walking is a great way to stay active. If you have pain when you walk, or if you want to switch back and forth between walking and other exercises, try walking in waist- or chest-deep water, swimming, or riding an indoor bike.

Continue to Where?

For more information about exercise and osteoarthritis, talk to:

• Your doctor.
• A physical therapist.
• An occupational therapist to help you regain and build skills that are important for being able to care for yourself.

For further information on exercise and osteoarthritis, the following organizations can provide information:

Organizations