Arthritis and exercise

Regular exercise is one of the most important things you can do to manage your arthritis and improve your quality of life. Exercise will reduce pain, keep you moving, restore flexibility and protect your joints against further damage.

It has other benefits too ...

• Helps you sleep better.
• Lifts your mood and mental wellbeing.
• Reduces stress levels.
• Lifts your confidence and self-esteem.
• Helps with weight management.
• Promotes good heart and lung health.
• Lowers blood pressure and cholesterol.
• Helps manage blood glucose levels (diabetes)
• Improves strength and balance.
• Gives you more energy.
• Improves memory and cognitive function.
• Helps maintain a healthy brain.
• Delays the onset of neurodegenerative disorders, eg, dementia.
• Promotes healthy ageing.

The best kind of physical activity for you depends on your arthritis and which joints and muscles are affected. 

Why isn't everyone with arthritis exercising?

The top 7 concerns the Arthritis NZ educators hear from people with arthritis are:

1. I am afraid exercise will make my pain worse or aggravate my condition.(external link)
2. I don’t know what to do or how to get started.(external link)
3. I lack the motivation to do it on my own.(external link)
4. It is hard to get going when I am in pain.(external link)
5. I don’t have the time.(external link)
6. I don’t have the energy when I feel tired.(external link)
7. I have tried before and didn’t stick with it.(external link)

Click on the links above to learn more about how to manage these concerns from Arthritis NZ. 

Understanding the 4 different types of exercise is important in determining which types of exercise could be suited to you.

Cardio exercise

Also known as CV (short for cardiovascular) aerobic or endurance exercise, cardio is anything that raises your heart rate and makes you breathe more heavily. You need to engage the muscles in your legs or arms (or both) and you’ll know if you are doing cardio exercise if you are ‘huffing and puffing’ and your body temperature increases.

Why is cardio exercise important?
It strengthens your heart and lungs and improves your metabolism which makes you better able to manage blood glucose for example. Cardio stimulates cognitive function (brain health) and helps with weight loss. It's also known to reduce mental issues like stress, anxiety and depression. Being ‘cardio fit’ means you can climb stairs or hills, play sport or run around with the kids or grandkids.

Image credit: Canva

Resistance exercise

Also known as strength or weight training, this is when you move against a resistance provided by your own body weight and gravity. Bands or weights (eg, dumb bells, barbells, kettlebells, weight bags, plates, etc) can be used and isometric exercise can also be useful as part of a resistance programme.

Why is resistance exercise important?
Resistance exercise counters the loss of muscle tissue (known as sarcopenia) that occurs with ageing from about the age of 35. Resistance training is also good for bone health as the action of tendons, which are attached to muscles, pulling on bone protects against declines in bone mineral density.

The obvious benefit of staying strong is being able to push, pull, carry and lift things. Your posture will improve and you will look more toned. As you get older the risk of falls increases and having the muscle strength and power to recover when you lose balance is crucial. Read more about falls and how to prevent them.

Mobility exercise

Also referred to as flexibility or stretching, mobility exercise is all about maintaining a good range-of-motion (ROM) in joints.

Why is mobility exercise important?
Whilst it provides temporary relief to keep painful joints bent (and is very easy to do), this becomes a ‘Catch 22’ as doing so for too long can cause further loss of mobility and hinder everyday activities even more. By taking joints through full range-of-motion in a controlled manner you will help to preserve as near normal function as possible.

Balance training

We tend to associate specific balance improvement exercises with older people who have had a fall in order to reduce the chance that they will have another. But this is like shutting the stable door once the horse has bolted!

Most people don't know that there's a complex combination of our visual, vestibular (inner ear) and proprioception systems working together to keep us upright and to move at will.  As you get older these systems are more likely to be affected so it's never too late to include balance work as part of regular exercise, but it's also never too early.

Why is balance training important?
To prevent falls and possible injury. A fall can happen at any age but carries increased risk with age, eg, 1 in 3 people over the age of 65 years will have a fall.

Here are some popular forms of exercise with information about what they offer but also what you need to consider.

Walking

Positives: Simple and easy to do at any time and it's free. Can be a social activity.
Considerations: Doesn't challenge your brain or include balance or upper body components. May not raise your heart rate enough. Can be a social activity.

Jogging and running

Positives: Can be done anywhere and anytime at no cost. Can be social.
Considerations: High impact so could aggravate your knees, hips or spine. 

Cycling 

Positives: Great for osteoarthritis in your knees. It's non-weight bearing and low impact so puts less stress on joints. If done inside you can join a class, change the intensity using a stationery bike and it's not weather dependent.
Considerations: Doesn't help to strengthen bones as it's low impact and doesn't strengthen upper back if needed for posture. If done outside you need access to a bike and somewhere safe to cycle. It's also weather dependent. If inside you need access to a stationery bike at home or by joining a gym class.

Swimming

Positives: Non weight-bearing so good for joints, Good for cardio.
Considerations: No bone strengthening or balance work provided, and you need access to a pool.

Image credit: Canva

Gym

Positives: Equipment provides cardio and resistance work and balance and flexibility can be included. You can personalise what you do and measure your progress.
Considerations: You may not feel confident going to a gym. You need to pay for access to the gym and to an exercise professional for advice on a programme to suit you.

Seated classes

Positives: Good if you have limited mobility, and can include strength work using bands and weights.
Considerations: No balance component involved and not very intense. There can be a cost involved.

Circuit classes

Positives: You can work at your own pace and include cardio, resistance and balance work.
Considerations: There's likely to be costs involved for access to a gym and a good instructor.

Yoga

Positives: Balance, strength and flexibility provided for. There's a good focus on breathing. It can be done in a class or at home.
Considerations: Need a teacher to provide alternatives and options which may have a cost.

Image credit: Canva

Tai Chi

Positives: Helps with balance and strength and cognitive skills (in learning moves). Gentle exercise.
Considerations: No cardio component, classes can be costly.

Pilates

Positives: Good for core strength and alignment, slow and controlled.
Considerations: No cardio challenge and not much balance work. You'll need to pay for a trained instructor. 

Zumba and dancing

Positives: There's a cardio component and a class with music can be motivating. There's a cognitive component in learning moves.
Considerations: No resistance work and not much balance required. You need access to classes. 

If you are starting out with exercise or are beginning after an injury, illness or flare up, our advice is start low, make it slow and keep it short. For example if you start with a 15 minute walk, doubling it to do 30 next time is too much – 20 minutes would be more appropriate. By building up the intensity and duration in small increments you'll be much less likely to have pain and discomfort.

• Start low: This relates to the the weight or loading that you use. If you're using weights, start with something that after 10 to 12 repeats is beginning to feel challenging but not impossible.
• Make it slow: Perform your exercises or stretches slowly and with control to ensure your technique is correct.
• Keep it short: This relates to the activity duration whether it's taking a walk, swimming or lifting weights. Start with a time that doesn't leave you too tired and build up by no more than 10 to 20% a time.
• Keep a record: This can be really helpful to track progress, see patterns that you can learn from and provide you with motivation when you see how you've improved over time.

Here's an exercise book created by Arthritis New Zealand(external link). They also have a range of exercise videos on the Arthritis New Zealand YouTube channel(external link). 

Here are some motivational tips and tricks that have helped others living with arthritis:

• List why you should exercise versus why you want to. Take a piece of paper and make 2 columns. In one column list all the reasons you should exercise and in the other all the reasons you want to exercise. Ideally the ‘want’ column will be more emotionally connected. Keep this list handy and refer to it regularly to remind yourself of your WHY.

Examples may be:
I want to exercise to be able to play with my children or mokopuna.
I want to exercise so that I don’t end up in a wheelchair when I am older.
I want to exercise because it makes me feel good about myself afterwards.

• Be flexible with your exercise routine. Some days will be better than others. Know what you can do and have a PLAN B on the days when you are sore.

• Set realistic goals and review them according to how circumstances change for you. It doesn’t matter if they’re very simple to start with. Gaining a sense of achievement, no matter how small, will keep you motivated to continue. Keep a visible record of these exercise goals and achievements. Learn more about setting goals.

• Reward yourself when you hit a goal or target.

• Run a movie in your mind seeing yourself exercising as you plan to and then conjure up the feeling of satisfaction you will feel and the positive effects on your body when you have done it. You could add a personal mantra like “I’ll feel great when I have done this” or “I always feel better when I exercise”. 

• Start short. Make a deal with yourself that you only have to do a short amount (say 5-10 minutes) and then after this time ask yourself if you can do more… chances are that you will have warmed up sufficiently to go on for longer.
• Move to music. Distract yourself by playing some motivating music that inspires you to want to move.

• Lay out your exercise clothes in clear view so you get into it in the morning without having to hunt it out. Once you are dressed to workout, you may as well workout!

• Make a date. Just as you would for any appointment or meeting, diarise your exercise and only miss doing it under extreme circumstances.

• ‘Phone a friend’ Speaking to or exchanging texts with someone who supports you is often the little nudge you need when it is tough to get going.

• Embrace social media. Join a Facebook page with others that understand your situation. Knowing that others living with arthritis can and have overcome the same issues you have is very powerful in helping you stay connected and motivated.

Image credit: Canva

Apps reviewed by Healthify

You may find it useful to look at some Arthritis apps, Physiotherapy and exercise apps, and Exercise apps.

Arthritis NZ Mateponapona Aotearoa(external link) offers information and support to all people affected by arthritis. Phone 0800 663 463.

Find out about their Facebook, local face-to-face and monthly Zoom Café support groups on their support page(external link).