Wise Moves: How you can stay active with arthritis

“In my 40s, one of my thumbs became painful and stiff. I ignored it, but it was an early indication that arthritis was going to be a problem for me,” recalls Susan Barron, 75, a retired school administrator from New York. “Then when I was in my mid-50s, my knee blew up so bad that I couldn’t walk.” Although not a gym-goer, Susan had enjoyed swimming, hiking, gardening and skiing. A diagnosis of psoriatic arthritis threatened to change that. 

“It became painful to do minor things, like making the bed. Everything was kind of exhausting. Then you lose strength,” she says. A rheumatologist put her on methotrexate and Humira®, and a physical therapist guided her through targeted exercises to rehab her knee. Today, 20 years after “the incident,” Susan still avoids the gym but stays active through gardening, walking and strenuous daily house-cleaning. 

A generation ago, it was commonly believed that exercise contributed to arthritis. While it’s true that some kinds of activity can worsen joint pain, we now know that regular low-impact exercise reduces arthritis symptoms over time. Staying active strengthens the muscles that support joints, relieving pressure and improving balance. 

“Not only does exercise keep joints strong and flexible, it also helps with pain relief for osteoarthritis, rheumatoid arthritis, fibromyalgia and a host of other conditions,” say Ricky Moore, an Aetna fitness coach who works with members with arthritis. 

Cardio exercise also helps control weight. For every pound of weight loss, experts say, you remove four pounds of pressure from your knee and hip joints. And, of course, weight loss reduces your risk of many other health conditions, from heart disease to cancer. 

Being cautious about exercise is smart, but don’t let that keep you from enjoying the activities you love. Read on to learn ways to work out wisely when you have arthritis.

What is the best exercise for arthritis?

Brisk walking, swimming, cycling and yoga are all great forms of exercise for people with any type of arthritis. “Swimming is probably the most gentle on the joints and allows you to work your full range of motion,” says Kelly Sems, MD, a rheumatologist and Aetna medical director, who notes that “swimming” can mean water aerobics or even walking in a pool. “Swimming is the number one exercise I recommended to my patients. Walking and yoga are a close second.” 

People with mild to moderate arthritis pain will achieve better results by moving their problem joint. For shoulder pain, pump your arms as you walk or grip the moving handles on an elliptical machine. Walking is beneficial for knee, hip and back pain. When foot or ankle pain makes walking difficult, you may find pool-based exercise more comfortable.

A gym or senior center can give you access to a pool, as well as equipment like recumbent bikes (which are easier on the back and shoulders), elliptical machines, treadmills and weights. But you can get the same benefit for free by walking around your neighborhood or working out at home to videos. “You can find many free yoga for arthritis programs through sites like YouTube,” says Dr. Sems. “And it’s cheaper to buy a yoga mat than a bike.”

With any activity, you should stop exercising if your pain increases after 5-10 minutes. Try something gentler instead, or avoid working the problem joint until you’ve built up more strength and stamina. Experts recommend steering clear of high-impact sports like running, which stress the joints. Kneeling and squatting are hard on the knees and hips. But as the saying goes, listen to your body. 

How much exercise do I need?

Start with 10-15 minutes most days of the week. Slowly work your way up to 30 minutes a day of moderate activity. Each week, increase the duration or intensity of your workout, but not both at the same time. 

If you’re already fairly active, aim for at least 150 minutes of moderate activity per week, or 75 minutes of vigorous activity. What’s the difference? Moderate activity will raise your heart rate and bring on a light sweat while still allowing you carry on a conversation. Vigorous activity is closer to your maximum effort. 

Keep in mind: The number one mistake older adults make is overdoing it. When a workout leaves you feeling wiped out or sore for days, you’ve done too much. Scale back your effort or the length of your session. The sweet spot is a level of exertion you won’t mind repeating the next day.  

How should I prepare for a workout?

A little preparation can make your workout easier, safer and more effective. 

• Joint braces and canes can make you more comfortable and stable during exercise. Your doctor or physical therapist can help you select the right one. (If these devices cause you some embarrassment, then make leaving them behind your ultimate goal.)
• Shoes and insoles also make a difference. Walking shoes, for instance, are designed with more cushioning and support. Orthopedic insoles can adjust your balance to relieve pressure on your hip or knee. Most supplies can be purchased with funds in your HSA or FSA. Learn more about health savings accounts and eligible expenses.
• Get a good’s night sleep. Lack of sleep has been linked to arthritis flare-ups. 
• Fuel your body. Drink water before, during and after a workout. Eat plenty of lean protein and vegetables. Some arthritis sufferers swear by supplements like turmeric, Vitamin C and fish oil.
• If you take regular pain medication, time your dose for about 45 minutes before exercise.
• Warm up your joint with a moist heat pack for 20 minutes before exercise. Heat will increase blood flow to the area and relieve stiffness. Read more tips on how to stick with a fitness routine

How important is rest and recovery?

Experienced athletes say that recovery time is a vital part of any training program. Resting allows your muscles and other tissues to rebuild. Give yourself a day off from exercise if you haven’t slept well the night before or you’re fighting a cold ― your body already has enough to do. You may also want to skip a day when the weather is sweltering or frigid.

For relief from minor discomfort after exercise, these tried and true remedies can help:

• Ice packs. Apply to your sore joint for 10-15 minutes to bring down swelling.
• Topical pain relievers. Try balms with active ingredients like menthol (found in Bengay®) or capsaicin, derived from chili peppers. 
• Gentle stretching. Stretching signals your muscles that it’s time to relax and rebuild. Note: Stretching before exercise doesn’t help performance and could strain tissue and joints.

Where can I find expert help?

Getting fit is challenging, but you don’t have to do it alone. Below are three options for professional support, for different levels of confidence, physical condition, time commitment and budget.

• Physical therapist. The gold standard is a PT specially trained in supporting older adults with arthritis. But any PT can guide you through one-on-one exercises designed to get you strong enough to continue you on your own. Your doctor can prescribe physical therapy so that it’s covered by insurance.
• Health coach. A credentialed health coach can advise you on fitness plans, nutrition, motivation, smoking cessation and more. Aetna members have access to free health coaching by phone; talk to your benefits administrator to learn more.
• Online virtual coaching. The National Institute on Aging’s free Go4Life program offers tools to help you set fitness goals, track your progress and celebrate successes.

There’s no cure for arthritis, but exercise may be the best medicine to treat its symptoms and prevent further joint damage. Whenever you make exercise a priority, make sure to congratulate yourself. Even better, post your accomplishment on social media and watch the “Likes” roll in. You’ve made a wise move for your health.