Arthritis – An Exercise Program For You

All About Swimming

Swimming gives your muscles, heart, and lungs a great workout. When one group of previously inactive middle aged adults swam for 12 weeks, their oxygen uptake increased an average of 20 percent, and their hearts pumped more blood with each beat.

The great thing about swimming is that the buoyancy of the water essentially carries your body weight. And your heart rate is lower in swimming than in other sports. It’s the ideal exercise for people with arthritis and joint problems (and it’s good for anyone who goes with you, too).

The right gear. To liven up your pool workouts, you may want to use fins. These make your legs work in both directions, using your thigh, calf, and abdominal muscles, and keep you from overworking your arms and shoulders. They’re also helpful when recovering from knee injuries.

You could also use a pull-buoy, which is two Styrofoam cylinders held together with cords. You place it between your thighs, and it holds your lower body up in the water, letting you paddle without kicking. And try a kickboard, a flat piece of Styrofoam you hang on to so that you can kick without paddling or arm strokes. Hand paddles and webbed gloves are designed to help strengthen your arms, but because they increase the risk of shoulder problems, steer clear.

If you’re troubled by swimmer’s ear (a bacterial or fungal infection caused when water washes away protective earwax), you may want to use earplugs. You can also swab your ears with alcohol after swimming or use an over-the-counter preparation of alcohol or glycerin drops.

Getting started. If you find yourself gasping for breath after one lap, you probably aren’t going to be eager to swim again. The trick is to get in shape first. Walk or use a stationary bicycle so that you’ll be fit enough to stay in the water longer when you do climb in. And stretch before swimming, in the pool or out. This warms up your muscles to increase blood flow and flexibility. You could walk or jog in place in the water or stretch while holding on to the side of the pool. Next comes light swimming to warm up for a few minutes.

If all you can do at first is stretch, warm up, paddle a lap, and then cool down, then that’s what you should do. Don’t force yourself through a painful or exhausting workout: If you’re tired, you’re going to get hurt.

Likewise, if swimming is tiring, you may need to improve your style. Swimming incorrectly can tire you or strain your muscles. You also may want to learn different strokes to make your pool time more interesting. You can sign up for lessons or join a masters’ swim group for coaching.

Realize that swimming in too-cold water causes you to lose too much heat and stresses your cardiovascular system. Too-warm water overheats you and also stresses your system.

Many pools are kept at 70 to 73 degrees, which requires you to move briskly to stay warm. (Wearing two swimsuits, one atop the other, and a swim cap can help.) Most of us can swim comfortably in temperatures of 82 to 86 degrees, but the 92- to 98-degree temperature of therapeutic pools is designed for limited movement only and is too warm for swimmmg.

Summary: Mild stress on elbows, shoulders, and spine.

All About Water Workouts

Remember doing calisthenics in high school? Or maybe you have grim memories of aerobics classes where you were doggedly leaping about, always one step behind and definitely not having fun.

Exercising in water is a whole new experience and most people with arthritis love it. You don’t need any special skills, and with certain simple equipment, you don’t even need to know how to swim. All you need is water. The natural buoyancy of the water aids movement, letting you do exercises that might be too painful or stressful on land.

Water exercise covers a wide range of activities: water aerobics, supervised sessions prescribed by a physical therapist, or running or doing jumping jacks in your backyard pool. It can be done with your head completely above water or can include bobbing or rolling in water. It can be done in deep or shallow water, in a regular pool, or in a heated therapeutic facility.

And water is a great place to work out. Water effectively reduces your body weight by 90 percent. So if you weigh 150 pounds, in water your limbs only have to support 15 pounds. Stress on joints, bones, and muscles is kept to a minimum.

Water can also help cool you off as you exercise, and any stiffness or pain you may be feeling may decrease. In heated or therapeutic pools there’s no cooling effect, but the warm water helps relieve the pain of stiff joints or injured limbs.

And because water provides resistance to movement, pushing to move through it can tone and strengthen muscles and improve your range of motion. You get benefits similar to those from doing the exercises on land but with none of the jarring or pounding.

The right gear. If you can’t swim, you may want to use a flotation vest, which also comes in handy for certain exercises. If you walk or jog in the pool, for example, the vest will keep you upright so that you don’t have to struggle to keep your balance. Or you can use it in deeper water to keep an injured foot or ankle completely off the pool floor. You may also want fins, a pull-buoy, or a kickboard to vary your routine.

Getting started. Once your doctor has given the okay, you can sign up for a class at the community pool or devise your own workout. If you have a physical therapist, your therapist will design a program for you.

Whatever your program, spend five minutes warming up to get your body ready. You can warm up in the pool or in a whirlpool or hot tub. You can sit on the edge of the pool and do flutter kicks and circle your feet in the water. Or, while you’re in the pool, jog in place or do other stretches.

A good beginning water exercise session might include a 5-minute warm-up, 10-minute workout, and 5-minute cool down, three times a week. Another workout you can do on your own is pool walking or jogging. Do warm-up, spend 10 to 20 minutes traveling back and forth from, one end of the pool to the other. For variety, try walking side-ways or backwards. If the pool bottom is slippery, wear a pair of rubber-soled water socks or water sandals.

Remember, for most pool exercises, a good temperature range is 82 to 86 degrees.

Summary: Mild stress on ankles, knees, hips, elbows, shoulders, spine.

All About Bicycling

Bicycling doesn’t pound your lower joints as jogging or even brisk walking can, because much of your weight is supported by the bicycle seat. This makes biking particularly good for people who are overweight or have some joint damage. People with osteoarthritis in bicycling programs not only improved muscle strength and aerobic capacity, but also reduced their joint pain and fatigue.

The right gear. An old bike may do just fine (after a quick tune-up). Be sure to adjust the saddle height, because riding with it too high or too low can cause joint problems. There should be only a slight bend in your knee when pedaling with the balls of your feet. If you’re rocking from side to side as you pedal, the saddle is too high; if your knee is bent quite a bit, it’s too low.

You can buy gel-pad-filled saddle covers if the saddle is too hard, and you may be more comfortable on wider saddles (women’s “sit” bones are farther apart than men’s). You can ride in any comfortable clothes, but you may want to consider the additional comfort of bike shorts with a padded, seamless crotch. (If you ride in long pants, wrap a rubber band loosely around the right pants leg so that it doesn’t get caught up in the chain, or buy bike clips made for that purpose.) Padded, fingerless bike gloves will keep your hands from getting numb and protect your palms in case you take a tumble. And a helmet is a must. Some folks can ride in regular sneakers with no problems, but if you find your feet getting numb, head to the bike store and check out bike shoes with stiff soles that spread the pressure around.

Getting started. When you’re just starting, you may want to limit yourself to jaunts around your neighbourhood. Specifically, stay away from hills. A beginner may want to ride 10 minutes at a time, three times a week, and increase that by 5 minutes each week.

Don’t make the mistake of pushing a high gear, which forces you to pedal slowly. This is inefficient and can cause knee and muscle pain. You’re much better off in a lower gear, spinning the pedals faster. Pedal with the balls of your feet, never your heels or insteps.

Glance at your watch or have someone time you for 60 seconds and count the number of times you turn the pedals over in one minute. Sixty or more revolutions per minute is the most efficient pace and least likely to cause injury.

Your goal may be to ride 20 minutes three times a week. Warm up the first three to five minutes and end with a three- to five-minute cool down by riding slowly in an easy gear. As your fitness level increases, you can increase the time you ride.

If you’re troubled by inflexibility or find yourself tightening up from cycling, start stretching out after your workout, specifically your hamstrings, calves, and quadriceps. Don’t stretch before riding, when your muscles are cold.

Riding indoors. If you’d rather cycle indoors, you have plenty of choices. You can put a regular bike on an apparatus called a wind trainer, or you can use one of many varieties of stationary bicycle. Many people find models with seat backs more comfortable, and others prefer recumbent or semirecumbent ones that you pedal with your legs in front of you. These bikes are less likely to cause pain in the buttocks and lower back and are often easier to climb onto.

In general, you want the smoothest, quietest ride and sturdiest bike possible, and a small digital panel that lets you track your workouts, preferably one that shows distance covered, speed, time, and how many calories you’re burning. You can start indoors with a similar schedule to regular biking, at first setting the control for very little resistance.

You can get a magazine rack to prop up your favorite reading material or a headset with music to exercise by. And lots of people enjoy watching television while they pedal.

Summary: Outdoor biking-mild stress on the ankles, wrists, elbows, shoulders and spine and moderate stress on the knees and hips; stationary biking-mild stress on the ankle and spine; moderate stress on the knees and hips.

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