For People with Arthritis, Exercising Regularly and Safely is Very Important

If you have some degree of arthritis — as do an estimated one quarter of the adult U.S. population — participating in joint-friendly, regular physical activity can improve your arthritis-related pain, function and your overall quality of life.

Physicians with Miami Orthopedics & Sports Medicine Institute, part of Baptist Health, who treat patients with arthritis will undoubtedly have a discussion about incorporating regular exercise into their lives — with certain considerations to avoid overuse injuries or otherwise aggravating existing conditions. Even the most qualified surgeons will advise patients about physical activity — in hopes of avoiding surgery.

Alexander van der Ven, M.D., orthopedic surgeon with Miami Orthopedics & Sports Medicine Institute.

 “The first discussion I have with every single person who walks through the door. What do you do for exercise? What do you do for fitness?” explains Alexander van der Ven, M.D., orthopedic surgeon with Miami Orthopedics & Sports Medicine Institute. “And when they say I don’t do anything, no matter what they need, we send them to the gym, or we send them to a trainer, or to a physical therapist. We give them instructions. We basically try to empower them. We try to give them confidence and instruct them about how to exercise and why it’s important.”

For decades, the benefits of exercise for everyone are well documented. Physical activity on a regular basis is vital for weight management, cardiovascular health and fending off chronic diseases including heart disease, diabetes and even some cancers, studies have shown for years. 

Being Overweight or Obese

People who are overweight or obese are more likely to get knee osteoarthritis than people who are not overweight. Moreover, physical activity can decrease pain and improve physical function by about 40 percent, says the CDC.  Still, 1 in 3 adults with arthritis are inactive.

“We know that people with arthritis who exercise feel better than people with arthritis who don’t exercise,” said Dr. van der Ven, who oversees the joint replacement surgery program at Doctor’s Hospital. “We know that people who are obese have more inflammation. They call these cytokines and adipokines, which are inflammatory markers that are released by fat cells. And the more overweight you are, the more inflammation you generate, which also causes the progression of arthritis.”

An estimated 55 million men and women suffer from arthritis, says the U.S. Centers for Disease Control and Prevention (CDC). It is a leading cause of disability, and contributes to pain, aching, stiffness, and swelling of the joints. Osteoarthritis is the most common type of arthritis It has been called “wear and tear arthritis.” It develops when the smooth cushion between bones (cartilage) breaks down and joints get painful, swollen and hard to move.

‘Better Than Medication’

Exercise works almost as well, “if not better than medication management for suppressing pain in our bodies, says Dr. van der Ven.

Without the benefits of exercise, many people can develop “mal compensation routines,” he says.

“If they have a painful knee, they start to walk funny and they start to use accessory muscles — then they start to get bursitis in their hip, they start to throw out their back, and they start to get bursitis in their knee,” explains Dr. van der Ven. “Then you take one condition and you start to create two or three other conditions because they’re not treating that condition correctly.”

Getting Started Safely

The CDC has a dedicated section for helping people with arthritis to start exercising. “Start slow and pay attention to how your body tolerates it,” the CDC states. “People with arthritis may take more time for their body to adjust to a new level of activity.” Coming with a routine that can be done at least three times weekly is crucial, says Dr. van der Ven.

“You’re going to typically come up with an exercise plan, which is going to be a regular routine, three to four times a week of moderate level activity,” says Dr. van der Ven. “You want to get your heart rate up, as long as it’s cleared by your physician. You want to generate those endorphins and get them going. A little soreness is okay, but pain is not. You want to avoid things that really hurt, but you can find activities that don’t hurt, such as a stationary bike, some weight training, yoga, Pilates.”

Working with a physical therapist or trainer is ideal, he says. But your physician can get you started with proper guidance.

“For people with low to moderate grade osteoarthritis, whether of the hip, the knee, the back, the ankle, I would say probably 80 percent are going to respond with some success,” explains Dr van der Ven. “We’re not trying to make them perfect. But if we could make somebody 75 percent better than where they were when they first come in, I think that’s a success.”

Avoiding Overuse Injuries

Trying a combination of exercise routines is crucial to avoid overuse injuries, explains Dr. van der Ven. If physical activity causes arthritic flare-ups, the Miami Orthopedics & Sports Medicine Institute’s arthritis clinic focuses on helping arthritic and injured people return to their daily activities and a functional level of life using non-surgical techniques and orthopedic medicine.

“The important thing is you need to change,” says Dr. van der Ven. “You cannot do the same activity over and over and over again –or you will get an overuse injury. Even walking will eventually create overuse injuries. You need to try a combination of things which is going to raise your metabolic rate. You need to increase your flexibility. You need to work on your core strength. You should continue to change your exercise routine so that you avoid those overuse injuries. It’s really important.”

The first challenge that many physicians face when consulting patient with arthritis is changing the mindset that exercise is something they cannot or should not undertake.

“It’s a matter of giving them confidence,” says Dr. van der Ven. “We have to clarify their misconceptions and clarifying what maybe somebody once told them, or they once read, or maybe helping to correct the effects of a traumatic experience. Maybe they played a sport and then they hurt their knee, and they’re so afraid that they think that it’s going to set them back again.

“But we do know that people with arthritis who exercise feel better than people with arthritis who don’t exercise. That is universally accepted and regular exercise is critical to treating your symptoms.”