Simple Tips for Staying Active with Arthritis

Living with Arthritis

Living with persistent joint pain can make exercise seem like an impossible mission. However, movement is one of the best things you can do for a joint that has some arthritic changes. To better understand what arthritis is and what causes it, visit our previous blog “6 Golden Rules for Osteoarthritis“.

Motion is Lotion, Movement is Medicine

For too long the public have been led to believe that joints degrade as we age, and the more punishment you put it through, the more it degrades. However, movement is good for the joint.

  • Compression (eg: the impact on the knee during running and walking) stimulates growth of the good protective cartilage linings in the joint.
  • Movement can help with maintaining weight, which can help with reducing the load.
  • Building strength and muscle mass can help distribute the forces across the whole limb, rather than relying on the joint to take the weight.
  • Learning good movement patterns gives your body more options, so that it doesn’t rely on one joint too frequently.
  • Healthy lifestyle can decrease inflammation and have a direct improvement on pain and joint health.

Pacing

The key to exercising or doing daily tasks is pacing. Pacing means slowing down and doing less. If you’ve been in pain for a long time, or if you’ve been less active than in previous years, then it’s unlikely that you can do the same amount of physical activity. It’s about breaking up tasks into a series of smaller bouts. If your goal is to vacuum the house, you may need to do it one room at a time, having a rest in between each – whether that’s for a few minutes, an hour, or a day.

Graded Exposure

The second key component to increasing your pain-free activity is graded exposure. Graded exposure means steadily increasing your exposure to a given task or physical activity. If you’ve been vacuuming one room per day for the last 2 weeks and it hasn’t stirred up your joint pain, then you’re likely ready to increase to 2 rooms per day. After a couple more weeks you can likely do 3 rooms, then in another fortnight doing half the house. Over a period of weeks and months, you can slowly expose your body to the task that was once flaring it up.

Try This

Walking is often an aggravating activity, but usually people have an amount they can cope with before pain sets in. Think about your baseline, can you walk your block? Maybe walking to your letterbox is as far as you can handle? Whatever is your current yardstick, do that consistently for 2 weeks and then slightly increase the time or distance by 5-10%. Every 1-2 weeks increase your time and distance, ensuring you have lots of rest and recovery to complement it.

How to Overcome Your Hatred of Exercise

Being physically active is an extremely daunting prospect for many people. A lot of us have had very negative experiences with exercise over our lifetime. Social pressures, perceived failures, injuries, pain, and being forced into sports and activities that we genuinely don’t enjoy, has tainted exercise for many of us. Now, into our adult life, there are other responsibilities that soak up so much of our time and energy. It can feel almost impossible to carve out enough time to get a workout in.

Unfortunately, our aversion to exercise is really hurting us. The benefits of physical activity are so broad and encompassing, and so extremely meaningful and powerful. If scientists were able to design a pill that provided the same physical, mental and social benefits as exercise, every person on the planet would be taking it.
Although it’s not as easy as taking a pill, physical activity doesn’t need to be hard and complicated either. Physical activity should be as easy and as painless as possible. It can, and should, fit into your life in a way that becomes second nature.

Exercise can become something that anyone can enjoy, it just needs to be reframed and rethought. These tips are here to help you form a positive habit and build exercise into your lifestyle.

1. Start small

Image: https://www.mentalfloss.com/article/67661/16-little-words-and-phrases-describing-small-amounts

Doing any physical activity is better than doing none. If you’re fairly inactive at the moment, just take the first step. It doesn’t need to be grand. In fact, habits are more likely to stick if they have a low barrier-to-entry and a good chance of immediate success. That means, don’t worry about fancy equipment or expensive gym memberships. What’s the most simple activity that you can think of that involves moving your body? Walk, dance, crawl, roll, sweep, dig, run, jump, swim, ride, play, pilates. Anything. Just move a little bit more than you did yesterday and you’re becoming physically active! Achieving a meaningful goal, no matter how small, will unlock the brain’s neurotransmitters to 1) make you feel good about yourself, and 2) rewire the neural circuitry of the brain to make that habit more permanent.

2. Have fun

Image: https://host-students.com/dance-workouts-you-can-do-at-home/

In what way could you move your body that will provide you with a feeling of happiness and fun? It’s different for everyone, and it can often take a long time to find the activity that lights you up. So be ready to experiment. And think outside of the box, it doesn’t need to be an organised form of exercise – like running, golf, kayaking, rock climbing, frisbee, etc – it can be any random activity that involves movement; kicking a ball around with your dog, dancing in the kitchen, walking to the supermarket, rearranging furniture in your house… Absolutely anything. Don’t restrict yourself to the schoolyard parameters of beep tests and team sports.

3. Team up

Image: https://www.austinfitmagazine.com/March-2015/stay-in-shape-by-walking-with-friends/

More often than not, you’re not the only person in your social circle who is looking to get more active. Be vulnerable and ask a mate if they’ll start going on a morning walk with you once or twice a week. Having an accountability partner makes it easier to get out of bed when the alarm starts ringing. It’s harder to bail on a buddy than it is to bail on yourself. Plus, the benefits of chatting, laughing and spending time with other people compounds the mental and emotional benefits of exercise!

4. Be forgiving

Image: https://centerforliving.org/blog/5-best-self-care-tips-this-fall/

It’s OK to miss a day, a weekend, a week, a fortnight… Don’t sweat it. We’re all human, fallible and imperfect. Sometimes life gets in the way – you get tired, become distracted, unmotivated or lazy. That doesn’t mean you’re a bad person. Your self-worth doesn’t depend on you being perfect, or exercising every day, or being kind and calm and caring to every person you interact with! You are allowed to stuff up. You’re allowed to be selfish. You’re allowed to sit on the couch eating ice cream and watching telly. You’re enough, regardless of these behaviours. So when you miss a day, wrap a metaphorical arm around your own metaphorical shoulder and forgive yourself – there’s always tomorrow, and every day thereafter, to go out and exercise. Habits aren’t built in a day, so having one off won’t derail the train. In his book Tiny Habits, leading behavioural expert B.J. Fogg says it best; “people change best by feeling good, not feeling bad”.

The Nuts and Bolts

Adult Australians are recommended to do 2.5-5 hours of moderate intensity exercise per week, or you can halve that time and do your exercise at an intense level for 1.25-2.5 hours.

Image: https://www.amhf.org.au/essa_helps_men_move_with_new_male_specific_exercise_resource

So what does that look like in practice? Here’s a couple of suggestions to get you up to the baseline requirement for physical activity without breaking a sweat.

  • You can briskly walk 15-minutes from your car to your workplace (and vice-versa) 5 days a week, and you’re hitting the low-level guideline. If you haven’t walked much for many months or years, start with a 5-minute walk and build up over a few weeks.
  • In the morning before work, put some music on while making breakfast, and dance around like a fool for 15 minutes til you get a little breathless. Do the same when you get home that evening, and bingo, there’s your 30-mins of daily moderate intensity activity.
  • Go for a 5 minute walk in the morning sun. Put on your favourite song and dance for 5 minutes. Do 2 push ups. Quickly vacuum the hallway. Throw a ball to your dog 5 times. Park 500m away from work. Do 5 squats on your lunch break. Get home and go for a 5 minute walk in the afternoon sun. Water the garden. Surely that’s 30 minutes all up?

Take Home Message

Don’t make it complex. Don’t make it hard. Make it fun, make it silly and make it likely to succeed. Once you get a few wins on the board you’ll be even more likely to start adding in more, higher intensity, activities.

5 Must-do Exercises for Beginner Runners

Some people might say I’m crazy but I seriously love running. It sets up my day, drags me out of bed, and gives me a boost of endorphins that allow me to drive all the way to work with very few road rage incidents. I use it as a way to catch up weekly with friends, meet new people, and keep myself relatively healthy. It’s easy, basically free, and accessible to almost anybody.

There are a myriad of benefits to running! It’s a safe and effective way to improve cardiovascular health, bone density, muscular endurance, boost mood, and improve energy. With these few exercises, some smart programming, and a few expert tips you too can enjoy all of these benefits – physical, mental and social.

But beware, all of the exercises in the world won’t make up for doing too much too soon. An estimated 60% of running related injuries are linked to increasing mileage too quickly. Get a running plan in place that is tailored to your needs and slowly increase your weekly load in 10% increments. If you’re new to running altogether, start by increasing your daily walking before beginning to add small bouts of running.

Every individual has their own unique injury history, strengths, weaknesses, and running goals. Therefore it may be helpful to speak to the team at Peninsula Osteopathy + Allied Health, to get screened and assessed on your current capacity, and provided with an individually tailored plan to ensure you hit the ground running! (Pun intended).

Single leg sit-to-stand

Single leg strength, stability, and endurance is a huge component of running efficiency and capacity. The average runner should be aiming to take around 160-180 steps per minute, so for a 25-minute jog, each leg must support the weight of the body approximately 4000+ times! The single leg sit-to-stand is the perfect way to begin loading the muscles of your hip, buttock and leg – in a similar fashion to the way they are required to work during running. Your health practitioner can help ascertain when and how to progress the exercise, by adding weights, increasing the range of motion, and more!

Sit to stand demonstration

Glute bridge

This exercise focuses on hip extension and increasing the control of your lumbopelvic region (from your low back into your hips and buttock). Our hip extensors, such as the gluteus maximus, are the powerhouse of the running stride. The glute bridge can be altered to become single leg, weighted or with different tempos, all of which may be smart progressions for your practitioner to explore with you.

glute bridge demo

Hamstring bridge

Weakness in the single leg hamstring bridge test has been shown to predict hamstring related injuries in AFL players and military personnel. While we may not be reaching the pace of an AFL player, hamstring strains, tendinopathies, and niggles are still very common amongst casual runners. Start double leg and work towards a single leg variation.

hamstring bridge demo

Copenhagen adduction

Hip and groin pain is another common running niggle. This exercise increases the strength and control of your adductors (groin) while also providing a side plank core control exercise – bang for buck! Begin with a short lever (knee on the chair) and progress to long lever when ready (ankle on the chair).

copenhagen demo

Calf raises

calf complex

The calf complex is made up of the gastrocnemius (the big two headed muscle you can see) and the soleus (underneath and severely under-appreciated). The soleus actually produces the majority of force in the ankle during running. To strengthen the soleus do calf raises with a bent knee and to strengthen the gastrocnemius do them with your knee straight. Did anyone notice that I snuck in 6 exercises?

calf raises demos     Bent Knee Variation    |   Straight Leg Variation

STRENGTH! WHAT IS IT GOOD FOR?

Training for strength

Strength training uses the most weight with the least amount of repetitions with long rest periods in-between. Aiming for the ability to lift large amounts of weight for less time. Following the process of task-specific training, this is most effective for people who are trying to increase their overall load to be moved.

Training for Muscle Hypertrophy (growth)

Hypertrophy refers to muscle size as well as strength, you may see this in body-building where they utilise lighter weights, more repetitions and less time resting for particular muscle groups. Muscles require metabolic stress to increase in size, thus as a result of lactate acid build up and micro tears, the muscle then uses its repair process to rebuild and grow larger. This principle is best used for those beginning any exercise program as this utilises the aims of both muscle strength and movement, combining components of strength and endurance principles.

Training for Power

Power training involves using reasonably lighter weights and longer rest periods whilst the aim of the movement is to encourage speed. Power generally refers to the ability to move at high speeds. Power also includes the use of physics where force equals mass times acceleration and power training aims to practicing the acceleration part of the lift. Power principles are usually seen in athletes or powerlifting where weight is increased but require a high speed to move a certain weight. Power based exercises can also be found in HIIT workouts where explosive movements are completed with reduced rest.

Training for Muscular endurance

Endurance training requires more repetitions to ensure muscle functioning can last longer, usually with lighter weights. Rest is usually less for this principle as endurance is suggestive for long durations with little recovery. Endurance based programs for created for marathon runners, or for the everyday person to be able to withstand loading for an extended amount of time.

Which one is for you?

Consider your goal – what do you want to achieve out of your exercise program?
Consider your day-to-day activities – what do you do each day that requires a specific exercise program relative to your daily routine?
Consider what you have done previously – exercise, work and medical history can all have an impact on the physiological systems used within each of the above principles.
A training program is a variety of structured exercises using the principle FITT will guide you towards achieving your goals better.
• Frequency
• How many times a week for an activity?
• For sedentary individuals, start with 2-3 days/week of aerobic exercise and build up to 5 days/week. Build an exercise regime suited to your lifestyle.
• Intensity
• How hard to exert?
• Someone new to exercise should start at a low intensity, but health changes occur at a moderate exercise intensity
• Type
• Which type of activity should you do?
• Should be enjoyable, affordable, and achievable
• Time
• How long in minutes
• This does not include the warm up or cool down.
• 10 min bouts of exercise can be accumulated throughout the day
• If walking is the exercise – first increase the time before increasing the intensity (walking uphill/at a quicker pace)

Training or exercise programs are always most efficient when tailored specifically for individuals and their goals.

Medical Clearance and assessment is always advised prior to beginning any new exercise regime
Individuals unsure of the correct technique, exercise programming or structuring of a resistance program individual to their goals should consider receiving information and education from a qualified health/fitness professional, or Exercise Physiologist.

Any questions or concerns or if you would like to book in for an appointment to discuss your exercise goals, please contact the clinic on 5253 2345. You can also book online on our website!

Written by Tiarna Preer, Exercise Physiologist

References:

American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription. Philadelphia :Lippincott Williams & Wilkins, 2000.

This pronouncement was written for the American College of Sports Medicine by: William J. Kraemer, Ph.D., FACSM (Chairperson); Kent Adams, Ph.D.; Enzo Cafarelli, Ph.D., FACSM; Gary A. Dudley, Ph.D., FACSM; Cathryn Dooly, Ph.D., FACSM; Matthew S. Feigenbaum, Ph.D., FACSM; Steven J. Fleck, Ph.D., FACSM; Barry Franklin, Ph.D., FACSM; Andrew C. Fry, Ph.D.; Jay R. Hoffman, Ph.D., FACSM; Robert U. Newton, Ph.D.; Jeffrey Potteiger, Ph.D., FACSM; Michael H. Stone, Ph.D.; Nicholas A. Ratamess, M.S.; and Travis Triplett-McBride, Ph.D. Progression Models in Resistance Training for Healthy Adults, Medicine and Science in Sports and Exercise: February 2002 – Volume 34 – Issue 2 – p 364-380