Step 10: Weight control and exercise

Weight control is important to successful arthritis management. Research suggests that:

• Being overweight is a risk factor for osteoarthritis
• Overweight young adults are likely to develop osteoarthritis of the knee as they age

Controlling your weight control can:

• Lessen pain by reducing stress on the weight-bearing joints (hips, knees, back, feet)
• Increase self-esteem and avoid the risk of psychological suffering and depression that can affect overweight individuals

Weight loss should be coupled with a regimen of more physical activity. A productive goal is a total of 30 minutes of daily exercise. People with osteoarthritis may need to alter their exercise habits, but most people with it can exercise.

Regular exercise is very important for successful control of osteoarthritis. Strengthening and stretching exercises can help by:

• Relieving pain and improve joint movement
• Building up the muscles around the joint, making the joint more stable and resisting further damage

Specific exercises may be prescribed to improve strength and range of motion in particular joints and muscles. Three types of exercise are used to treat osteoarthritis:

• Stretching exercise
• Isometric exercise
• Aerobic exercise

Stretching exercise

Also called range-of-motion (ROM) exercise, stretching exercise helps to maintain joint flexibility and reach. It includes anything that puts a joint through its fullest range of motion (for example, stretching the shoulder joint by holding the arms out at the sides and circling them in a windmill fashion). Stretching exercise often is more easily performed if the person takes a pain reliever or applies heat to the joint before starting to exercise.

Isometric exercise

This is exercise in which muscles are tensed for a period without actually moving them. It can be performed without actually bending a painful joint. As muscles are exercised against resistance, their size and power will increase.

Aerobic exercise

This is endurance-building exercise that improves cardiopulmonary (heart and lung) fitness. For most individuals with osteoarthritis, the best aerobic exercises are:

• Swimming (especially in a heated pool)
• Walking on level ground

Such gentle exercises are less stressful on the joints. Water exercise is especially recommended for people who have osteoarthritis of the large joints (hips, knees). The buoyancy of the water makes it possible to exercise while the body weight is supported.

People with osteoarthritis of the weight-bearing joints should avoid activities such as jogging and tennis. These sports can put too much strain on the legs or require sharp turns and twisting movements. In addition, exercise bicycles should be used with caution by people with arthritic knees.

Since pain may worsen with increased activity, people with advanced osteoarthritis may need to take several rest periods during the day. On the other hand, too much inactivity can worsen osteoarthritis by causing increasing stiffness. An optimal treatment plan should achieve a balance between daily exercise and adequate rest.

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