by Dr Nilima Bedekar
Arthritis is a disabling progressive condition, especially when multiple joints are affected. There is pain, swelling which affects movement and function. Muscles are not able to generate force due to pain and stress. If swelling or effusion persists longer, the joint sensation call proprioception is affected hence difficulty in balance. Joint supportive tissues the ligaments and capsule- the joint coverings get affected further causing problem in activating muscles and keeping normal alignment. Once the structures get affected and arthritis becomes progressive muscles are not able to move the joint properly. Hence exercises are important to be started as early as possible to gain better control and preserve joint health and function. It is never too late to begin! Exercises with Orthotic or special device support is required at specific joints. Proper exercise prescription helps to control and gain independence. Cycle of pain, oedema, range restriction, weakness can be reverted by exercises. Physical well being gives better mental or psychological attitude. As adherence to fitness programme is vital; needs lot of perseverance, support and guidance. Muscles are beautiful organ under voluntary control. Make use of this to control body and mind.
Large movements to bigger joints, fine muscle work/skillful combinations for smaller joints.
Exercises in various positions, Shoulders-Sitting/standing
- Raise one or both arms above try touching the ceiling so ribcage also will be stretched. Maintain at end range then lower down slowly. Lift from front and side ways. Repeat the side-ways keeping elbows as straight as possible. Circle full or as much possible. Keeping arms by side, bend elbows move forearms in and out. Achieve more and more with repetitions.
- Hold a bar/ stick with both hands, bend and straighten at elbows. Keep forearms , hands on table turn to touch palms and then back of palms on table surface.
- Get Thera-putty / clay dough / plasticin clay. Press the ball sze with gripping exercise. Make small pieces. Do paper crumpling exercises.
- Sitting on a stool, do bending forwards, back , sideways and rotate for cervical spine/neck and lower back area. Do five repetitions for each movement.
- Sitting on stool or chair, take a towel or paper
sheet under foot, bend toes to squeeze it
Hip exercises-Lying on back
- Move alternate hip and knee closer to body, support with palms as necessary. Bend both hip and knees, knees coming as close towards chest.
- Keeping hip knee bent, feet on bed, lift the buttocks off called bridging exercise. Ten repetitions.
- Lift from one hip keeping knee straight called as straight leg raises. Repeat it lying on sides and on tummy.
- Lying on tummy bend from knees and make knees straight as slow as possible. Using elastic resistance bands is a great way to increase muscle strength. It can be carried anywhere. Progressive resistance bands are available.
- Stand straight, put equal weight through both feet initially take a chair in front for hand support if needed. Lift both heels up and down .
- Try standing on one leg.
- Take two to four steps sideways. Walk backwards five to eight steps.
- Try taking very long steps to walk around ten meters. Then progress to walk with long steps with increase in speed.
- Do deep breathing exercises with slow speed and very gently without any excessive force. Feel good chest expansion. Every day do some form of relaxation for five to ten minutes. Do distribute the series of these exercises in two or three timings. Join some group for exercise if possible which can have added benefits. Isolation leads to more depression. Maintain your activity levels.
