Frederick A. Matsen III, M.D.
Used with Permission.
Last updated February 19, 2003
Tips for Exercising
Communicate with your doctor
Talk with your doctor or therapist to decide
what types of exercises are best for you. Your decision will
be based on what type of arthritis you have, which joints
are affected, what you like to do, where you live and other
If you find a program on your own and you
have serious joint problems, show a copy of the exercises
to your doctor or therapist. They may suggest ways to modify
the exercises to protect your joints, or may suggest other
exercises to add to the program.
When to exercise
In general, it is best to exercise:
- at a specific time and place
- when you have the least pain and stiffness
- when you are not tired
- when your arthritis medication is having the most effect
Here are a few more tips about exercise times:
- Try exercising at different times of day until you decide
what is best for you.
- Exercise on a regular basis: try to do range of motion
exercises daily and your other exercises every other day.
If you miss several days, you may need to start again
at a lower level. If you must miss a day, just pick up
again where you left off.
- Don't do strenuous exercises just after you eat or just
before you go to bed. Wait at least two hours after a
meal. Do gentle range-of-motion exercises in the evening.
This helps reduce morning stiffness for some people.
Massage the stiff or sore areas or apply
heat and/or cold treatments to the area. Heat relaxes your
joints and muscles and helps relieve pain. Cold also reduces
pain for some people. Here are some ways you can apply heat
- Take a warm (not hot) shower before you exercise.
- Apply a heating pad or hot pack to the sore area.
- Sit in a warm whirlpool.
- Wrap a bag of ice or frozen vegetables in a towel, and
place it on the sore area.
Be sure to apply the heat correctly! Mild
heat will give you results. It should feel soothing and comfortable,
not hot. Apply it for about 20 minutes at a time. Use cold
for 10 to 15 minutes at a time.
Warm up first. Do gentle range-of-motion
and strengthening exercises at least 10 to 15 minutes before
more vigorous exercise. Begin your activity at a slow pace
and gradually work to a faster pace. This helps avoid injuries.
Wear comfortable clothes and shoes. Your
clothes should be loose and in layers so you can adapt to
changes in temperature and activity. Your shoes should provide
good support and the soles should be made from non-slip, shock-absorbent
material. Shock-absorbent insoles can also make your shoes
Don't hurry. Exercise at a comfortable, steady
pace and give your muscles time to relax between each repetition.
For range-of-motion and flexibility, it is better to do each
exercise slowly and completely rather than to do many repetitions
at a fast pace. You can gradually increase the number of repetitions
as you get into shape.
Breathe while you exercise. Don't hold your
breath. Counting out loud during the exercise will help you
breathe deeply and regularly.
Move swollen, painful joints gently. Ask
your doctor or therapist how to adapt your regular exercises
on days when your joints are more painful and swollen than
Cool down for five to 10 minutes after exercising.
This helps you cool off, lets your heart beat slow down, and
helps your muscles relax. To cool down, simply do your exercise
activity at a slower pace, such as walking slowly. Also try
gentle stretching to avoid stiff or sore muscles the next
At first, it may be hard to start moving
your stiff, sore joints. Keeping your goals and the benefits
of exercise in mind will help you during this time. Try to
gently move your joints by yourself. If you need help, ask
a therapist who is trained to help people with arthritis.
The therapist can also train your friends or family members
to help you.
If you're having a flare
Exercises that seem easy one day may be too
much on days when your joints are more painful and swollen.
When this happens, cut back on the number of exercises. Gradually
add more when you can. If you notice a big change in what
you are able to do, talk to your doctor or therapist about
Do not attempt fitness exercises when your
joints are swollen and painful. If just one or two joints
are swollen or painful, you can adapt your exercises to put
less stress on those joints. For example, if your knee flares
up, switch to exercises in water instead of walking.
Know when to stop
Stop exercising right away if:
- you have chest tightness or pain, or severe shortness
- if you feel dizzy, faint, or sick to your stomach
If these symptoms continue, contact your
Stop exercising if you have muscle pain or
a cramp. Gently rub and stretch the muscle. When the pain
is gone, continue exercising with slow, easy movements.
Know your body's signals. During the first
few weeks, you may notice that your heart beats faster, you
breathe faster, and your muscles feel tense when you exercise.
You may feel more tired at night, but awake feeling refreshed
in the morning. These are normal reactions to exercise that
mean your body is adapting and getting into shape.
Don't do too much: you'll know you have done
too much if you have joint or muscle pain that continues for
two hours after exercising, or if your pain or fatigue is
worse the next day. Next time, decrease the number of times
you do each exercise, or do them more gently. If this doesn't
help, ask your therapist about changing the exercise. A good
general rule to remember is, to stop exercising if you start
having sharp pain or more pain than usual. Pain is your warning
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