Exercises for Arthritis

Exercise is one part of a comprehensive arthritis treatment plan.  Once the pain level has gone down, it's time to get on your feet. In short, the answer to whether or not arthritis can be helped by exercise is: Yes.
Studies have shown that exercise helps people with arthritis in many ways.  Exercise reduces joint pain and stiffness and increases flexibility, muscle strength, cardiac fitness, and endurance. It also helps with weight reduction and contributes to an improved sense of well-being.

The most recommended forms of exercise are boiled down to three main categories:

• Range-of-motion exercises (e.g., dance) help maintain normal joint movement and relieve stiffness. This type of exercise helps maintain or increase flexibility.
• Strengthening exercises (e.g., weight training) help keep or increase muscle strength. Strong muscles help support and protect joints affected by arthritis.
• Aerobic or endurance exercises (e.g., bicycle riding) improve cardiovascular fitness, help control weight, and improve overall function. Studies show that aerobic exercise can reduce inflammation in some joints.

Following are the exercises designed for arthritis depending on which part of the body is affected.

Neck Exercises

1. Heads up
   This exercise relieves jaw, neck, and upper back pain.
   Sit or stand straight.
   Gently slide your chin back.
   Keep looking forward as your chin moves backward.  You will feel the back of your neck lengthen and straighten.  Put your finger on your nose and then draw straight back from your finger.
   
   
2. Two-Way Neck Stretch
   In heads-up position (Exercise 1), and with your shoulders relaxed,
   a) Turn slowly to look over your right shoulder.  Then turn slowly to look over your left shoulder.
   b) Tilt your head to the right and then to the left.  Move your ear toward your shoulder.  Do not move your shoulder up to your ear.

Caution: Don't do these exercises if they cause neck pain, or pain or numbness in your arms or hands.

Hand And Wrist Exercises

Do these exercises at a table that supports your forearms.

1. One Two Three Finger Exercises
   For the best hand function, you should be able to touch the tips of your fingers to the palm and straighten the fingers completely. Use the one-two- three approach to stretch and strengthen fingers.
   To bend fingers:
   (1) Begin bending the joint closest to the tip of the finger
   (2) Bend the middle joint
   (3) When your fingertips are touching the palm, or are as close as possible, bend the knuckle joint.
   To straighten your fingers, just do the movements in reverse:
   (3) First straighten the knuckles
   (2) Then the middle joint, and
   (1) Straighten the fingertips.
   You can exercise your fingers individually or together, using your other hand to help if necessary.
   
   
2. Thumb Walk
   Holding your wrist straight, form the letter "O" by lightly touching your thumb to each fingertip. After each "O" straighten and spread your fingers. Use the other hand to help if needed.
   
   
3. Hi and Bye
   a. To strengthen and limber your wrist, rest your forearm on a table with your hand over the edge. Keep fingers relaxed and bend your wrist up and down.
   b. To strengthen the small muscles of the hand, slide your arm back until your fingers hang over with your knuckles at the table edge. Keeping your fingers straight and together and your palm flat, move your fingers up and down.
   
   
4. Door Opener
   This exercise stretches the muscles and ligaments that rotate the forearm, letting you turn doorknobs, use a screwdriver, of put your hand in your back pocket.
   Start with your forearm resting on a table, palm down.
   Keeping your little finger on the table, turn your hand so the palm faces up.
   If you use your other hand to help, grip your forearm, not the wrist or hand.

Shoulder Exercises

1. Pendulum
   This is good for a painful or limited shoulder. It helps to relax shoulder muscles and moves the joint in all directions.
   You can do this exercise either standing or sitting.
   Lean slightly forward. Let your arm hang freely in front of you. Relax and feel the weight of your arm.
   Keeping the arm relaxed, begin to make small circles. Gradually increase to larger circles.
   Exercise just past the point of discomfort, but don't push too hard.
   
   
2. Shoulder Cradle
   Grasp one arm near the elbow with your other hand and raise the arm up over your head.
   Holding your arm as high as it will go, bend and straighten your elbow. If your shoulder is painful or tight, you may do this exercise lying down.
   
   
3. Wand Exercise
   If one or both of your shoulders are particularly tight or weak, this exercise is good for you.
   Use a cane, yardstick, or mop handle as your wand.
   Place one hand on each end and raise the wand as high overhead as possible.
   This exercise can be done standing, sitting, or lying down.
   
   
4. Shoulder Pulley
   Fasten a hook or pulley in a beam or on the top of a door frame.
   Place a piece of rope or clothesline through the hook. Start with enough rope to let you sit while exercising.
   Hold one end of the rope in each hand. If gripping the rope is uncomfortable, add padding or handles.
   As you pull down with one arm, the other arm will be raised. Move your arms up and down in front of you and also out to the side.
   
   
5. Pat and Reach
   This exercise helps increase flexibility and strength for both shoulders.
   Raise one arm up over your head and bend your elbow to pat yourself on the back.
   Move your other arm to your back, bend your elbow, and reach up toward the other hand. Can your fingertips touch?
   Relax and switch arm positions. Can you touch on that side?
   For most people, one position will work better than the other.
   
   
6. Shoulder Blade Pinch
   This is a good exercise to strengthen the middle and upper back and to stretch the chest.
   Sit or stand with your head in heads-up position and your shoulders relaxed.
   Raise your arms out to the sides with elbows bent.
   Pinch your shoulder blades together by moving your elbows as far back as you can.
   Hold briefly, then slowly move your arms forward to touch elbows.
   If this position is uncomfortable, lower your hands to touch your shoulders.

Back And Abdominal Exercises

1. Knee-to-Chest Stretch
   Lie on the floor with knees bent and feet flat.
   Bring one knee toward your chest, using your hands to help.
   Hold your knee near your chest for ten seconds and lower the leg slowly.
   Repeat with the other knee.
   Relax and enjoy the stretch.
   Note: You can also tuck both legs at the same time if you wish.
   
   
2. Pelvic Tilt
   An excellent exercise for low back pain.
   Lie on your back with knees bent, feet flat.
   Place your hands on your abdomen.
   Flatten the small of your back against the floor by tightening your stomach muscles and your buttocks.
   Imagine bringing your pubic bone to your chin, or trying to pull your tummy in enough to zip a tight pair of trousers.
   Hold the tilt for five to ten seconds. Relax.
   Arch your back slightly.
   Relax and repeat the Pelvic Tilt.
   Keep breathing. Count the seconds out loud.
   Once you've mastered the Pelvic Tilt lying down, practice it sitting, standing, and walking.
   
   
3. Back Lift (1)
   This exercise improves flexibility along your spine.
   Lie on your stomach and rise up onto your forearms.
   Straighten your elbows. Breathe naturally and relax.
   Caution: If you have moderate to severe low back pain, do not do this exercise unless it has been specifically prescribed for you.
   
   
4. Back Lift (2)
   This exercise is good for strengthening your back muscles.
   Lie on your stomach with your arms at your side or overhead.
   Lift your head, shoulders, and arms. Do not look up.
   Keep looking down with your chin tucked in.
   Count out loud as you hold for a count of ten.
   Relax. You can also lift your legs off the floor instead of your head and shoulders.
   
   
5. Low Back Rock and Roll
   Lie on your back and pull your knees up to your chest with your hands behind the thighs.
   Rest in this position for ten seconds, then gently roll knees from one side to the other, rocking your hips back and forth.
   Keep your upper back and shoulders flat on the ground.
   
   
6. Curl Up
   This exercise is great for strengthening your abdominal muscles.
   Lie on your back, knees bent, feet flat.
   Do the Pelvic Tilt (exercise 2 above).
   Slowly curl up to raise your head and shoulders.
   Uncurl back down, or hold for ten seconds and slowly lower.
   Breathe out as you curl up, and breathe in as you go back down. Do not hold your breath.
   Caution: If you have neck problems, or if your neck hurts when you do this exercise, do not do this exercise. Do the exercise 7 below instead. Never tuck your feet under a chair or have someone hold your feet!
   
   
7. Roll Out
   This exercise is a good abdominal strengthener. It is also easy on the neck. This exercise is recommended instead of the Curl Up (exercise 6) above if you have neck pain. If neck pain is not a problem, you can do both these exercises.
   Lie on your back with knees bent and feet flat.
   Bring one knee up to your chest.
   Do the Pelvic Tilt (Exercise 2) and hold your lower back firmly against the floor.
   Slowly and carefully, move one leg away from your chest as you straighten your knee.
   Move your leg out until you feel your lower back start to arch. When this happens tuck your knee back to your chest.
   Reset your pelvic tilt and roll your leg out again.
   Breathe out as your leg rolls out. Do not hold your breath.
   Repeat with the other leg.
   Note: You are strengthening your abdominal muscles by holding your pelvic tilt against the weight of your leg. As you get stronger, you'll be able to straighten your legs out farther and move both legs together.

Hip And Leg Exercises

1. Straight Leg Raise
   This exercise strengthens the muscles that bend the hip and straighten the knee.
   Lie on your back, knees bent, feet flat.
   Straighten one leg. Tighten the muscle on the top of that thigh and straighten the knee as much as possible.
   Keeping the knee straight, raise your leg one to two feet (about 50 cm) off the ground. Do not arch your back.
   Hold your leg up and count out loud for ten seconds.
   Relax. Repeat with the other leg.
   
   
2. Hip Hooray
   This exercise can be done standing or lying on your back.
   If you lie down, spread your legs as far apart as possible. Roll your legs and feet out like a duck and then in, pigeon-toed.
   If you are standing, move one leg out to your side as far as you can. Lead out and in with the heel. Hold onto a counter for support.
   
   
3. Back Kick
   This exercise increases the backward mobility and strength of your hip.
   Hold onto a counter for support. Move the leg up and back, knee straight. Stand tall and do not arch your back.
   
   
4. Knee Strengthener
   This exercise strengthens the knee.
   Sitting in a chair straighten the knee by tightening up the muscle on top of your thigh.
   Place your hand on your thigh and feel the muscle work.
   Holding your knee as straight as possible, push out with your heel and then point your toes.
   Make circles with your toes.
   As your knee strengthens, see if you can build up to holding your leg out for thirty seconds. Count out loud. Do not hold your breath.
   
   
5. Power Knees
   This exercise strengthens the muscles that bend and straighten your knee.
   Sit in a straight-backed chair and cross your legs above the ankles.
   Your legs can be almost straight, or you can bend your knees as much as you like. Try several positions.
   Push forward with your back leg and press backward with your front leg.
   Exert pressure evenly so that your legs do not move. Hold and count out loud for ten seconds.
   Relax. Change leg positions. Be sure to keep breathing.
   
   
6. Hamstring Stretch
   This is a good exercise to do if you get muscle cramps in the back of your thigh.
   Caution: If you have unstable knees, or "back knee" (a knee that curves backward when you stand up), do not do this exercise.
   Lie on your back, knees bent, feet flat. Grasp one leg at a time just above the knee and hold the leg at a right angle with the body.
   Holding the leg out at arm's length, slowly straighten the knee. Hold the leg as straight as you can as you count to ten.
   Caution: Be careful. It's easy to overstretch and be sore with this exercise.
   
   
7. Achilles Stretch
   This exercise helps maintain flexibility in the Achilles tendon, the large tendon at the back of your ankle. This exercise is especially helpful for cooling down after walking or cycling, and for people with ankylosing spondylitis or psoriatic arthritis and also for calf cramps.
   Stand at a counter or against a wall. Place one foot in front of the other, toes pointing forward and heels on the ground.
   Lean forward, bend the knee of the forward leg and keep the back knee straight, heel down. You will feel a good stretch in the calf.
   Hold the stretch for ten seconds. Do not bounce, Move gently.
   
   
8. Tiptoes
   This exercise strengthens your calf muscles and makes walking, climbing stairs, and standing less tiring.
   Hold on to a counter or table for support and raise up on your tiptoes.
   Hold for ten seconds. Lower slowly.
   Notes:
   How high you go is not as important as keeping your balance and controlling your ankles.
   It is easier to do both legs at the same time.
   If your feet are too sore to do this standing, start doing it while sitting down.

Ankle And Feet Exercises

These exercises are for flexibility, strength, and comfort.

1. Ankle Circles
   Sit in a straight-backed chair with your feet bare.
   Hold your feet slightly off the ground and slowly circle your ankles to the right and then to the left. Go as far in each direction as you can.
   
   
2. Towel Grabber
   Sit in a straight-backed chair with your feet bare.
   Spread a towel out in front of your chair.
   Place your feet on the towel with your heels on the edge closest to you. Keep your heels down.
   Scoot the towel back underneath your feet by pulling it with your toes as you arch your feet.
   When you have done as much as you can, reverse the toe motion and scoot the towel out again.
   
   
3. Marble Pickup
   Do this exercise one foot at a time.
   Sit in a straight-backed chair with your feet bare.
   Place several marbles on the floor between your feet. Keep your heel down and pivot your toes toward the marbles.
   Pick up a marble in your toes and pivot your foot to drop the marble as far as possible from where you picked it up.
   Repeat until all the marbles have been moved.
   Reverse the process and return all the marbles to the starting position.
   Note: If marbles are difficult, try other objects like jacks, dice, or wads of paper.
   
   
4. Foot Roll
   This exercise stretches the ligaments in the arch of the foot.
   Sit in a straight-backed chair with your feet bare.
   Place a rolling pin (or a large dowel or closet rod) under the arch of your foot and roll it back and forth.

The Whole Body Exercise

The Stretcher
This exercise is a whole-body stretch. Do it lying on your back. You can start the motion at your ankles as explained here, or reverse the process if you want to start with your arms first.
Point your toes, and then pull your toes toward your nose. Relax.
Bend your knees. Then flatten your knees and let them relax.
Arch your back. Do the Pelvic Tilt. Relax.
Breathe in and stretch your arms above your head. Breathe out and lower your arms. Relax.
Stretch your right arm above your head, and stretch your left leg by pushing away from you with your heel. Hold for a count of ten.
Switch to the other side and repeat.