No Pain, No Gain Isn’t True of Arthritis, But Exercise

No Pain, No Gain Isn’t True of Arthritis, But Exercise Is Still Important
David Silva

National Institute of Arthritis and Musculoskeletal and Skin DiseasesRecent studies have shown that exercise may acually help people with arthritis in a number of ways. It can reduce joint pain and stiffness. It can increase flexibility, muscle strength, and endurance. And it can also help with weight reduction and contribute to an improved sense of well-being.Most comprehensive arthritis treatment plans should include an exercise regiment. Rest and relaxation, proper diet, medication, and instruction about proper use of joints and ways to conserve energy (that is, not to waste motion), as well as the use of pain relief methods should also be included in treatment plans.What types of exercises are best for people with arthritis? Try these three:Range-of-motion exercises to help maintain normal joint movement, relieve stiffness, and increase flexibility.Strengthening exercises to help keep or increase muscle strength. Strong muscles help support and protect joints affected by arthritis.Aerobic or endurance exercises to improve cardiovascular fitness, help control weight, and improve overall function. Weight control can be important to people who have arthritis because extra weight puts extra pressure on joints. As always, people with arthritis should discuss their options with their doctors before starting on an exercise program. Easy, range-of-motion exercises and low-impact aerobics are gennerally a good way to get started. And make sure to ask your doctor about any sports or exercise programs in which you currently participate. Some programs may do more harm than good.You should also be aware that your doctor may decide to refer you to a physical therapist. A therapist with experience in arthritis can design an appropriate home exercise program and teach you about pain-relief methods, proper body mechanics, joint protection, and conserving energy.So what’s the best way to get going? First, always first, discuss your exercise plans with your doctor.Next, start with supervision from a physical therapist or a qualified athletic trainer.Apply heat to sore joints.Stretch and warm up with range-of-motion exercises.Start strengthening exercises slowly with small weights (a 1 or 2 pound weight can make a big difference).Progress slowly.Use cold packs after exercising.Add aerobic exercise.Ease off if joints become painful, inflamed, or red and work with your doctor to find the cause and eliminate it.Like any exercise program, choose a program you enjoy and make it a habit.Range-of-motion exercises should be done at least every other day. Strengthening exercises also should be done at least every other day unless you have severe pain or swelling in your joints. Endurance exercises should be done for 20 to 30 minutes three times a week unless you have severe pain or swelling in your joints.Additional information on arthritis and exercise can be found at the following resources:Arthritis FoundationThe Foundation publishes a free pamphlet on exercise and arthritis and a monthly magazine for members that provides up-to-date information on all forms of arthritis. http://www.arthritis.orgAbout Arthritis TodayInformation on the causes, symptoms, and treatments of arthritis.http://www.aboutarthritistoday.com/arthritisexercise/Spondylitis Association of America (SAA)SAA sells books, posters, videotapes, and audiotapes about exercises for people who have arthritis of the spine.http://www.spondylitis.orgAmerican College of Rheumatology/Association of Rheumatology Health ProfessionalsThis association provides referrals to physical therapists who have experience designing exercise programs for people with arthritis. The organization also provides exercise guidelines developed by the American College of Rheumatology.http://www.rheumatology.org About the Author
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What Spinal Cord Injury Patients Can Accomplish with Physiotherapy

Sports injuries and car accidents, among other injuries, can cause spinal cord injury. The range of spinal cord injury is wide. Some of these injuries are fairly minor and will heal well with a limited amount of physiotherapy, while others need physiotherapy for the rest of their lives.

As always with physiotherapy, the first step is evaluation. A plan is formulated that will include therapies specific to the kind of spinal cord injury the patient has. Neck injuries can cause quadriplegia, which requires special treatments.

An important issue in spinal cord injury is the level of the damage. If a physiotherapy program is not followed faithfully, the spine will begin to atrophy below the level of the spinal cord injury. The spine will shrink and the whole body below that point will become weaker as time goes by.

It is important that spinal cord injury patients get exercise of some form. They are prone to osteoporosis and heart problems, among other conditions. If there is a total lack of exercise, these risk factors become even more pronounced.

Physiotherapy for spinal cord injury involves exercising and stimulating the nerves and muscles below the level of the damage. This will allow patients with spinal cord injury to stay in good physical condition where they can. That way, if a cure becomes available, they will not be too weakened to benefit from it.

Every exercise the physiotherapy personnel go through with the spinal cord injury patient should be video-taped. This allows work to go on at home with an example of each exercise. Range-of-motion exercises are done by a caregiver, who moves the limbs so that they will not become set in one position.

For spinal cord injury patients who are not quadriplegics, there is physiotherapy using mats. These mats are raised off the floor, and can be operated by a hand crank or a power system. The physiotherapist will give exercises where the patient lies on the side, back, or stomach and works out or sits up and works out.

There are many restorative therapies in physiotherapy for spinal cord injury patients. These include electrical stimulation, biofeedback, vibrational therapy, laser therapy and other stimulation activities. Aqua therapy is also a physiotherapy method that is conducive to progress in spinal cord injury patients.

With all these therapies, spinal cord injury patients can sometimes restore themselves to earlier functioning. Other times, they can simply keep their bodies from deteriorating as they wait for a cure.

Spinal cord injury research is being conducted constantly. Physiotherapy is one of the fields that are being explored. One study is putting spinal cord injury patients in harnesses over treadmills stimulating walking. They are trying to find a way to help people walk again who had given up hope of doing so.

Physiotherapy gives hope for spinal cord injury patients. It allows them to have the most normal functioning that they are currently able to have. Perhaps when a cure comes outcomes will be even better. However, physiotherapy will probably always be needed for spinal cord injury patients.

The Busy Field of Geriatric Physiotherapy

Clinics that specialize in geriatric physiotherapy never run low on work. The elderly have diseases and disorders in greater numbers than any other age group. Their care is difficult, but rewarding.

Geriatric physiotherapy became a specialty of physical therapy study in 1989. Since then, physiotherapists have worked to understand the problems of the aging. There is a long list of problems dealt with in geriatric physiotherapy.

Alzheimer’s, arthritis, balance disorders, cancer, cardiovascular disease, incontinence, joint replacement, pulmonary disease, stroke, and osteoporosis are only a few of the problems covered by geriatric physiotherapy. Physiotherapists have a whole range of therapies for these ailments.

The types of problems faced in geriatric physiotherapy are grouped into three different categories. One category is the problems that happen because the patient simply does not use their limbs or does not exercise. These problems can be addressed by reconditioning through range-of-motion exercises and other exercises.

Another category geriatric physiotherapy deals with is cardiovascular disease, like heart disease and stroke. The physiotherapy professional has an array of tools at her disposal to work with these conditions. Exercise, aqua therapy, electrical stimulation, and more can be used.

The third category is skeletal problems. Geriatric physiotherapy helps people who have these disorders, such as osteoporosis and osteoarthritis. These problems require special attention as osteoporosis makes patients frailer, and osteoarthritis is very painful.

Because falls are such a problem, the osteoporosis therapy is crucial. Along with that, geriatric physiotherapy is responsible for preventing many falls because of work with balance and gait. Some clinics focus entirely on balance issues for the elderly.

Much of the work of geriatric physiotherapy is not aimed at returning patients to their earlier states of health. The most important goals are to be able to function at their best abilities. Doing everyday tasks and living an unconfined life are valuable assets.

At the same time, geriatric physiotherapy can have a profound affect on a person’s ability to enjoy physical activities. Golf is an activity that many seniors enjoy. It can be a very hazardous sport for the elderly if they are not in condition to play. It does have many health benefits, too.

Geriatric physiotherapy can focus on physical training to get an older adult in shape to play sports like golf. This strengthens them in many ways. The fact that it allows them to play golf will make them even healthier, both physically and psychologically. Since depression is a growing problem among the elderly, any help they can get in this area is needed.

Another role of geriatric physiotherapy is to help with rehabilitation after knee or hip replacement surgeries. People who have these operations are likely to walk differently. It affects their abilities to do daily chores, and their quality of life. Physiotherapists can help.

Some people turn to physiotherapy as a means of better functioning. Others are referred to physiotherapy clinics by their doctors for specific problems. Still others end up in geriatric physiotherapy care in hospitals or nursing homes after accidents or illnesses. All of these people can be helped.