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EXERCISING IN RHEUMATOID ARTHRITIS

When in you are in pain, getting list of exercises from your physiotherapy doctor and building fit musculature is the last thing on your mind! But believe me exercises have a great role, not only in reducing pain but also to avoid deformities and joint complications that may arise with arthritis. In this article, I am going to discuss about how we can prevent joint deformities and pain in small joints of hand and feet.

Before we do that, let us have a quick view of how exercises can help you in arthritis and save your joints.  

(Benefits of exercises) Regular exercises mean,
ü  Less pain from arthritis:-
·         Exercises help in improving blood circulation, more blood flow means more nutrients and oxygen to working muscles and joint. Improved blood flow helps removing toxic products from the tissues.
·         Working muscles are more flexible and stronger. Stronger the muscle less is the pressure on the joint and this in turn slows down joint wear and tear. 
ü  Stronger bones:-
·         Studies prove that when the bone is stressed with weight bearing exercises the mineral absorption increases this helps in improving bone quality and strength.
ü  Ability to move better and faster:-
·         Less pain and better joints and muscles, means you move faster.
·         Like muscle strength, exercises also help build balance sense which helps in swift movements.
ü  Have more energy:-
·         Of course, yes! Less pain, good muscles, improved balance..you are set for longer working days.
·          If you are more energetic more confident you are and it shows!
ü  Healthy heart and other muscles:-
·         Like joint fitness it really important to have healthy heart and endurance. Exercises help you achieving this goal as well.

The nightmares.. joint deformities!
Having a fixed deformed joint in arthritic patient is one of the worst nightmares of the doctor! The deformities can be cribbing and cause serious loss of function leading to difficulties in daily routines. The good news is they can be either controlled or totally avoided if proper care is taken.   
Deformity is result of stiffness or constriction in muscles, joints, tendons and ligaments that restricts normal movements.
In a joint affected by auto immune arthritis, inflammatory cells from immune system gather in the lining of joint (synovium), forming a fibrous layer of abnormal tissue (pannus). The pannus releases substances that quicken bone erosion, cartilage destruction and damage to the surrounding ligaments. The involved joints lose their shape and alignment resulting in deformities. Severe deformity leads to total loss of function. There are 3 stages in joint destruction:-

Preventive exercises for small joint deformities:
There is not a one-size-fits-all exercise prescription for people with arthritis. Every individual has different joint problems also different work demands, so you should get tailor made prescription made from a physiotherapist for best results. I am providing you with list of general exercises, unless there is a specific problem, they should be safe to do but please consult your physiotherapist before practising them.
Hand exercises:


 Start by holding your hand upright and pointing your wrist, fingers, and thumb upward. This also serves as the neutral starting position for many of the hand exercises that follow. Hold for 5 to 10 seconds. Repeat for
 5 times.





Keep your wrist straight in the neutral starting position and bend the base joints of your fingers, which connect the fingers to the palm. Keep your middle and end joints and your wrist straight. Hold for 5 to 10 seconds. Repeat for 5 times.






 Keep your wrist and the base joints straight, and bend your middle and end joints of your fingers toward your palm. Hold each position for five seconds. Repeat for 5 times.

                
Bend each finger from the base joint downward using your other hand to move your fingers. Repeat this movement using the second row of knuckles in your finger. Repeat this exercise on the third row of joints in your fingers, closest to the fingertips. Repeat on all 10 fingers for 10 times.





 With your hand straight and fingers pointing upward, bend your fingers downward so they are touching your palm. Do not make a fist. Instead, your fingertips should be touching the palm of your hand. Hold for five seconds. Repeat for 5 times.




Foot:

Sit in a chair, and put your affected foot across your other knee.Grasp your heel with one hand and then slowly pull your big toe back with your other hand. Pull your toe back toward your ankle until you feel a stretch along the bottom of your foot.Hold the stretch for at least 5 to 10 seconds.Repeat 2 to 4 times.





Sit in a chair with your feet flat on the floor. (You can also do this exercise lying on your back with your affected leg propped up on a pillow).Lift the heel of your sore foot off the floor, and slowly trace the letters of the alphabet.

         


Precautions:
As exercises are important, doing them at right time and at right intensity is equally important. So it is crucial that you learn all the exercises and perform them in proper phase of disease to get best results.
The exercises when new can give little stretch feeling or fatigue, but this can be tackled by adjusting exercise frequency and intensity. Talk to your physiotherapist regarding this.
The exercises should be stopped immediately if they give you sharp shooting pain or induce swelling or warmth in the joint or any other unusual symptom.
The exercises should not be performed if you are already in severe pain or having fever.
Some cases will require regular splinting along with exercises to avoid deformities, consult your doctor if there any need for it.
Do not take heat pack or massage without consulting as it may actually damage joints in some cases.   

Exercise regularly, eat healthy and stay healthy!

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