Arthritis and Exercise: Do They Go Together?

By D. Hodari Brooks, MD

As a board certified orthopedic surgeon practicing in the greater Atlanta area I am asked lots of questions by my patients on a daily basis. Today I wanted to take the time to address one of the more common questions that I have been getting recently. This question can have many forms but in general the question is: “Doctor, I know that I have arthritis but can I, and should I still exercise?” It is apparent to me that there is a fair amount of confusion in the lay press and even on the internet regarding the risks and benefits of exercise. Let’s take this question in two parts:

The first part of this question relates to whether a person with arthritis CAN exercise. Now, like all medical questions, the answer is both simple and complex at the same time. The simple answer is a definitive YES. Regardless of a person’s degree of arthritis they can usually perform some type of exercise. In general if arthritis involves the joints of the lower extremity, i.e. the hips, knees, and ankles then these individuals should focus primarily on low impact exercises. Examples include the elliptical, stationary bike, and Nordic track. This is important in order to limit the impact on the knees and hips in particular. This doesn’t mean that you have to completely give up your treadmill or running program, however, it does mean you should give strong consideration to modifying your exercise program. If you have a milder degree of arthritis then you can still perform high impact activities, however, my recommendation is that you reduce your frequency of impact exercises and add more nonimpact activities. It is true that as a patient’s arthritis progresses that their ability to perform aggressive exercises decreases. These individuals usually do best with aquatic therapy which significantly limits the stress on all joints. There does come a point, however, when the arthritis becomes so severe that any type of exercise becomes extremely difficult. It is at this point that patients should consider joint replacement surgery to help restore their quality of life.

The second portion of this question relates to whether a patient with arthritis SHOULD exercise. Again the answer is a definitive YES. There are clear benefits of exercise regardless of whether you have arthritis or not. In general the reason that exercise is so beneficial is that it allows individuals to strengthen their muscles around the joints. The effect of this is to decrease the force that your joints have to be exposed to during a particular activity. By decreasing the forces on your joints you can often decrease the speed at which your arthritis progresses and importantly decrease the pain you experience with everyday activities. In addition to benefiting your muscles and joints, exercise also has a clear benefit on the health of your heart. It is important to add, however, that if your overall health is not very good then you need to check with your primary care physician to discuss whether you are healthy enough to engage in a physical exercise program.

Thus it is both acceptable and desirable to exercise even if you have arthritis. Certainly the relative severity of an individual’s arthritic disease will have an effect on just how successful an exercise program can be. It is my experience that virtually all patients feel better if they can exercise. So I encourage all of my readers to commit to getting involved in a personal exercise program for 2009. I know you will feel better, and your joints will too.