culled from:prevention.com
When I was in my 20s, I’d go to the gym, hop on a machine and start working out without thinking twice about my joints. Now, at 55, there are days when it seems a whole lot easier to skip my workout altogether than to deal with my achy knees. And, since you’re reading this, I’m guessing you can relate to my frustration.
The key, as I’m sure you probably know: Getting ourselves to do it anyway. Research shows that regular exercise helps to reduce the chronic inflammation associated with arthritis and can even increase your pain tolerance. Exercise also strengthens the muscles around the joint and increases blood flow to the joint, two things that can minimize discomfort, says Nathan Wei, MD, a rheumatologist in Frederick, MD. It also increases the production of endorphins, which can further reduce pain (not to mention put you in a better frame of mind to handle it).
If you’re thinking, "Seriously? Have you been in my body lately?? It hurts!" I hear you. Getting started when your body sounds and feels like the Tin Man is far from easy. But making a few simple changes to your exercise routine can mean the difference between a pain-free workout and one that hurts.
Here are 11 tweaks and tricks that can make staying active when you're hurting so much easier.
1. Warm up thoroughly.
Most people tend to skip the warm-up, but there’s good reason for
you not to: Jumping into a workout without first warming up your muscles
can increase joint pain, especially after age 40, says David Kruse, MD,
a board certified sports medicine specialist with Hoag Orthopedic
Institute in Irvine, CA. "Joints hurt more when muscles and tendons are
stiff. As we age, our joint mobility and tissue flexibility decline; a
thorough warm-up helps accommodate these changes." It doesn’t have to be
long and it doesn’t have to complicated: Five minutes of light
movement, like an easy walk, is all you need to get that blood flowing,
warm up your muscles, and get them ready for the task at hand.
2. Use a foam roller.
Joint pain can feel worse when your fascia (the elastic, weblike
matrix of fibrous connective tissue that supports, binds, or separates
your other tissues, joints, and organs), becomes dry and
brittle—something that happens as we age. Ideally, your fascia acts a
cushion for your joints, and helps to protect them from impact during
exercise, says Sue Hitzmann, an exercise physiologist and creator of The
Melt Method. The more hydrated your fascia, the more cushion you
get. Creating gentle compression with a soft foam roller helps rehydrate
your fascia by stimulating its cells and helping fluid move back into
that tissue, says Hitzmann. While research shows that foam rolling
before or after your workout can minimize discomfort, Hitzmann says that
even doing it three times a week can reduce joint pain by about half.
Get started with these 4 foam rolling exercises.
3. Shake things up.
If you want to avoid overuse injuries—not to mention burnout and
boredom—you know it’s not a great idea to do the same routine every
single day. But mixing up your workouts is even more important if you
have achy joints or arthritis, says Kruse. Muscles are involved in the
control and function of joints; when they’re weak from overuse, your
joint is forced to take on more impact. (So if you’re pushing through a
run with overworked quads, for instance, you’re likely to feel it in
your knees.) Instead, mix up high-impact activities, like running, with
something a little more gentle—think swimming, biking, yoga, or
Pilates—once or twice a week.
4. Find the best cardio for you.
To determine the best cardio program for your joints, Kruse
recommends testing various progressions of impact to find your tolerance
level. Start with the least impactful movement and slowly increase
until you find your breaking point (that moment when your joints start
to complain). For example, you may be able to use a recumbent bike
without pain, but upgrading to an upright bike could cause issues. "How
much you can do depends on the source of the pain and discomfort," says
Kruse. "You may feel soreness while you’re doing the activity or the
next day—keep a log to track how you react to each exercise plan to find
what’s most effective." According to Kruse, the activities ranked by
the least to most impact are swimming, recumbent bike, upright bike,
elliptical, treadmill, outdoor running.
5. Alternate upper and lower body exercises.
The usual workout advice is to work your bigger muscles first and
then move on to the smaller ones, mainly because the smaller muscles
stabilize and support the larger ones. But bouncing back and forth
between upper and lower body exercises makes life easier for your joints
by giving them a longer break in between. When weight training, for
example, alternate between arm and leg exercises to avoid overworking
one body part or joint within your exercise routine, says Christa Gurka,
MSPT, a physical therapist and founder of Pilates in the Grove in
Miami, FL.
6. Take time to stretch.
When time is of the essence (and when isn’t it?) it’s tempting to
skip stretching post-workout to save time—but your joints will pay the
price. "Tight muscles decrease normal movement patterns and range of
motion within joints," says Gurka. "For example, tight quadriceps will
push more heavily on the kneecap and cause more inflammation to an
already compromised joint." So after your workout, be sure to stretch
out all of your major muscle groups, holding each stretch (do not
bounce) for 20 to 30 seconds. (Try these 3 essential stretches after your next walk.)
7. Use props to ease pain.
Planks and push-ups can be hard enough without dealing with sore
wrists. Luckily, almost any exercise can be modified to make it more
comfortable. "Take pressure off wrists when doing planks by performing
them while on your forearms instead," says Gurka. For push-ups, try
using dumbbells or yoga blocks to hold on to, which keep your wrists
straight, as opposed to having your hands on the floor. Or, as an
alternative to push-ups, try using a Smith machine (a bench press type
machine on a sled) or use a higher body angle, says Irv Rubenstein, PhD,
exercise physiologist and owner of S.T.E.P.S., a science-based fitness
facility in Nashville, TN. "Exercise tubing or cable machines may also
work."
8. Shift your weight.
If your knees complain when you do squats or lunges, there’s an
easy fix to turn down the discomfort: Shift your weight back on to your
heels, versus the balls of your feet, which reduces strain on the
kneecaps and quadriceps, says Gurka, making the moves more comfortable.
How can you tell if you’re doing it correctly? When your weight is in
your heels, you should be able to wiggle your toes off the floor. As a
bonus, you’ll also firm up your backside faster, as keeping the weight
in your heels activates your glutes. (If squats are out of the question
for you, give this no-squats belly, butt, and thighs workout a try.)
9. Modify your range of motion.
In addition to shifting your weight, shortening your range of
motion can also ease joint pain. This works on both upper and lower body
exercises such as chest presses, as well as squats and lunges. "Do not
allow your knees to bend below 90 degrees, as this increases compressive
forces on the joint surfaces," says Gurka. To reduce the risk of
shoulder pain, avoid overhead movements such as overhead presses, and
strengthen shoulders by keeping your palms up during moves such as
lateral raises. This opens up the shoulder joint and allows for more
space and less likelihood of shoulder impingement, i.e., when the
shoulder blade puts pressure on the rotator cuff muscle, causing pain,
says Gurka.
10. Include yoga or Pilates.
Consider these low-impact modalities your joints' new best friends.
"Pilates, for example, focuses on joint mobility and stability,
creating balance around joints and increasing flexibility around
joints," says Gurka. "It also works on body awareness to improve balance
and alignment." Additionally, yoga has been shown to work particularly
well for those with rheumatoid arthritis; a study by the Arthritis Foundation found that two, one-hour yoga classes eased pain and swelling for those with rheumatoid arthritis. (Here’s a gentle yoga practice to get you started.)
11. Add water.
Even if you don’t know the backstroke from the butterfly, working
out in a pool can be a game-changer. "The buoyancy of the water results
in less body weight on the joint, so any movements that you do takes
less impact," says Rubenstein. The deeper the water, the more support
and the less impact on joints. An added bonus: water provides resistance
so you can still build and strengthen the muscles that surround and
support joints. Overhead movements like the crawl stroke can create a
greater risk of pain for those with shoulder arthritis, so stick with
the breaststroke if your shoulders ache, says Rubenstein. Also give our joint-friendly water workout a try.
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