In a country plagued by disease, it’s no surprise 50 million Americans suffer from arthritis. The pain and swollen joints associated with arthritis can make exercise seem impossible. In fact, arthritis prevents more people from living a healthy lifestyle than any other disease. For decades, the medical community has been largely unsuccessful at getting people with arthritis to exercise. An example of this gap is the Arthritis Foundation’s Exercise Program. The program has been shown to be effective at improving mobility and pain management in people with arthritis, yet less than 1% of arthritic adults participate in the program.
Medical professionals agree the benefits of such a program are significant, especially for older women who have the greatest prevalence of arthritis. In the meantime, health agencies, including the National Centers for Disease Control and Prevention, have been working to develop evidence-based exercise programs that improve function among adults with arthritis. A breakthrough in this area comes from a study published in the Journal of Rheumatology. The 16-week study led by a group of scientists at Tufts University achieved a 43 percent reduction in pain scores, and a 71 percent increase in quadriceps strength (muscles of the upper leg). Results of this magnitude had never been achieved with any exercise protocol. The study’s lead author, Dr. Miriam Nelson, attributes the remarkable results to the intensity of the strength training.
Eight years later, a study published in the American Journal of Lifestyle Medicine demonstrated similar results with a supervised strength training program. The study examined the effects of a community-based strength training program in women 55 years of age and older with arthritis. In the 12-week study, women who completed two strength workouts per week achieved a 32 percent increase in lower body strength, while the control group (women who were not strength training) experienced a 7.3 percent decrease in strength. There was an 11.6 percent improvement in mobility among the strength-trained group, and no change in the control group. Flexibility of the lower back and hamstrings also improved by 18.4 percent in the strength-trained group, but did not change in the control group.
This 12-week study shows that participating in a strength training program significantly increases lower body strength in older women with arthritis. In fact, significant improvements in all areas of physical function were seen in the strength training group. The strength training program was well tolerated as indicated by the high level of compliance and no adverse effects being reported!
Here’s how the workouts were structured:
The workouts were progressive (the weight lifted gradually increased) with the goal of reaching an intensity level that participants described as “getting hard” to “very hard.” This intensity range was chosen because it has been shown to increase strength and muscle mass in numerous studies.
The workouts were full body, targeting all the major muscle groups.
The program included two strength workouts per week.
The workouts were supervised by trained fitness instructors.
Approximately 5 minutes of stretching was combined with the strength workout.
The fact that this strength training program was well tolerated is important because the prevalence of arthritis is expected to increase significantly over the next 25 years. The benefits from strength training are primarily due to increases in muscular strength. Stronger muscles reduce the force absorbed by weight bearing joints during activities of daily living (such as walking, kneeling, stair climbing, etc.). Less force on weight bearing joints means less pain and improved joint health.
At MEDFITNESS, we use the Arthritis Foundation’s exercise guidelines that recommend working around joints that are painful. This includes using techniques such as: partial range-of-motion repetitions, timed static holds, and indirect work for target muscles. These techniques allow us to strengthen muscles without irritating arthritic joints.
The arrival of modern strength training is good news for adults living with arthritis. A healthier muscular system not only reduces pain scores, it effectively lowers risk for multiple chronic diseases (i.e., heart disease, diabetes, osteoporosis, obesity, low-back pain, etc.). In other words, adults living with inflammatory arthritis (i.e., rheumatoid arthritis, etc.) or degenerative arthritis (i.e., osteoarthritis) can increase their health span (the number of healthy years they live). This is a big improvement compared to medical advice of the twentieth century when patients were often told to avoid physical activity. We now know better. An inactive lifestyle accelerates the aging process and increase risk of premature death.
By investing less than 1-hour of your week, you can improve arthritis symptoms and take control of your health. If you don’t have arthritis, strength train to prevent it! If you’re living with arthritis, strength train to live better!
1. Journal of Rheumatology. 2001; 28: 1655-65.
2. Arthritis & Rheumatology. 2003; 49(3):463-470.
3. American Journal of Lifestyle Medicine. 2009;3(6):466-473.
4. Nelson, M., Baker, K., Roubenoff, R. 2002. Strong Women and Men Beat Arthritis. New York, NY. The Berkley Publishing Group
5. Arthritis Foundation, https://www.arthritis.org/living-witharthritis/exercise/workouts/ simple-routines/circuit-training-workouts.php