It’s been said: “If all the benefits of exercise could be placed in a single pill, it would be the most widely prescribed medication in the world.” Scientific evidence continues to mount supporting the numerous medicinal benefits of exercise. In fact, there’s hardly a disease that I can think of that exercise won’t help in one way or another, be it prevention, treatment, or even cure in some instances.
Is there such a thing as an anti-inflammatory diet? While there is no specific “diet” that people with arthritis or rheumatoid arthritis (RA) should follow, researchers have identified certain foods that can help control inflammation. Many of them are found in the so-called Mediterranean diet, which emphasizes fish, vegetables, olive oil, whole grains, nuts and seeds, among other staples.
Arthritis is the most common cause of disability in the world.3 Osteoarthritis, the most common form of arthritis, has led to a dramatic increase in the incidence of hip and knee replacements in recent years. The rate of total hip replacements has almost doubled between the years 2000-20101 and approximately 7.2 million Americans are now living with hip and/or knee replacements. 6 While these rates have nearly doubled in recent years, the number of younger individuals (ages 45-54) having these replacement surgeries is increasing.5
The rapid and dramatic increase in individuals living with osteoarthritis and/or joint replacements has created a massive void between the number of people living with these issues and the number of qualified individuals to help them safely and effectively accomplish their functional goals. This void, however, has created an incredible opportunity for fitness professionals to align themselves with allied health professionals to become part of the solution. This article will discuss some recent changes in the thought process about how osteoarthritis develops, how fitness professionals are an important part of the solution, and why this is the most opportune time for fitness professionals to specialize and align themselves with health professionals.
While injury, overuse, age, obesity, genetics, and race have been given as possible causes, there has been a lack of solid evidence to explain why the incidence rate of osteoarthritis continues to skyrocket. 2,3,5 However, recently there have been suggestions that osteoarthritis is not as previously suggested, due only to old age or genetics. Dr. Ian Wallace, a postdoctoral researcher who has studied more than 2,000 skeletons, believes the recent dramatic increase in osteoarthritis isn’t an inevitable consequence of living longer. He believes it is more attributable to the modern decline of physical activity and is quoted as follows: “Dr. Wallace thinks the most obvious candidate to explain the increase in knee osteoarthritis is the modern decline in physical activity.” 8
Nevertheless, it is not just about people needing more quantity of activity; it’s also about the quality of the exercise.10,11 If exercise is performed without optimal joint alignment and control, the individual is at risk for developing degenerative joint changes.10,11 Therefore, it’s imperative that fitness professionals specializing in working with individuals that have osteoarthritis or joint replacements are able to properly assess for non-optimal and inefficient posture and movement habits and from these results, develop an appropriate exercise program. Additionally, fitness professions specializing in this niche must also be able to instruct proper exercise form and understand what exercises or activities are contraindicated with these populations. 10,11
A well-designed exercise program that includes flexibility, strength, and cardiovascular exercise is required to appropriately address the postural and movement habits that contributed to the development of osteoarthritis. Likewise, many individuals will have developed compensatory patterns as a result of joint pain or loss of mobility and subsequently developed non-optimal posture and movement habits that need to be addressed.
Several organizations including the Arthritis Foundation, Center for Disease Control, and American College of Sports Medicine have created guidelines for working with individuals that present with arthritis. General recommendations include improving joint mobility/flexibility, aerobic conditioning, resistance training, maintaining a healthy weight, and consulting with a medical doctor.2,3,13
Helping individuals develop a more optimal and efficient posture and movement strategy is one of the most effective strategies for safely working with individuals with osteoarthritis and joint replacements.9,10,11 An approach that includes using the most appropriate soft tissue release, mobilization, stretching, neuromuscular activation strategies, and appropriately progressing the individual through the fundamental movement patterns has been shown to improve joint mobility and strength in individuals with osteoarthritis as well as joint replacements. 9,10,11 Additional strategies that have been shown to be helpful in improving strength and mobility and managing the symptoms of osteoarthritis include three-dimensional breathing7,9,10,11, proper nutrition featuring a whole-foods, plant-based diet4, and meditation.14
The great news is that there is a growing need for qualified fitness professionals to work with the increasing numbers of individuals that have osteoarthritis and/or joint replacements. However, this requires that the fitness professional have both the right education and the appropriate skillset as many of these individuals will require a thorough approach to address their specific needs and to provide them with the best functional outcomes. Organizations such as the MedFit Network, The Institute for Integrative Health and Fitness Education, and the Functional Aging Institute are helping to create the education necessary for health and fitness professionals to develop specializations in working with special populations including the older adult populations experiencing osteoarthritis and joint replacements. Additionally, through their educational platforms and live course work, they provide fitness professionals with strategies for aligning and working with allied health professionals.
For many individuals experiencing pain or loss of function secondary to osteoarthritic changes, seamless integration between medical procedures, rehabilitation, and functional fitness is becoming a viable and necessary alternative to narcotics and surgery. Hence, the birth of the medical fitness space where fitness professionals work either in collaboration with or in the actual physical location of medical doctors, physical therapists, chiropractic physicians, and massage therapists. Clinics such as Rejuv Medical have provided a model for how to improve patient outcomes by combining the benefits of regenerative medicine procedures (Plasma Rich Protein and Stem Cell Therapy), physical therapy, and personal/group training.
Specialization in working with individuals that have osteoarthritis and/or joint replacements and working in the medical fitness space is the future. The fitness professional that acquires the appropriate education and develops a working relationship with allied health professionals will be able to attract more individuals that need, want, and will pay for their expertise. By providing a more integrated and effective approach to helping individuals accomplish their health and fitness goals, these fitness professionals will continue to thrive in the coming years.
This article was featured in MedFit Professional Magazine.
Dr. Evan Osar is an internationally recognized speaker, author, and expert on assessment, corrective exercise, and functional movement. Dr. Osar is committed to educating and empowering fitness professionals while helping them develop relationships with allied health professionals. He is author of the Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction and has developed the industry’s most complete training certification, the Integrative Movement Specialist™. With his wife Jenice Mattek, he created the on-line educational resource www.IIHFE.com.
References:
“By the year 2040, an estimated 78.4 million (25.9% of the projected total adult population) adults aged 18 years and older will have doctor-diagnosed arthritis” (Hootman JM, Helmick CG, Barbour KE, Theis KA, Boring MA)
The time is now! Let’s talk about how to prevent the onset and symptoms of various forms of arthritis through myofascial release!
It is a type of physical therapy often used to treat myofascial pain syndrome. Myofascial pain syndrome is a chronic pain disorder caused by sensitivity and tightness in your myofascial tissues. These tissues surround and support the muscles throughout your body that are affected by arthritis.
This holds the muscle together and keeps them in the correct place. The fascia separates the muscles so they can work independently of each other. The fascia provides a lubricated surface so that the muscles can move smoothly against each other. When fascia is constricted, it prevents blood flow and decreases circulation.
Rolling for Youth Preservation: First, let’s discuss regaining a rejuvenated look for our skin. When looking at what causes skin aging, it is a slowing down of circulation of blood. As noted by the NIH, this consists of a slowing in the circulation of nutrient-rich blood and detoxifying lymph and increasingly sluggish skin-cell turnover; the skin becomes more “stagnant.”
Rolling the Face. When “rolling” the face, be sure to apply gentle to medium pressure. The two main points of tension are in the superficial fascia and the other is lymph. Lymph is a highly underrated circulatory system within the body that is responsible for detoxifying waste from the skin on a cellular level, in addition to its many, many other functions. When holding tension in the muscles and fascia, lymph cannot move freely and do its job of clearing out waste from the tissue. The result of poor lymph flow can present as dull skin, an accumulation of blackheads and milia, and/or stubborn hyperpigmentation, and more. Superficial fascia is the layer of connective tissue right under the skin on the face. It acts as the support and infrastructure for your skin and is responsible for giving it “lift and tone.” It can also carry a lot of tension and adhesions that restrict circulation of blood and lymph. If you’ve ever used a foam roller on tight legs, think of how much softer one leg feels after rolling when compared to the unrolled leg. Foam rolling is a form of self-administered myofascial release, and that is EXACTLY what we want to do for the face.
Rolling for Neck Tension. The neck is the superhighway of ALL circulation to and from the face. A tight neck acts like a traffic jam between the body to face and back again. This prevents detoxifying lymph from draining as well as it should, and working the neck alone can be major in bringing flow and vitality back to the complexion as well as reducing puffiness in the face. Many people experience a very high level of neck and jaw tension due to everyday stress. Remember that working hard also means you must self-care harder!
Rolling to Fight Arthritis: To reduce the onset of symptoms from various diseases such as arthritis that affect facial and neck muscles, various myofascial release techniques such as Rollga rolling stimulates muscles, improves blood flow and enhances circulation. Because the jaw is a joint that is commonly affected by arthritis, myofascial release eases tension, improves joint mobility and decreases pain while speaking or chewing.
Learn more about Rollga rolling for the face and neck by contacting info@ContiFit.com
Request a manual, attend a workshop, or take an online course to learn about myofascial release with Let’s FACE it Together™ Facial Exercise & Rehabilitation!
Check out the Arthritis Fitness Specialist Online Course from MedFit Classroom.
Reprinted with permission from Christine Conti. Originally printed on rollga.com.
Christine M. Conti, M.Ed, BA is and international fitness educator and presenter. She currently sits on the MedFit Education Advisory Board and has been nominated to be the 2020 MedFit Network Professional of the Year. She is currently writing the MedFit Network Arthritis Fitness Specialist Course and is the CEO and founder of ContiFit.com and Let’s FACE It Together™ Facial Fitness & Rehabilitation. Christine is also the co-host of Two Fit Crazies & A Microphone Podcast and the co-owner of TFC Podcast Production Co.
If you have arthritis but want to improve your current strength levels, there are smart strategies to get you there. In this article, we’ll discuss them and provide some basic steps to follow. With a solid foundation in place, you’ll be feeling stronger in no time.
The best bet is to start working with a personal trainer who’s trained clients with arthritis. That way you get to work with a professional who knows the appropriate training style and protocol to use.
Someone who knows to avoid exercises that put more stress on your joints. And instead provide exercises to improve your range of motion, flexibility, and of course, overall strength — all in a comfortable and safe way.
Then after several months of one-on-one training, you’ll have the knowledge and skills to confidently work out on your own, or continue training with the professional, if that’s what you prefer.
Pick a time of the day where your pain level is at its lowest. Exercising while in pain, stiff, or feeling inflamed will make the exercise uncomfortable, and that’s exactly what we don’t want.
Always warm up your body before an exercise. With arthritis, it’s better to have a longer warm-up time, so plan on setting aside 10 minutes or so. After this, your joints will feel lubricated and will make the exercises more enjoyable.
If you decide to workout at home, rather than with a personal trainer or physical therapist, then you’ll need to purchase some dumbbells or resistance bands if you don’t already have them.
Dumbbells and bands are more ideal than a barbell because they’re easier and safer to use. Safer in the sense that you could have an imbalance in joint strength and that would make it more difficult to use a barbell. Whereas, with dumbbells or bands, you can work your left or right sides individually and gradually increase your strength over time.
If it’s been many months or years since you exercised, then ease back into it gently and slowly. Pushing yourself too hard too soon will only overload and burden your muscles, which can increase joint pain.
This means starting with low weights as we just mentioned. It’s better to do more repetitions than to start off using heavy weights and only doing a few reps. Also, try to do a little bit every day. Even if that means going for a walk, doing some light stretching, or a few bicep curls. Being active every day will help decrease arthritis-related pain.
Furthermore, when you do work with a professional trainer or physical therapist they’ll teach you good form. And this is not only fundamental to effective exercise, but also for injury prevention.
Hydration keeps your body healthy, and it helps to lubricate the joints. As you know, this is essential for minimizing pain from arthritis. Plus, the more you exercise and sweat, the bigger the need for hydration becomes.
As the owner of Results Performance Training in Williamsburg, Virginia, Detric Smith helps people achieve their fitness goals through customized training and action-based coaching. Over the last two decades, Detric’s made it his mission to study the habits, strategies, and techniques of personal trainers and coaches who are successful and, most importantly, happy. Also, during this time he’s authored a book, mentored trainers through multiple organizations, and his own business. Finally, Detric’s written for well-respected fitness websites, magazines, and journals. Find out more about Detric at: resultsperformancetraining.com and www.detricsmith.com
References:
Rheumatoid arthritis (RA) can be a difficult disease, and cause a whole host of complications and challenges when you’re navigating life with it. Though it is, in some people’s estimation, lower on the list in terms of chronic disease, it…
It all started over 40 years ago, when I chose as my sport – some would say, my life – the Korean martial art of Tae Kwon Do. I was young, fit, pretty strong and, unbeknownst to me, very flexible – perfect for the art of kicking high and hard. Once I got hooked on it, I was in the gym a few hours a day, 6-7 days a week…for the next almost 20 years. That did not include the running I did to get my cardiovascular conditioning primed for the art and sport I was practicing at high levels of both skill and competition. I knew then, at age 19, that I was going to pay for the training and abuse I was putting my body through, but not until I was older, say, 40 or so.
When left unchecked, rheumatoid arthritis can be majorly debilitating and cause real and continued pain. However, if you’re willing to do the research and put in the work, you can do certain exercises which can majorly reduce the symptoms, improve your overall mood and actually make you that much physically healthier, generally speaking, which can only be a good thing. The real question then is, what sort of exercises ought you be doing to try and achieve this. Well, let’s take a look at five ways to help improve those symptoms.
Stretching is actually something which we all ought to do and can be a great way to start anyone’s day. Daily stretching reinforces a healthy sense in which the muscles are able to become increasingly limber and flexible across time. Stretching is a personal thing, and it will depend a bit on where most of your arthritis pain is concentrated. When you stretch you want to go slowly and thoroughly. Warm up for a few minutes and then stretch each of the muscles you want slowly, pushing yourself further in tiny intervals. To guarantee success, track down a physical therapist with an understanding of rheumatoid arthritis.
“It’s all too common that rheumatoid arthritis has an adverse and painful effect on the hands, meaning this is an area which ought to be focused on in terms of exercises that can be done”, advises Charles Tevesham, health writer at LastMinuteWriting and Writinity. There are only a limited number of ways in which one can move one’s hands, so you ought to do your best to try and explore the full range of stretches available. Using a stress ball and a small roller can help to achieve this as well.
Sometimes when you are in pain, having to get up and go on a walk can be the last thing that you want to do. But, it’s hugely beneficial. The act of walking involves so many of the different muscle groups and makes it so easy to do something that will be beneficial for your arthritis. It is also a great way to boost your mood, since it is exercise and involves being outdoors. Make sure you drink water and try to slowly increase your speed across the duration of your walk.
Completing exercises, stretches and other forms of aerobics in a pool is a wonderfully forgiving way of going about your pain reduction routine. Being in water helps to reduce the impact of your body weight so it makes it very easy to do exercises without fearing that you are going to injure yourself. Furthermore, the act of swimming is actually a really good exercise that involves using all o the muscle types in your body in a way which is actually deeply therapeutic and relaxing. If the water is warm, that’s an even better way to soothe pain.
Cycling is another good exercise option. “Cycling is definitely one of the more strenuous options available to you, but it’s one that will really help ensure that the increase in the risk of cardiovascular problems that rheumatoid arthritis involves, doesn’t get the better of you”, says Mary Simmons, health blogger at DraftBeyond and ResearchPapersUK. You ought to make sure that you have stretched thoroughly before you get onto a bike as the intense locational nature of the workout, in other words the amount of pressure it puts your leg muscles under, can cause you an injury. That said, it’s an incredibly good way to exercise the muscles in the lower half of your body and has long term benefits to flexibility and pain reduction.
Overall, stretching and various other exercises are actually vitally important to giving yourself the best chance of avoiding unnecessary and difficult to deal with pain. Rheumatoid arthritis is never going to be pleasant, but if you really commit to a routine of exercise you can be sure that the way you feel, physically and mentally, is going to improve and that steps towards managing the symptoms will be moved through quickly.
Harry Conley is a content editor at LuckyAssignments and GumEssays. He develops training procedures and manages the workflow to give writers supplemental support instruction. A man of many interests, Harry also works in providing supplementary materials and instructional support for contributors.
References
Charles Tevesham, health writer, LastMinuteWriting and Writinity.
Mary Simmons, health blogger, DraftBeyond and ResearchPapersUK
Although arthritis today is considered one of the leaders of the pack in the epidemic of chronic illness, millions of those affected are living fulfilling lives and living them well.
According to The Institute of Medicine’s New Report on Living Well With Chronic Illness, 8.6 million Americans are living with disabilities related to arthritis. The Arthritis Foundation reports it as “striking one in every five adults, 300,000 children and as the leading cause of disability in the United States.” Arthritis is a chronic illness that impacts many.
Those living with arthritis can live well and have a good quality of life by employing lifestyle interventions as medicine, in conjunction with, prevention, joint protection, weight management, physical activity, wise food choices, stress management and a good medical regimen. By combining all these necessary recommendations into a personalized Wellness Strategy and Plan, a coach can assist an arthritis patient in organizing what is important for them to live life well. The Wellness Plan then becomes a map by which to navigate toward managing and maximizing the patient’s best life possible.
A common factor also influencing quality of life for those challenged by arthritis or any chronic illness is what is called “adherence” or “medical compliance”. Lack of adherence to medical and lifestyle improvements is a large piece of the cost of healthcare today and contributes to the epidemic of chronic illness. Average patient adherence rates for prescribed medications are about 50 percent, and for lifestyle changes they are below 10 percent.
The World Health Organization reports “improving adherence also enhances patients’ safety because most of the care needed for chronic conditions is based on patient self-management, use of medical technology for monitoring, and changes in the patient’s lifestyle.” A coach assists in supporting patient compliance and self-accountability and works with the patient to forward the action toward their goals.
The same report goes on to say “patient-tailored interventions are required and must be customized to the particular illness-related demands experienced by the patient. There is no single intervention strategy that has been shown to be effective across all patients.” Therefore, working with individuals one on one is of primary importance for enhancing their quality of life. Coaches work with clients on a one on one basis assisting them in creating a wellness plan that is personalized to them.
Dr. Bennett and team’s article Health Coaching for Patients with Chronic Illness states “it is critical that those with arthritis understand, agree with and participate in the management of their chronic condition. Health coaching is one way to accomplish this function.”
A long-term study done at Stanford University indicates that interactions with a coach can significantly increase the health of people with chronic illness. Stanford’s Chronic Disease Self-Management Program brought patients (including those with arthritis) together with a coach. “Subjects who took the Program, when compared to those who did not, demonstrated significant improvements in exercise, cognitive symptom management, communication with physicians, self-reported general health, health distress, fatigue, disability, and social/role activities limitations. They also spent fewer days in the hospital, and there was also a trend toward fewer outpatient visits and hospitalizations.”
It was found “This type of self-management, through coaching, is so effective it has been endorsed by the Surgeon General of the United States.”
“Give a man a fish, and he eats for a day. Teach a man to fish, and he eats for a lifetime.” Health & Wellness coaches work with a client to tailor-make a wellness plan that includes self-management, coordinating their medical regimen, and forwarding lasting lifestyle changes. Working together with a coach, a patient can successfully manage their condition and create a strategy to living life well with arthritis.
► Work with you to take an inventory of your current wellness status
► Guide and facilitate your personal well-life vision toward the life you would like to live
► Work with you to develop a personalized Wellness Plan that is tailored to your needs. The wellness plan becomes the map that integrates your important areas of focus including: self-management support, the medical regimen, and lifestyle improvements.
► Bridging the gap between clinician and patient.
these gaps between the medical team and patient by following up with patients and guiding a patient-centered approach, asking about needs and addressing obstacles, addressing health literacy, cultural issues and social-class barriers.► Provide accountability & support for you to be successful
► Provide ongoing evaluation of progress toward your goals
► Serve as a continuity figure
► Assist in patient-directed achievement of successful lifestyle behavioral change
Dr. Linda Gogl is a Doctor of Physical Therapy with Board Certification in Orthopaedic’s with over 20 years in healthcare. She currently serves as Director of Development and Team Member for Real Balance Global Wellness Services. Her professional experience includes outpatient Clinical Director, Developer/Director of an APTA Credentialed Orthopaedic Residency Program, Director of Quality Assurance for the largest physical therapy private practice in California, Credentialed Clinical Instructor, Adjunct Professor of Anatomy & Physiology, Research mentor and Clinical Coordinator for University affiliations. More recently she also served as National Director of Training and Implementation for OptimisPT, a physical therapy software system.
References