Dr Sarah Jarvis Don’t let joint pain stop you exercising

One of the first things many of my patients do when they have joint pain is to stop exercising.

It’s natural to worry that exercise could put more pressure on their joints or damage them further. But in fact, that’s the opposite of what doctors advise for manyy typesyp of joint pain. Regular exercise can reduce stiffness and pain, and provide long term benefits. But you need to choose your exercise.

Osteoarthritis, or OA, is the commonest cause of joint pain in the UK. While it most often affects weight bearing joints (hips,p, knees, spine) as well as fin ngers and thumbs, it ca an affect any joint. Age, be eing overweight, ge enetics, overuse of a jo oint (for instance in manual m jobs) or joint damage d can all contribute. c

OA causes painful j oints in about 8.5 million m people in the

UK, mostly over the age of 50. Often called ‘wear and tear’ arthritis, it’s actually more to do with the fact that the natural repair process that goes on all the time as we use our joints becomes faulty.

Rheumatoid arthritis is an inflammatory arthritis, where your immune system attacks your own joints.

Regardless of the cause of your joint pain, regular exercise will help strengthen muscles – this will improve your balance and cut the chance of falls.

Any weight bearing exercise (most exercise apart from swimming or cycling) can help strengthen bones, reducing the risk of osteoporosis. However, if you have painful joints, swimming (where the water supports your joints) can relieve stiffness and increase your range of movement.

Lots of my patients with osteoporosis worry that they may risk breaking a bone if they exercise. In fact, while you want to avoid rugby tackling and bungee jumping, being physically active is very unlikely to cause a broken bone and the benefits usually greatly outweigh the risks.

Weight-bearing exercise can be divided into low, medium and high impact. Low impact includes walking, stair climbing, Pilates, most yoga and gardening. Racket sports, skipping, jogging, aerobics and dancing are medium impact. If you’ve had a fracture of your spine, you may want to stick to low impact, but otherwise use a combination of both.

As a rule of thumb, after you finish exercising you should

EXERCISE HELPS YOU SLEEP BETTER AND HAVE MORE ENERGY – JUST AVOID DOING IT TOO CLOSE TO BEDTIME

feel as if your muscles have done some work and have stretched a little. If you’re still more sore than before exercise by an hour after you finish, you may have overdone it.

Avoid excess pressure on joints. For instance:

● If you’re lifting, use several joints to spread the weight. For instance, use both hands to carry your shopping.

● Try not to grip too tightly. A padded handle will help.

● Use your larger joints as levers. For instance, use your whole arm, not just your hand, to open heavy doors.

● Don’t carry a bag on one shoulder. A handbag with a long strap worn across your body, or a rucksack, will spread the load through several joints.

It’s worth remembering that some sorts of pain affect your muscles or the tough connective tissues that connect

joints or joint to muscles. For instance, plantar fasciitis causes pain under your heel. It’s caused by inflammation in the fascia – the tough band of connective tissue that runs under the sole of your foot. Sudden stretching (eg going upstairs, walking on tiptoe) may make the pain worse. It’s often caused at least in part by wearing shoes without the right cushioning. For this, regular gentle stretching of your achilles tendon (by bending your knee with your foot flat on the floor) can help.

Tennis and golfer’s elbow are forms of ‘repetitive strain injury’ caused by doing the same movement repeatedly. In this case, it’s important to rest the affected area short term. The same applies for 3 days or so after you sprain your ankle. NEXT WEEK: Keep your heart healthy