McGovern Physical Therapy Associates - The Personal Care Professionals

ARTHRITIS AND PHYSICAL THERAPY

What Is Arthritis?
Arthritis is a general term for a group of more than 100 diseases. The word "arthritis" means "joint inflammation." Inflammation is one of the body's natural reactions to disease or injury, and includes swelling, pain and stiffness. Inflammation that lasts for a very long time or reoccurs, as in arthritis, can lead to tissue damage. Arthritis is very common. As many as 70 million Americans, or about one in three, have some form of arthritis or joint inflammation. It is a major cause of lost work time and serious disability for many people. Osteoarthritis, the most common form, affects more than 20 million Americans. Arthritis affects people of all ages, but is more common in older females.

People with arthritis often have stiff joints because they avoid movements that can increase pain. By immobilizing arthritic joints, the stiffness and pain only get worse. Therefore, people with arthritis often benefit from physical therapy. Physical therapy is a treatment method that focuses on pain relief, healing, restoring function and movement, improving body mechanics, as well as overall fitness and wellness. Physical therapy also is useful after an injury, such as from a fall, and after joint surgery, especially for artificial joint replacement.

What Is the Goal of Physical Therapy?
The goal of physical therapy is to get a person back to the point where they can perform normal, everyday activities without difficulty. Preserving good range of motion is key in maintaining the ability to perform daily activities. Therefore, increasing the range of motion of a joint is the primary focus of physical therapy. Building strength in the involved muscles surrounding the joint also is extremely important, since stronger muscles can better stabilize a weakened joint. Physical therapists provide exercises designed to preserve the strength and use of your joints. They can show you the best way to move from one position to another and can also teach you how to use walking aids such as crutches, a walker or a cane, if necessary.

Types of Exercise
Generally there are 3 types of exercises that are appropriate for people with arthritis:

Range-of-motion exercises. These exercises should be done daily to help maintain normal joint movement, relieve stiffness and increase flexibility.

Strengthening exercises. These exercises can also be done every day (unless you have severe pain) to help increase muscle strength. Strong muscles help support and protect joints affected by arthritis. Your therapist will instruct you on proper ways to lift and flex during these exercises.

Endurance or aerobic exercises. These exercises can be done three times a week for 20-30 minutes. They improve cardiovascular fitness, help control weight and improve overall function. Examples include walking and bike riding.

Other Therapies
In addition to therapeutic exercise, physical therapists may use other treatment modalities such as:

Heat Therapy –warm heat packs are placed on the affected area to relieve pain by increasing blood flow and relaxing tissues.

Cold Therapy - ice packs or ice massage is applied to painful areas reducing swelling and pain.

Therapeutic Ultrasound - ultrasound waves are applied to the affected area neutralizing pain while increasing circulation

Aquatic Therapy – exercising in water is a safe, ideal environment for arthritis sufferers. Aquatic therapy allows for accelerated rehabilitation, reduced pain, joint protection, reduced exercise stress, decreased swelling, increased circulation, increased strength and endurance, increased range of motion, flexibility, balance and coordination, and increased muscle tone.

Manual Therapy – manual techniques including myofascial release, joint mobilization, massage, muscle energy techniques, and traction can help increase flexibility and circulation.

E-STIM (Electric Muscle Stimulation) - therapy in which electrodes are applied to the skin and a mild electrical current is sent to specific nerves to block pain signals.

Paraffin Baths – a form of moist heat that helps pain and stiffness in your hands or feet. It is especially useful before exercise.

Orthotics – appropriate foot-care advice, including custom-sculptured orthotics molded exactly to the contour of each foot, allowing for proper alignment and reduced joint stress.
Many people continue their exercise programs at home after their prescribed physical therapy is finished. A physical therapist will instruct you on the proper ways to do your exercises at home and give you tips on how to continue your treatment on your own.

Here are our top 10 ways people with arthritis can stay healthy:

#1 Stay Ahead of the Game! Visit your doctor regularly. This is true whether you have already been diagnosed with arthritis or are interested in preventing it. Be sure to tell your physician about any pain or discomfort you have.

#2 Get Up and Go! Regular physical activity will reduce the risk of falling, reduce anxiety and depression, help you maintain a healthy body weight, preserve cartilage, and increase joint strength and mobility. If you are unsure about how to start, talk to a physical therapist about developing an exercise plan that is best for you.

#3 Cut the Fat! The more you weigh, the greater the stress on your joints. If you are overweight, losing even 10 to 15 pounds can help reduce your pain. Losing weight will also make you feel better and therefore more likely to keep up with your healthier lifestyle. If you are severely overweight, talk to your doctor about a weight loss program that will allow you to lose large amounts of weight safely.

#4 Sit Smart! If you need to do a lot of sitting, make sure you are doing it safely and correctly. Follow these simple guidelines when sitting:

Make sure your feet are flat on the ground or a solid surface (like a footrest). Do not cross your legs; sit with knees bent and thighs level.

Make sure the chair you sit in has good lumbar support in the right area for your shape and size. If you can, sit in a chair that has an adjustable support to get the best position. If this is not possible, use a rolled towel or a cushion to support your lower back.

Make sure the arms of the chair are correctly adjusted so that your shoulders are relaxed, not hunched forward or raised.

Stop and reposition yourself often. Relieve stiffness by stretching and relaxing any areas of your back that feel tense or tight. Get up and walk around when you can. Stop what you are doing if you feel pain.

#5 Stand Smart, Too! Many people have jobs that require them to do a lot of standing. This can also place a great deal of pressure on joints, especially in the spine. Following these important standing tips:

Stand in a stable position with feet flat on the ground.

Avoid twisting the lower back to reach for things, instead, move your whole body when reaching to change your posture. Avoid over-reaching.

If you must bend, bend at the knees not at the back. Try to face the objects before bending to avoid twisting.

Lean when you can, this can take some of the pressure off your back and can reduce fatigue.

#6 Save Those Joints! Avoid too much stress on your joints. Learn your limits and don't push yourself beyond them. Joint protection is important to keep in mind during regular day-to-day activities. If you need to, use an assistive device such as a walker, cane or brace. Use wheeled carts to carry heavy items. Look for household items such as electric can openers, step stools and reaching devices that spare your joints and prevent strained movement.

#7 Only Eat the Good Stuff! Good nutrition and a balanced, low-fat diet rich in fresh vegetables and fruit are a must! Look for foods that are high in vitamin C to reduce the risk of osteoarthritis. Foods like fortified dairy products and fish are rich in Vitamin D which helps preserve cartilage. Calcium will help strengthen bones. Eating well will also help keep your weight under control.

#8 Kick the Habit - Don't Smoke! If you smoke, quit. Especially if you have to have spinal or joint surgery. Smoking can actually prolong your recovery. If you are having trouble quitting, talk to your doctor about a smoking cessation program that is right for you.

#9 No Pain, All Gain! Since there are such a wide variety of pain management options today, don't stop until you find the one that works best for you. Arthritis sufferers no longer need to "grin and bear it" - pain relief is possible. If you are not satisfied with how you are managing your pain, talk to your doctor about other options.

#10 Be Good To Yourself! Probably the best tip of all is to take care of you. Be aware of your body and your arthritis symptoms so that any changes can be taken care of right away. Treat yourself regularly to things that make you feel good - whether it's a massage, a night out with friends, planting a garden or reading a good book. Avoid stress in your life by eliminating those things that cause you pain and discomfort. Be good to yourself and you will be amazed at how much better you will feel!

McGovern Physical Therapy Associates, the personal care professionals, is a multispecialty provider of outpatient physical therapy care. Voted “Best PT Practice 2004” by ADVANCE for Directors in Rehabilitation magazine, our clinicians offer personalized manual therapy and exercise expertise, including a variety of customized treatment options. Combining innovation, experience and excellence, our staff of clinicians, as well as dedicated office personnel, work as a team to provide caring, convenient and professional service for total patient recovery.

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