PT on the Net Research

Arthritis


Question:

I was wondering if you could do an article on arthritis and working with clients with this problem.

Answer:

There are several forms of arthritis. I am unsure which one your client is afflicted with, so we will look at a few of the most "popular" types. Osteoarthritis is a degenerative joint disease that breaks down the cartilage on the ends of the bones. The cartilage becomes thin and rough and no longer allows a smooth gliding surface for the bones to glide on. Usually, you can here crepitus (grinding) of the most effected joints and pain, stiffness and swelling are present. Some people feel this is a genetic thing.

Rheumatoid arthritis is next on the popularity list. This type of arthritis attacks the synovium that lines the inside of the joint. The synovial lining is responsible for lubricating the joint. This affliction causes the synovium to become thick and release large amounts of poor lubricating fluid. This fluid also contains destructive enzymes that cause deterioration in the bone, cartilage and tendenous material around the joint. Joints that are under this type of arthritic influence are swollen, hot, painful, stiff and sometimes deformed.

Trauma can also cause a arthritic condition. This is usually generated by old "sports" injuries that have allot of scar tissue. This scarred area becomes rough and incompatible with other smooth surfaces causing inflammation, swelling and pain.

I am unsure of the limitations your client may have and what type of physical condition he is in? The actual exercises that can be used are dependent on the person. Without that information it is difficult for me to write a program. However, here are a few guide lines that work well for me when training some of the folks that have arthritis:

Some people suggest using pain medication before training. I leave it up to the person, but I suggest trying to train without meds and the blunted pain mechanism. This way, if a joint is not doing well, you will not "over do it" too far where swelling and pain persist for days. By applying ice and anti inflammation meds after training the pain, swelling and irritation will be minimized.