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How to exercise safely with joint pain

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Staying active is key to soothing sore and achy joints. But the type (and intensity) of your movement matters. Here are the joint-friendly activities you need to feel better.

As we age, we gain many beautiful things. Wisdom, knowledge, perspective. Unfortunately, stiff joints can come with the territory, too.

When your joints feel sore, achy or even hot, being active is probably the last thing you want to do. But movement can be essential to ease the pain, and keep you doing what you love.1

Exercise strengthens the muscles and tissues around your joints. Think of them as a brace. And activity triggers a cascade of physical changes. Your joints get bathed with fluid that helps loosen them up. Blood flow increases, which supplies joints with the oxygen and nutrients they need to work their best. Plus, regular exercise boosts your body’s natural repair mechanisms.

The trick? Picking the right type of movement. You want joint-friendly activities that keep you feeling good. And what those are can depend on which joints bother you. Or even whether you’re in a flare-up or not.

We consulted Sherri Betz, PT, DPT. She’s a board-certified geriatric physical therapist and an expert in joint pain and exercise based in Monroe, Louisiana. Here, Betz shares her guidance on how to build your move-more, feel-good plan. 

Be choosy with your activities

There’s no one right way to move with joint pain. The activity you do will depend on a whole host of factors. Namely, how severe your pain is and your overall health. How active you’ve been in the past matters, too.

In general, experts suggest activities that are easy on your joints.2 Think of walking, biking or swimming. But feel free to think outside the box. What feels good to you may be different from someone else who also has joint pain. Plus, the more fun you have, the more likely you are to stick with it.

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Here are some more low-impact ideas to get you started:

  • Shuffleboard
  • Cross-country skiing
  • Nordic walking (like cross-country skiing but without the snow)
  • Pilates
  • Tai chi
  • Water aerobics

It’s always a good idea to talk with your doctor before starting anything new. They’ll have insights into what activities are best. And they may even have resources to help you along the way. Learn more about living an active life.

 

Add in strength training

Betz says one of the top mistaken beliefs about joint pain is that you shouldn’t strength train.

“When people have knee pain, hip pain or back pain, they often don’t do any strengthening. That’s because so many people say ‘don’t lift anything,’” Betz says. “But that’s a problematic downhill spiral. If you don’t lift, your bones are going to decline. And your back and leg muscles will weaken.”

We need strong legs and backs to support our joints, Betz says. And that’s especially true as we age. Adults over age 50 lose about 1% of their leg strength every year without strengthening exercises. And the loss gets faster after 60.3 So it’s important to keep your strength up when you’re dealing with joint pain.

Betz’s top three strength exercises for healthy joints in the lower body are:

  • Chair squats: Sit on a chair and scoot to the edge of the seat. Maintain a neutral spine position. Lean forward from your hips, keeping your back straight and knees apart. Then stand. Slowly hinge at your hips to lower down until the backs of your thighs just touch the seat. Stand back up. Repeat 10 times.

  • Shallow lunges: Stand with your feet hip distance apart. Step forward about three feet with your right foot. Keeping your body upright, slightly bend both knees to lower down. Go only as far as comfortable. Stand back up. Repeat 10 times on each side. Stand against a doorframe, or hold on to the wall or counter for extra balance support.

  • Heel raises: Stand tall with feet together. Shift your weight onto one foot. Keeping your knees straight, raise your heel and lift onto the ball of your foot. (You may be more comfortable in shoes.) Lower back down. Try to keep your head, shoulders and hips aligned. Repeat 10 times on each side. Stand near a sturdy chair or counter for balance support.

And for the upper back and shoulders, she loves exercises like “cobra.” That’s lying on your stomach and lifting your upper body. You can add light dumbbells for added resistance as you get stronger, she says.

If lifting is new to you, don’t be afraid to reach out for help. Physical therapists can show you how to strengthen your body without causing more pain.

Start slow

When you’re amped to get active, it can be easy to go overboard. But if you have joint pain, try not to do too much too soon. It’s important to give your body time to adapt, says Betz.

If exercise is new to you (or it’s been a while), try just a few minutes of movement a few times a day. Maybe you walk to the mailbox and back a few times before getting your mail. Or you do a few heel raises while you wash the dishes. Then, if you feel good, keep adding small bits of exercise over time.

Betz is also a fan of warming up and cooling down your muscles before and after you exercise. This helps ease your joints in and out of physical activity. That could be starting and ending your walk extra slowly. Or doing your strength moves but with a much smaller range of motion to ready joints.

Go easy during flare-ups

Feeling extra sore and achy? Remember Betz’s mantra: Gentle movement heals.

“When you’re in a flare-up, you’re going to work out differently than when you’re not in a flare-up,” says Betz. The goal is to reduce joint pain. “So you’re going to want to limit strenuous activity. Start with gentle movement instead.”

What does that look like? Betz is a fan of water workouts. The water offers you buoyance and support, she explains. This way you can move your body without aggravating your symptoms.

Betz says to submerge the painful joint and put it through gentle movements. Once the inflammation (soreness) goes away, you can slowly ease into your normal activities again.

Train your center

Back pain is very common. A whopping 8 out of 10 people will deal with it in their lives.4

To ease spine pain from stiffness or disk issues, you’ll want to work on your core. If the middle of your body isn’t strong, it could be putting extra strain on your back.

Specifically, Betz recommends flowing movements that work through your spine’s range of motion. She prefers flowing moves over deep stretching. They’ll be way more helpful for easing stiffness in your spine.

Her favorite flowing spinal exercises include:

  • Bridges: Lie on your back with your knees bent, feet on the floor. Breathe in. As you breathe out, slowly begin to lift your hips. Imagine you’re rolling up your spine one joint at a time. Pause when you reach the tips of your shoulder blade. Your knees, hips and shoulders will be in a line. Slowly lower back down one vertebrae at a time. Repeat five to 10 times.

  • Gentle spine twist. Lie on your back with your knees bent, feet on the floor. Keep your knees close together, then slowly drop them to one side. Go only as far as you can without lifting your shoulder or rib cage off the floor. Hold for a few breaths. Lift your knees back up. Repeat on the other side.

You can also strengthen your core with exercises like “dead bug” and the Pilates move “the hundred.” For both moves, Betz says to just make sure your core is activated. One way to engage your core is to place a strap (like a dog leash) under your low back. Then press your low back onto the strap and maintain it throughout the exercise. Don't let your back arch or your abdominals bulge. This will support your spine during these exercises. Here’s how to do them:

  • Modified dead bug: Lie on your back with your knees bent, feet flat on the floor. Lift one knee up toward your chest until your shin is parallel to the ceiling. Lower the knee and tap your toe on the floor. Lift your knee back up. Repeat 10 times on each side.

  • Modified hundred: Lie on your back. You can use a pillow behind your head if it’s more comfortable. Place your legs at a 45-degree angle. Raise your arms off the floor so they’re extended straight out next to your body. Hold your legs still. Pump your arms up and down 100 times, slowly breathing in and out.

Consider warming up your spine first by going for a walk or taking a warm bath, says Betz. Then do whatever flowing movements feel good on your back.

Support your knees

Is your knee your problem joint? You may need to focus on keeping your hips and feet in better alignment, says Betz.

Here’s how to check: Do squats or walk up and down stairs. When your knee bends, look down and see where it extends over your foot. If it reaches right over your middle toes, you’re good. But if it’s cranking to one side or the other, it may not lined up properly. And that could be the secret to reducing your joint pain.

Betz’s go-to exercises for better knee support? Heel raises and what she calls “long-stride lunge preparation.” To do it, step forward with one foot so your feet are about 36 inches (or one yardstick) apart. Then raise and lower the heel of your back foot.

“This exercise stretches the front of your back hip. You’re also activating the arch of the back foot, the calf and the glutes,” says Betz.

Bike riding is another great exercise for knee pain. It allows you to move and curb soreness without loading weight on your knee. As you start to feel better, slowly start weight-bearing exercises like walking, says Betz. 

Don’t be afraid to ask for help

There are many exercises you can try on your own to ease joint pain. But if you’re new to exercise or just having a lot of discomfort, talk to your doctor. It may be smart to start working with a physical therapist. It can be hard to take that first step. But once you do, you’ll be that much closer to feeling better. Ready to get started? Find Optum providers near you now.

Sources

  1. Centers for Disease Control and Prevention. Physical activity helps arthritis pain. Last reviewed September 21, 2021. Accessed July 8, 2022.
  2. American College of Rheumatology. Exercise and arthritis. Last updated December 2020. Accessed July 8, 2022.
  3. Frontiers in Physiology. Changes of Maximum Leg Strength Indices During Adulthood a Cross-Sectional Study With Non-athletic Men Aged 19–91. Published November 1, 2018. Accessed July 26, 2022.
  4. National Library of Medicine. Back pain. Last updated October 21, 2016. Accessed July 8, 2022.

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