Despite years of advice that the arthritic should lay off their joints, doctors and therapists now say proper movement is the best medicine for the nation's leading cause of disability, whether the goal is alleviating pain or even protecting against the condition.
The Arthritis Foundation, working with the Centers for Disease Control and Prevention, recently launched a national campaign to spread the word. Experts say preliminary research has shown that for many, exercise can relieve pain just as well as over-the-counter drugs such as Tylenol and Aleve, without the dangerous side effects of a number of medications.
Of course, hitting the gym or a trail is easier said than done if your knees are throbbing. But the right kind of exercise can help to loosen stiff joints and strengthen the muscles around them, giving sufferers less pain and more mobility. In the bargain, exercisers get a potent weapon to control heart disease and diabetes, which afflict many arthritic patients in middle age and beyond.
The key, experts agree, is getting people in pain to overcome their reluctance to move.
Pete Conti Jr., a 50-year-old St. Petersburg, Fla., truck driver who's on medical leave with arthritis and diabetes, is a believer.
His big goal: avoid joint replacement surgery.
"I just didn't want it to get worse," Conti said of his arthritis. "I'm doing everything in my power to stay out from underneath the knife."
Joint mechanics
To appreciate the healing powers of exercise, you have to understand the mechanics of joints - body parts that get little attention until they hurt.
Joints don't get their nutrients from large blood vessels the way muscles and organs do. Synovial fluid, a substance as slick as oil, feeds cartilage, which protects the bones from grinding against each other.
Movement lubricates the process much like squeezing water through a sponge, said Steve Tompkins, manager of outpatient rehabilitation at Bayfront Medical Center in St. Petersburg, where Conti is in therapy.
"You don't want to just sit around and be a couch potato," said Tompkins, who is a physical therapist. "You'll have a dirty sponge."
Exercise also strengthens the muscles around the joint and increases blood flow to the surrounding tissues.
And maintaining a healthy weight, through diet and exercise, is crucial to managing arthritis. For every pound gained, experts note, the pressure across your knees increases by four pounds.
Proper balance
The good news for the fitness averse: You don't have to knock yourself out to get the positive results of exercise. In fact, you shouldn't. Over time, pounding exercises such as running can wear down the cartilage in the joint, effectively causing osteoarthritis.
"What's hard is that most people think exercise is really going and killing yourself, whether it's running or whatever," said Dr. Patience White, vice president of public health at the Arthritis Foundation, which offers specific fitness guidance on its website, www.arthritis.org, and through its local chapters. "The point here is balance."
John Leanes has learned this lesson the hard way.
A basketball nut since the age of 4, he played three to four times a week until his mid-50s, when his right ankle began swelling up like a balloon. He wrapped his ankles and rubbed soothing ointment on his knees, anything to stay on the court.
When he finally saw a doctor, the St. Petersburg man learned his basketball days were over.
"It's a depressing piece of news to hear. Maybe 15 years ago, if I had this understanding, I could have slowed this process down," said Leanes, now 62. "It was hard for me to say to myself, 'John, you're aging. You need to do some things differently.'"
Where he once ran five miles a day, he now power walks for three or four. He still indulges in a monthly pickup game, but only on indoor basketball courts that better absorb the impact.
"You have to figure out a way not to exercise less, but to exercise with less forces," said Jeff Konin, executive director of the University of South Florida's Sports Medicine and Athletic Related Trauma Institute. "It doesn't take a physician visit to know that there's too much force on whatever joint is involved."
Learn more
To learn more about arthritis and exercise, visit the Arthritis Foundation's website at arthritis.org or the Centers for Disease Control and Prevention website at cdc.gov/arthritis.
