WebMD Health - Rheumatoid Arthritis

Apr 4, 2011 3:46 PM

5 Steps to Physical Therapy Success

When your fingers are swollen, your wrists are throbbing, and your knees hurt from rheumatoid arthritis, moving them may be the last thing you want to do. But it can be one of the best things you do. Daily physical therapy exercises for RA help strengthen muscles that support your joints while helping you retain flexibility and movement and increase stamina.

"You're going to hurt no matter what," says Brett Cook, a physical therapist who works with arthritis patients at Independence Rehab in Sandy, Utah. "When you get up and move, you'll actually have less pain and more energy."

Cook knows what he's talking about, and not just because of his medical background. At the age of 1, he was diagnosed with juvenile rheumatoid arthritis. "I understand the pain and fatigue of living with RA," Cook says. "I also know firsthand that physical therapy for RA vastly improves one's quality of life."

Follow these five suggestions from Cook and other RA experts to make physical therapy a successful part of your rheumatoid arthritis treatment.

PT for RA: Work With a Pro

Cobbling together your own exercise program could result in more pain and joint damage. Ask your rheumatologist to recommend a physical therapist who has experience working with people with rheumatoid arthritis.

"We can create an individualized physical therapy program based on your RA symptoms and disease progression," says Jim Long, senior physical therapist at Cleveland Clinic's Lutheran Hospital. Plus, a physical therapist can make sure you're doing the exercises correctly. And she can show you new ones to try, so you'll be less likely to get frustrated and give up.

Adopt a "No Excuses" Policy for Physical Therapy

Though it may be tempting to say, "I hurt too much today. I'll do my exercises tomorrow," don't give up. Instead, work a different, less painful part of your body.

For instance, if your knees are killing you, "do some seated wrist and arm exercises like bicep curls," suggests Cook. Warm-water exercises are also good because the water's buoyancy relieves pressure on your joints, and the warmth is soothing.

As with any kind of exercise program, you're more likely to do it if you make a habit of doing it at the same time every day. Schedule your workout time on a calendar and treat it just like you would a doctor's appointment. In other words, don't cancel!

Stiff Joints? Turn Up the Heat

Mornings can be tough since joints get stiff overnight. A warm shower does more than wake you up -- it also serves as your therapeutic warm-up. Moist heat increases muscle relaxation, boosts blood supply to the painful area, and relieves muscle spasms.

For Audrey Sawyer Mills, who was diagnosed with RA a decade ago at age 29, warm water is a relaxant, pain reliever, and motivator. "I'm more likely to follow through on my physical therapy exercises once the water's soothed me," she says. Mills' home in Houston, Texas, is equipped with a hot tub, whirlpool sauna, and a shower rail.

Physical Therapy and Aerobic Exercise

Physical therapy for RA involves more than range-of-motion exercises and resistance training. Aerobic exercise is an essential part of PT for RA. "Weight-bearing activities build and strengthen bone while reducing your risk of other health problems like heart disease and diabetes that often accompany rheumatoid arthritis," Long says.

Pair up with a walking partner or sign up for a class for people with arthritis. "You're less likely to bail on an activity if you know others are counting on you to show up," Long says.

Check with your local Arthritis Foundation office to find a health facility near you that offers arthritis-friendly exercise programs including aquatic, tai chi, yoga, and walking activities.

Set Goals for Your PT

The first few years after her diagnosis, Mills felt she was in too much discomfort to manage any physical therapy. Her pain and mobility got worse until the once-active young mother was using a cane. "I was a 30-year-old trapped in a 90-year-old's body," Mills recalls.

Determined to "get better for my kids," Mills began working with a physical therapist and vowed to do her exercises every day, even through painful flare-ups. "I was especially motivated because I saw how rheumatoid arthritis affected my mom's ability to get around and enjoy life," she says.

Whether you want to be able to keep up with your on-the-go family, pick up your grandchild, or climb the stairs in your home, physical therapy is the tool to help make these things happen. Let family and friends know about the goals you've set: You'll be less likely to cheat yourself and more motivated not to skip your PT. Plus, loved ones can cheer you along the way.

In addition to keeping up with her kids, Mills' other goal was to get back to the gym. Today, she teaches spin class three days a week and competes in body-building competitions. "People say they'd never guess I have a debilitating form of arthritis," says Mills, who acknowledges, "I wouldn't be the active person I am today if I didn't make physical therapy for RA a priority every single day."