Exercise is one of the best ways to improve joint performance and relieve symptoms of psoriatic arthritis (PsA). Potential benefits include increased flexibility and stronger muscles that better support joints, which can mean less pain and more function, says physical therapist Brian Blevins, DPT, of Stride Strong Physical Therapy in Portland, Oregon.
“Being active also improves balance and heart health; it lowers blood pressure and blood sugar levels, reduces weight and, therefore, pressure on joints. It improves bone and joint health, and it makes it easier to sleep,” says Blevins. Here, he answers questions about staying safe while reaping the benefits of physical activity.
Q: It’s been a while since I’ve exercised. How do I get started?
A: Build up slowly! If you start too fast, you’ll end up sore and could potentially overstress joints. So, start slow and work up, even if it that means beginning with as little as five to 10 minutes of activity each day a few days a week. Then gradually increase activity to 30 minutes of moderate-intensity exercise three to five days a week. Be sure to check with a health care provider – your primary care doctor is ideal – before initiating any new exercise program.
Q: What fitness goals should I focus on?
A: Improving range of motion – how far you can move joints in one direction without pain – and building strength are important for people with PsA. Range-of-motion exercises help maintain and improve joint mobility. These exercises include stretching and specific movements, which a physical therapist can teach, that target your individual joint issues. Resistance exercises with light weights strengthen muscles so they can better support and stabilize the joints they surround.
Q: How can a physical therapist help me be more active?
A: Physical therapists can work with you on general aerobic conditioning, create an individualized exercise program tailored to your joint issues, demonstrate proper positioning of joints and discuss coping strategies. For example, we can make suggestions for workplace accommodations and the use of devices such as braces, which may make exercise easier and safer. We can also do interventions that aren’t exercise-based to help you when you’re having a flare, such as manual therapy, which refers to hands-on techniques to manipulate and mobilize soft tissues and joints that reduce pain and increase range of motion.
Q: How can I protect my joints?
A: Avoid holding the same position for long periods of time and doing repetitive activities. Those are the top two things I see causing joint issues. If you’re using weights, start light and don’t go too heavy. Also, avoid gripping things too tightly to keep from stressing hand and finger joints. Maintain proper posture. And be mindful about how you move – that means moving slowly and gently with no jerky motions. Pace exercise to avoid fatigue, and by fatigue, I mean working to the point where you can barely lift your arm or leg. We want to fatigue muscles, not the whole system. Finally, if your joint pain worsens, stop.
Q: What exercises will help me build strength and range of motion?
A: Start with low-impact activities that improve flexibility, muscle strength and cardiovascular endurance. These include walking, biking, tai chi and exercising in the water. Exercising in the pool decreases the impact of gravity on joints. When you have PsA and possibly weak muscles, your joints tend to be overstressed already, which is what we want to avoid.
Q: Can you explain the benefits of a stationary bike?
A: Biking is a great low-impact exercise. If your joints can’t handle walking, running or hiking, biking is a great way to strengthen lowerextremity muscles, especially the quads, hamstrings and glutes. Biking also takes the knee and hip through certain ranges of motion without the impact that gravity normally offers. And you can easily increase intensity as you progress: With most exercise bikes, you can change resistance from zero all the way up to a hill climb.
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Q: How do I find a physical therapist?
A: That depends on your insurance. Most states have direct access, so often you do not need a referral. Ask for a recommendation from your primary care provider or friends with similar joint issues. The American Physical Therapy Association website lets you search for a PT in your area. Call individual clinics and ask them to check your insurance benefits and explain potential costs. You can also ask clinics if any PTs have experience working with people who have inflammatory joint disease.
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Brian Blevins, DPT, specializes in treating patients with active lifestyles, including athletes ranging from amateur to professional in high-intensity sports such as basketball, baseball and football. Blevins is an Advanced Training Specialist and is certified by the National Academy of Sports Medicine as a Performance Enhancement Specialist.
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