Special Considerations for Individuals with Arthritis

Special Considerations:

• Avoid strenuous exercises during acute flare ups and periods of inflammation. 
• Adequate warm-up and cool-down periods of 5-10 min are essential for minimizing pain. These activities can involve slow movement of joints through their range of motion (ROM).
• Individuals with significant pain and functional limitation may need interim goals of lower than the recommended ≥150 min/week of aerobic exercise activity. They should be encouraged to undertake and maintain any amount of physical activity that they are able to perform. 
• Inform individuals with arthritis that a small amount of discomfort in the muscles or joints during or immediately after exercise is common, and this does not necessarily mean joints are being further damaged. However, if the patient's pain rating 2 hours after exercising is higher than it was prior to exercise, the duration and/or intensity of exercise should be reduced in future sessions. 
• Encourage individuals with arthritis to exercise during the time of day when pain is typically least severe and/or in conjunction with peak activity of pain medications
• Appropriate shoes that provide shock absorption and stability are particularly important for individuals with arthritis. 
• Incorporate functional exercises such as the sit-to-stand and step-ups as tolerated to improve neuromotor control, balance, and maintenance of activities of daily living (ADL).
• For water exercise, the temperature should be 83° to 88° F because warm water helps to relax muscles and reduce pain. 

*Moderate aerobic activities with low joint stress are appropriate. Adequate warm-up, cool-down, and stretching are important for minimizing pain.