Exercising with arthritis

Do you suffer from arthritis?

The first thing to remember is that ‘Exercise is beneficial for people with arthritis’. Arthritis is a very general term which covers a multitude of conditions which affect joints and is frequently (but not always) linked to the body’s aging process.

If you have arthritis follow these simple guidelines to get the most benefit from your exercise:

  • Make sure your warmup is slow and gentle warm up with movement to mobilise your joints encouraging the release of synovial fluid to lubricate the whole joint more effectively.  It’s a bit like warming oil in a pan so it coats the whole pan surface.
  • Choose low impact activities to reduce the stress placed on the joint. Pilates, yoga, walking and swimming are all good.
  • Include strength training as studies have suggested it can decrease pain.  It also works to build bone density which encourages healthy joints. Simple exercises standing up can help build strength so don’t choose classes which are all mat based.
  • Try to maintain the range of movement and flexibility of a joint.  You may not become more flexible but should be able to maintain the movement range that you currently have.  (Without regular exercise you will gradually have less range of movement.)
  • Don’t exercise if you have rheumatoid arthritis and your joints feel warm and swollen. This is an indication of flare up and exercise at this time could worsen your condition.
  • Avoid movements which require extreme flexibility and stretching exercise techniques.
  • Avoid exercises which require kneeling if your knees are affected.
  • Avoid exercises which require repetitive stress or high impact activity such as road running.

By following these simple guidelines you’ll be able to gain all the benefits of regular exercise enabling you to keep ‘fit for life for all of your life’.

5 Adaptations your exercise plan needs once you are over 50

5 Adaptations your exercise plan needs once you are over 50

As your body ages, exercise is essential to keep it functioning at its best for the whole of your life,  keeping you active into old age.  The problem is that as your body ages it becomes less able to handle rigorous exercise, more prone to injury and less able to recover.  The good news is that with a few modifications you can continue to exercise whatever your age.

Age is ‘just a number’ so it’s difficult to be precise about when to start modifying your exercise programme to take account of the aging process.  Bear in mind that, for example, most people over the age of 40 will show some degeneration in the spine.  With a few key adaptations you can reduce the risk of injury and achieve an effective workout to keep you ‘fit for life for all of your life’.

A Longer warm up
Age related changes are seen in all tissues. The heart and cardiovascular system is no exception. The heart cannot pump as efficiently, the maximum heart rate is slower and it recovers more slowly.  Take account of this by warming up for longer, reducing the intensity of your exercise, monitoring your heart rate and allow a longer cooling down period.

Steps to avoid cramp
No one knows the details of what causes cramp, but we do know scenarios which will affect the likelihood of cramp.  Cramp has a variety of causes for all people including being new to exercise.  Older people have a reduced tolerance to muscle fatigue and associated blood acidity which leads to cramp.  More effort is needed to achieve movement due to the decrease in amount of muscle tissue.  This leads to an increase in levels of lactic acid which can cause cramp.  Compounding this effect is the fact that the body is less able to tolerate acidity as it get older.  Cramp is also linked to dehydration.  The body holds less water as it ages making cramp more likely.  Ensure you drink plenty of water.

More specific joint mobilisation
Age related changes show within the joints with less synovial fluid being released as well as the fluid becoming less effective in lubricating the joints.  Joint mobilisation can encourage the release of the synovial fluid and this is essential prior to exercise so the joints move more easily.

Focus on deeper breathing
While our lungs remain able to hold the same amount of air on each breath throughout our lives the amount of air that we breathe in and out on a regular breath cycle decreases.  This effects the level of oxygen in our blood and therefore our ability to exercise.  It’s important to take deep breaths to increase the available oxygen which enters the lungs on each inhalation. Start off with a few deep inhalations and include them in your cool down too to speed up recovery.

Less extreme movement
Changes occur in the cartilage and connective tissues of all joints reducing the range of movement and causing stiffness, especially in the mornings.  As the cartilage thins between the intervertebral discs in the spine its shock absorbing ability is reduced.   This will have an effect if you take part in high impact exercise such as running. Less elasticity within connective tissue make movements such as sitting cross legged more difficult. Movements to avoid include: those which move any joint beyond normal range, those with extreme flexion (leaning forward) and extension (leaning back) and using poor posture particularly when carrying heavy weight.

For more information do get in touch.  I am happy to help you get started on an exercise programme and to adapt your current programme to make it more suitable.

HIIT Pilates – What is it and should you be doing it?

The latest fitness trend to be big in the UK is HIIT – High Intensity Interval Training.  Everyone is doing it, teaching it, and apparently loving it.  Last week I saw HIIT Pilates classes using Pilates equipment to gain the high intensity workouts.  My reaction to that was simply WHY?  Pilates and HIIT are two different regimes with different aims.  I don’t believe they mix at all.Pilates is a fabulous fitness programme which tones specific areas, encourages the correct muscle engagement, uses breath, focus and concentration to achieve great posture, alignment and muscle balance.
Pilates can be practised as rehabilitation post-surgery or as an exercise programme to help with arthritis or other chronic conditions.
Pilates concentrates on small, slow, controlled movements to train the body to engage the correct muscles for everyday movement and strengthen them where they are weak.
Pilates is suitable for almost everybody.
Pilates is NOT intended to be an aerobic work-out.  It will not improve your stamina nor enable you to lift heavy weights
HIIT on the other hand is targeted to improve your stamina and dynamic fitness, a completely different aim.
So, is HIIT something you should be doing as well?
That depends on the benefit you are seeking to gain and how much effort you are prepared and able to put in to achieve it.
If you are healthy, enjoy pushing yourself to meet new physical challenges and are looking to increase strength and cardiovascular capacity it could definitely help you.  If you are an athlete or sportsman looking to improve your performance then HIIT could be a beneficial part of your program, as could a bio-mechanics program and regular Pilates classes.
On the other hand, remember that it is high intensity exercise. If you have any medical history which precludes pushing your heart rate up this is not for you.  If you have joint pain or disease it could aggravate it.  If you do not use correct technique it is easy to pick up injuries.  And finally remember that it’s not the only exercise programme which delivers results, a gentler progressive programme may suit you better.
Don’t follow the latest trend because it is promoted in the glossy magazines with celebrity endorsements, choose a programme that gives you the benefits you are looking for.
HIIT Pilates is ‘HIIT’ using Pilates equipment.  It is not Pilates in any shape or form. Don’t be confused.

Fit for what? An event or for life in general?

Are you aiming to be Fit for a specific event? Fit because it’s good for you?  OR, Fit so you can be active for the whole of your life?

It’s a question I have found myself pondering for a long while and one which has changed my approach to fitness in recent years.

There are several reasons that lead people to join a gym or a class and a several more that prevent people from keeping it up on a permanent basis. To benefit from exercise it must be for life, not just for a few months or in the ‘post-Christmas diet’ weeks.

The question then is what type of exercise can you keep up on a permanent basis? The answer to that question depends on your aim. If you are booked to run a marathon the exercise should be a specific programme ensuring you are in the best physical shape for that event. If you feel that being fit is ‘good for you’ give some thought to exactly what you mean by that phrase. Do you mean keeping your heart healthy, keeping muscles toned, controlling weight gain or simply an all over general fitness? Or would you like to give your body the best chance of keeping you active for the whole of your life?

In recent years I have changed my approach to exercise. I have undertaken extensive training to help those with back pain, arthritis, restricted mobility and other chronic conditions continue to exercise. The results have been amazing and for some life changing. It has made me realise that an exercise programme which aims to keep you active for the whole of your life can be easy to follow and enjoyable as well as beneficial. It is not looking to get you to a high level of fitness where there is a risk of injury. It is not offering any exercises which put unnecessary strain on the joints. It is simply keeping your body in the optimum condition possible while taking account of its current state.

Many of my clients walk, cycle, ride, look after children or are simply busy. In this way they already get a reasonable amount of cardiovascular work. It may be at a low level but it’s done on a regular basis week in week out. What I offer is a complimenting exercise programme to enable them to lead an active life for the rest of their lives.

Key aims are:
Keeping joints mobile
Correcting muscle imbalances
Building a strong core
Maintaining a healthy back
Preventing the deterioration of balance
Ensuring muscles can stretch to optimum lengths.

To take part in a this type of class you won’t need gym clothing and you probably won’t get hot and sweaty. You will benefit from feeling that your body moves more freely, your back aches less, your joints have more range and you will feel more stable when you take part in other activities or sports. You will also benefit from the shared knowledge of what to expect as your body gets older and what you can do to keep reduce the effect of aging process on muscles joints and bones.

Remember that this is general advice. If you have a specific condition I recommend that you book a one to one session first so I can assess the best way to help you.

http://thestudionorfolk.co.uk

 

Are you stretching or working your muscles?

Are you ‘Stretching’ or ‘Working’ a Muscle?

Confusing working a muscle with stretching a muscle is really common. When you go to the gym or your exercise class are you strengthening or stretching your muscles? Can you tell the difference, what are the benefits of each? How do you know which you should be doing

What happens when you work a muscle?
When you ‘work’ a muscle you tighten the muscle fibres, either by shortening the muscle or by holding it in a static contraction. In order to ‘work’ a muscle there has to be effort on your part. The brain needs to send messages to the muscle to activate and engage it. This gives a sensation of strength and if continued will make the muscle tire and ache, maybe giving a ‘burning’ sensation. You can also physically feel the muscle harden. Try pulling your abdominal muscles in as hard as you can. Prod across your tummy and feel the muscle harden.

Why should you strengthen a muscle?
To give support and stabilisation to the bony structures of the body. This is especially important for the shoulder girdle, pelvis and knees.
Strong muscle tone will enable the body to move effectively with less effort. This in turn means that the body can move more before becoming tired.

What happens when you stretch a muscle?
When you stretch a muscle you are trying to lengthen it. To do this one end of the muscle is stabilised and the other is moved to a longer position. In practise this is hard to achieve and frequently the stabilised end of the muscle ‘cheats’ by subtly moving to protect the tight muscle and prevent it stretching. Stretching usually involves you taking up a position without consciously putting in any muscle activation.
A common example of this is seen when trying to stretch the gluteus (hip) area. To try this, lie on your back, knees bent, feet flat on the floor and spine neutral (relaxed with a natural gap under and below the waist. Put your right foot across the left knee, lift the left foot off the floor to bring your knees towards your chest. This should give a stretch across the gluteus (hip) area, over the butt cheek down the back of the right side. The pelvis end of the muscle is static and the other end has moved. Now check whether your back changed its position when you lifted your feet off the floor. Ideally your back will still be neutral. If it has moved to be flat on the floor this will have moved the pelvis end of the muscle, giving your lumbar spine a stretch it doesn’t need and leaving the gluteus area tight. Roll your pelvis to put the gap back and feel how that changes the stretch as the pelvis is put back into a stable position.

Why should you stretch a muscle?
Some muscles need to be stretched as they shorten through daily activities and this leads to muscle imbalance and pain.
Modern lifestyles can cause other muscles to lengthen. Stretching these will not help and could do further damage as they actually need to be shortened by strength exercises.
There are frequently muscles which are tight but the body protects that tightness so although stretching would be beneficial it is hard to achieve.

In Conclusion
Try to strengthen the weak muscles within your body. When you stretch try to ensure that the correct muscle gets the benefit.
Most people have a pattern of weak lengthened muscles which need shortening and strong tight muscles which need lengthening. A postural assessment will identify these so you can work and stretch to correct imbalances whether in a class, at the gym or in everyday life.

Just how much flexibility do you need?

Just how flexible do you need to be?

Recently I’ve been looking at the advantages and disadvantages of different levels of flexibility which raises the question of ‘how flexible do I need to be?’

During my early training as a dancer the answer was always ‘as flexible as possible’. Being able to ‘do the splits’, put hands flat on the floor with straight legs or the gymnasts ‘box splits’ was something to aspire to. Sadly I could never do any of these without a great deal of effort. My body simply wasn’t made to be that flexible.

Over the years working as a full time fitness instructor I stretched my body on a daily basis and did achieve an above average level of flexibility. Over the years I noticed that a number of clients would comment that the seated stretches (reaching for the feet) gave them backache. This made me question the validity of these exercises, to question why we need to do them at all and how much flexibility we actually need.

The answers to these questions took me through Postural Assessment techniques looking at the effect of our day to day posture on our bodies. From here I looked into Bio Mechanics, how each part of our body interacts with another and the effect that muscle imbalance has on our posture.

The way in which our bodies respond to exercise varies as our bodies are all slightly different. A stretch for one person will result in a strain for another. An exercise may be designed to strengthen and/or stretch, but in a specific individual it may create imbalanced strength and strain rather than stretching. The key is in finding exercises which strengthen and stretch without straining while keeping the body in a balanced position. This is an individual process. The level of stretch depends on a variety of complex relationships within the body. Many people with rounded shoulders (kyphotic posture) will have lengthened inactive muscles across the shoulder area and weakness in the pelvic area. Those with a hollow back (lordotic posture) are likely to have tightness in the hip flexor which can make it difficult to stretch the hamstring without impingement.

Sitting on the floor leaning over towards the feet puts a huge strain on the lumbar region of the spine. Many stretches allow the pelvis to twist encouraging instability in an already unstable area. Bio Mechanic training shows how often (especially in women) the pelvis twists to give a greater degree of movement in a hip stretch. This results in no stretch to the area which is being targeted.
Why do we do these stretches? How long do your hamstrings need to be? If you are an Olympic hurdler then the answer is likely to be very different to someone who sits in the office all day and plays a little golf at the weekends. For the average person the amount of flexibility we need is surprisingly low. When did you last need to kick your foot above 90 degrees?

Then, there are a whole group of people who have the opposite problem – hypermobility. These are people with joints which move beyond the normal range of movement. They are prone to sprains and dislocations and in later life frequently arthritis. They need exercise to stabilise the joints and to learn what a normal range of movement is. For this group strength and stabilisation is far more important than stretching.

In a group exercise class it is easy to be carried with the group and stretch as far as possible regardless of your body’s ability or needs. As well as not being good for you this could actually be harmful.

Next time you think about stretching bear the following points in mind:
How much flexibility do you actually need to live your life and do your activities comfortably?
Do you ever have backache after an exercise session? This could be due to the stretch positions putting unnecessary strain on your back.
Do you have hyper mobile joints? It could be that you don’t need to stretch at all, or need to stabilise the joint prior to assuming a stretch position.
Once you have considered these points you can choose how far to take each stretch and gain the maximum benefit.

If having read this you are unsure how your body reacts to stretching and would like to check your positioning and technique in the exercises you currently practise at the gym, in a class or at home do contact me to book an appointment.