Download click here for presentation

Arthritis
Joint pain, joint enlargement, joint stiffness. Bridging the gap to comfort.
Introduction
• Dawn Gordon – NSCA CPT, AFAA Group Fitness
• Doug Wheeler – NSCA CSCS, AAAI/ISMA CPT and Group Fitness/Cycle Instructor
Resistance training will have the greatest effect on…
Arthritis
Osteoporosis
Range of Motion
Balance & Stability
50%
50%
or
o
sis
R
an
ge
o
f M
ot
io
. ..
B
ala
nc
e &
S
ta
b.
..
0%
O
st
eo
p
hr
iti
s
0%
A
rt
1.
2.
3.
4.
Putting the tongue to the roof of your mouth will help with Resistance training
Osteoporosis
Range of motion
Balance & stability
an
ge
o
f m
ot
io
. ..
B
ala
nc
e &
st
ab
. ..
sis
R
or
o
O
st
eo
p
an
ce
tr
a.
..
25% 25% 25% 25%
R
es
ist
1.
2.
3.
4.
What is the most versatile resistance training?
Band training
Body weight training Pilates
Free weights
B
ht
s
ei
g
ee
w
P
i la
te
s
Fr
od
y w
ei
gh
tr
a
in
t t
in
g
r. .
.
25% 25% 25% 25%
B
an
d
1.
2.
3.
4.
Inflammation
• Though the medicines prescribed for arthritis fight inflammation the more help they get the more comfortable your patients will be.
• Natural anti‐inflammatories in the form of food and vitamin support will help the comfort level.
Check With Your Dr. before You Start
• An exercise program,
• Taking vitamins,
• A diet plan
Movement and Pain
• Though stiffness and pain are a good excuse to sit still, they will further agitate the joint and inflammation within.
• Movement is key on keeping the joints functional.
• Joint noises scare patients, however as synovial fluid enters a tight joint it creates creaking sounds. Patients want to hear that these noises are o.k. from their Doctors. Patients are afraid to exercise, older patients especially. Try to reassure exercise is beneficial.
• Fear keeps many people out of the gym. Goal of Exercise
•
•
•
•
•
•
Long term pain reduction
Added stability
Increased mobility and function
Reduced inflammation
Reduced medications less side effects
Improved quality of life
Reduce the Onset of Inflammation • Keeping selected items; sugar laden foods, white potatoes, foods that convert to sugar in the body, processed foods out of your diet will help with the amount of inflammation one experiences.
• Exercise has been shown to reduce occurrences of inflammation in those with arthritis.
• Although the exact physiological mechanisms are unknown, exercise can increase the quality of life and reduce complications of arthritis.
Inflammation and Exercise
• Instant gratification can not be expected in this model. Time is required to reap the gains to be enjoyed.
• Strength training tears down the muscle for it to grow back with added density. This tear down leads to inflammation. Short term inflammation that leads to long term reduced inflammation. • As strength and adaptation take place the chronic inflammation of arthritis should subside.
Things you as a doctor or healthcare provider should know
• Many people do not know how to eat healthy.
• My personal experience with many diabetic clients that have met with registered dietitians still do not understand how to put together a quality meal.
• Many people with Arthritis do not realize some foods agitate their condition beyond the realm of their medicines.
• Still, sedentary lifestyle compounds the above.
Doctors please let your patients know:
•
•
•
•
•
•
•
Start slow and build up
Keep an eye on heart rate
Soreness is expected
Reassure when fear interferes
Acute pain needs to be addressed
Ask patient what might prevent
follow‐through Pro‐Active Patients
• Giving your patients something to do for their condition grants ownership, which hopefully will lead to better quality of life.
• Western medicine is known for increasing longevity. Help your patients live to the fullest during those extra years.
• Getting your patients on board the healthy lifestyle train will improve your relationship with your patients, along with their livelihood.
Food Diary
• A very effective way to find trigger foods, is to have patient log the food for 3 regular eating days, logging the joint pain on a scale from 1‐10. Then have them log three days of eating as healthy as possible then log their joint pain by the same scale.
• Finding the foods that trigger the worst inflammation can lead to better control of the medications.
What keeps people coming back to the gym?
1. Friends or work out buddies
2. Body composition
3. Improved quality of life
4. Improved self image
...
..
se
lf li.
Im
pr
o
ve
d qu
a
ve
d Im
pr
o
po
s it
i. .
.
B
od
y c
om
Fr
ie
nd
s o
r w
or
...
25% 25% 25% 25%
Remember Heart Rate Formula?
•
•
•
•
•
•
•
Baby is born with Heart Rate 220
Take away for age (say 35y) ‐35
________
100 % Heart Rate 185 Max
85 % Cardio Range 157
Interval up to 95% 176 < 1min
Recover at least 1min to increase VO2max Use Heart Rate as a Guide
• Most cardio machines have heart rate indicators.
• Moving is good, staying within the 80% heart rate range of ones age is great. The body gets a clear message ; exercise the cardiovascular system. Better cardiovascular health leads to reduced overall inflammation. • This tool is a long term goal tool.
Body PH and the Immune system
• Remember our immune system when operating properly can heal and improve many ailments.
• Foods sway our body PH in and out of the optimum range.
• Some side effects from medications can interfere, as well as sugars in the diet. A good rule of thumb here is, “A vegetable with every meal”.
Weight loss
• Every pound you loose = 4(four) pounds less pressure on EACH knee. • Recommending exercise along with a healthy diet will improve joint function, reduce inflammation and improve quality of life. • Just getting on the path will encourage a more satisfying life. • Goals can be small to encourage continued success. What is the best way to improve overall fitness?
un
ni
n
g
25%
R
tr
ai
n.
..
te
s
25% 25%
In
te
rv
al
re
ng
th
tr
ain
.. .
25%
P
i la
Strength training
Pilates
Interval training
Running
St
1.
2.
3.
4.
Osteoporosis
Affecting 44 million
2 Million bone fractures per year
Hip fracture most debilitating
Do exercises to increase bone density –weight‐
bearing exercises such as squats, pushups, other lifts. Non weight‐bearing activities such as swimming will not help.
• Age 35+ is time to start preventative maintenance and maintain bone density and building bone density
•
•
•
•
Muscle Atrophy
• Sedentary life styles, lead to unfulfilled lives. • Replacing weak muscles with strong muscles, leads to thicker ligaments and tendons along with less painful joints.
• The compound nature of muscle atrophy leads to a path of added chronic aliments.
• Remind patients with a sprained ankle they can still exercise their core and upper body. Patients want to hear this from their Doctor.
Sarcopenia
• Sedentary lifestyle leading to a downhill slide
• The frail ARE afraid to get back moving; they need to hear it is O.K. from their doctor to start back exercising.
• They are afraid of strength training which is the answer to restore function.
• Please reassure patients that starting slow and progressively increasing intensity level will improve lifestyle.
Multi‐Joint Weight Bearing
Weight Bearing
• Add 10% of bodyweight to multi‐joint exercises for osteoblast stimulation
• The bones must flex slightly to stimulate growth
Resistance Training can improve lung function to a greater effect than cardio exercise?
T
50%
lse
ru
e
50%
Fa
1. True
2. False
What is the reason for this?
1. Stronger skeletal muscle
2. Valsalva maneuver
3. Improved CNS function
4. Greater pulmonary perfusion
...
ul
m
on
G
re
at
er
p
Im
pr
o
ve
d CN
S f
...
eu
.. .
m
an
va
sa
l
V
al
St
ro
n
ge
r s
ke
le
...
25% 25% 25% 25%
Fear of Falling
• Vital exercise minimizes the threat of falling
• So many people sit, thinking this prevents falling. • Get your patients up to minimize falling
• lack of muscle increases the threat of falling
• Encourage strength or resistance training for your patients that are able.
Osteo Target Populations
•
•
•
•
Small frame, slender body individuals
Fair skinned and Asian have increased risk
Outdoor sunshine a calcium builder
Calcium rich foods and supplements
• Watch for calcium destroyers
Medications and Side Effects
• Remember the side effects sometimes can interfere with the positive direction of overall health improvement. Take this fact into considerations when prescribing medications.
• When a patients is doing the work to reduce the medications, try a reduced amount to see if the exercise and/or better eating is requiring less medication. This can further assist a patient in getting back on the functional track.
Can the side effects of medications be overcome with exercise?
So
ep
e.
..
m
et
im
es
d
ep
e.
..
m
et
im
es
d
c i.
..
So
e m
ed
i
N
o,
th
it h
d
il i
.. .
25% 25% 25% 25%
Y
es
, w
1. Yes, with diligence
2. No, the medicine is controlling
3. Sometimes depending on chemistry
4. Sometimes depending on medication
Depression can be minimized
1. By running 1 mile a day
2. Interval training
3. Exercising 30 min. a day
4. Exercising for 10 min. three(3) times a day
ng
fo
r
er
cis
i
Ex
er
cis
i
...
ng
30
..
.
n.
..
ai
tr
In
te
rv
al
Ex
B
y r
u
nn
in
g 1
m
...
25% 25% 25% 25%
All of the above are valid
1. Any kind of exercise that increases the heart rate will improve the brain chemistry balance.
2. Consistency over time can minimize the need for medication.
50%
Any kind o...
50%
Consistenc...
Range of Motion
Lost as We Age Unless Maintained
• Strength is built in the range we exercise in, reduced range‐reduced strength.
• ROM is sometimes lost due to adhesions that form in muscles due to improper form. Stretching alone can sometimes restore functional range of motion.
• Body alignment is key to keeping range of motion in tact
Balance and Stability
•
•
•
•
A function of strength in the range of motion.
Core strength has biggest impact here.
Water workouts focus on core.
Tongue to the roof of mouth stabilizes core.
Pilates is great for core strength and most populations can accomplish all of the exercises, even bed ridden, and extremity injured.
Joint Health
• Moving an extremity through the full rang of motion supports the tissues, minimizes inflammation and encourages healing.
• Massage works along the same principle. Joint health is key in restoring range of motion, which leads to greater strength.
• Resistance training improve and regenerate the joints function.
Range Of Motion for Independence
• Moving extremities through the full range of motion often throughout the day vs. no motion can change the rate of age related muscle disintegration
• Resistance training in addition can reverse muscle aging at the gene level.
• Moving and stretching can restore function via adaptation and demand. Use it or lose it.
Enthusiastically Support
•
• Individualized, positive reinforcement. • Give suggestions for better quality of life with movement and exercise.
We Share the Same Goal
• Getting our client/patient to live a rewarding life.
• Hope that they will have the time and energy and mobility to live life to the fullest on a whim. • To maintain a stable outlook for desired improvement and a functional, comfortable life.
What we would like to see
• In the future, we would like more clinics to incorporate exercise and certified personal trainers to work with patients when exercise is required or not contraindicated.
• Living a healthy life of exercise is much cheaper in the long run than medications and hospitalizations.