Millions of Americans suffer from “achy joints” with causes ranging from arthritis, degeneration, injuries or just plain old age. Exercise is a great way to help protect those achy joints and keep them as healthy as possible but what you do and how you do it are critically important to avoid flare-ups. Strengthening muscles around our joints will help decrease stress on the joint itself, which can reduce pain and stiffness.
Here are some general tips for clients with achy joints:
- Slow and Steady wins the race. Make sure you movements are smooth and not jerky. This will allow improved joint mechanics and prevent shearing forces that often happen with quick and uncontrolled movements.
- Lift weights that are light enough to perform 10-12 repetitions.
- Alternate between arm exercises and leg exercises to avoid overworking one body part or joint within your exercise routine. For example you can do bicep curls followed by lunges followed by abdominal or back strengthening then back to an upper-body exercise.
- Include flexibility in your exercise program. Keeping muscles loose and mobile will decrease strain and compression on the joints.
Some modifications for individual body parts:
Knee pain accounts for 1/3 of all orthopedic doctors visits in the United States. Achy knee joints usually are a result of the degeneration of the cartilage between the joint surfaces leading to bones (femur and tibial condyle) being rubbed together and causing inflammation. We generally recommend clients with knee pain stay away from open chain knee strengthening such as knee extensions. Lunges and Squats should be performed in a safe range of motion making sure not to extend the knees over the toes when bending. If pain persists with squats and lunges modifications can include shortening your range of motion or redirecting the forces from your toes to your heels. Transitioning you weight back on to your heels will reduce the stress on the patella and quadriceps muscles and reduce anterior knee pain. You should be able to wiggle your toes off the floor when performing squats or lunges. Also avoid any knee bends below 90 degrees as this also increase compressive forces on the joint surfaces.
We generally recommend that clients with shoulder pain avoid overhead activity however some light overhead strengthening can be beneficial if performed properly and safely. Light weight or resistance should be used when performing overhead exercises. It is important to remember to avoid shoulder hiking with an overhead press. If the upper traps overwork during these exercises they will cause shoulder shrugging and cause pinching and pain in the joint due to impingement of the rotator cuff or bicipital tendon. To keep this from happening make sure to engage your scapular depressors to stabilize the scapula and reduce the shearing forces on the shoulder joint. We often cue clients to gently pull your shoulder blade towards your back pockets as you lift your arm. As an alternative to overhead strengthening we can also strengthen the shoulders by keeping the shoulder below 90 degrees. Turning the palms up vs. keeping palms in neutral or turning thumbs down also opens up the shoulder joint allowing for more space and less likelihood of shoulder impingement. Here are some other modifications to help with achy shoulder joints:
- Keep shoulder movements slightly in front of the body
- Keep bar 5-6 inches away from chest with chest press
- Use an underhand grip with rows or pull ups
- Always keep bar in front of head with lat pull downs
Wrist pain is another common complaint among Americans mostly do to repetitive trauma and overuse. Weight bearing exercises can be particularly painful for clients with achy wrists. If it is painful or difficult for you to perform planks due to wrist pain try to perform then down on your elbows as opposed to on your wrists. If performing pushups causes increased discomfort in our wrists try using dumbbells or blocks to hold on to as opposed to having your hands flat on the floor. This decreases the compressive angle of weight bearing while performing push-ups.
Pilates is a great alternative to traditional weight training for clients with achy joints for the following reasons:
- Low Impact
- Focuses on joint mobility and stability creating balance around joints
- Increases flexibility around joints
- Works on body awareness to improve balance and alignment
Christa Gurka, MSPT, PMA®-CPT