Importance of Exercise in Rheumatic diseases
Rheumatic diseases affect either Joints or muscles or skin or a combination of more than one or all of the above mentioned organs. The Inflammation in the joints or the muscles leads to Stiffness in the joints and weakening of the muscles. Muscles are extremely important in moving the joints and supporting the bones.
To illustrate a few examples:-
In
Osteoarthritis
Which exercise do you need to do?
What we mean by exercises are systematic exercises as taught by a physiotherapist under the guidance of a rheumatologist: These exercises are taught after examining the affected joints so as to improve the range of movement of the joints and toning the muscles in the affected area without straining the joints.
The following do not construe Exercise:
Exercise does not mean household work: A lot of women feel that because they do all their household work they are set and no further exercise in needed. Household work is tiring. Exercise is refreshing and rejuvenating so how can they be the same. During our routine lives we do a lot of work which strains the joints. Exercise is meant to reverse that so it is not the same. Exercises do not mean “Pranayam”: Pranayam is very good for improving our breathing pattern and calming the mind. But it does not contribute to our muscle strength or improve joint mobility. Exercises cannot be substituted by walking alone: Walking is a good exercise for the legs. It promotes blood circulation in the lower limbs mainly the calf muscles and hence is a useful for patients with Diabetes mellitus and heart disease. Walking does not help the thigh muscles hence it will not help people with Osteoarthritis. Moreover walking is of no help for the shoulders, arms, hands, neck , back etc unless you do “Shirsasan” (Head stand) and also walk on your hands.
What about Yoga?
Well Yoga is nearly as good but the problem with Yoga is that some yoga postures are not appropriate for patients with certain rheumatic diseases and this prescription varies from patient to patient depending on their rheumatic disease. Yoga teachers are not medical professionals and hence they cannot decide which exercises are inappropriate for a particular patient. Thus patients may even land up suffering an injury or worsening in their joint condition.
But exercise makes me feel worse!
But of course in the initial stages you are bound to feel pain. It is only natural to feel pain when you have hardly ever done any exercise before. You think all these well bodied and tough looking actors got their physique sitting at home and watching TV? Your joints are weak and stiff. Your muscles are weak. Initially exercises are bound to feel like the most difficult task in the world but as you persist things get better and better and then you reach a stage where you feel like normal human being again and doing day to day activities become easier.
But Doctor I just don’t have any time!
My family duties take up all my time. My children school Tiffin then their homework. My in- laws, my cooking… blah blah blah! We know a 79 year old man who exercises daily. He is still working and is a very busy man. He runs the whole country and his name is Mr. Manmohan Singh. If the prime minister of India can exercise everyday then why can’t you? How many million people do you have to worry about? Exercise does need to be done at a specific time. Who said you have to do it in the morning only? Do it in the afternoon when you children are in school just before you have your lunch. Or do it in the early evening before you start cooking dinner. Any time is a good time to exercise. Please remember, medicines will only control the inflammation in the joints and relieve you of pain. In order to reduce the joint stiffness, improve mobility and regain strength you will need to exercise. Whether you like it or not there is no choice so might as well accept it. Who knows you may even start enjoying it…
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