Arthritis is a condition that affects many clients in the UK and as a fitness professional there is a strong chance that at some point in your career you will work with a client who suffers with it. There are two types of arthritis that people can suffer with:
Osteoarthritis - this is where there is damage to the cartilage of a joint most commonly due to wear and tear. This is normally localised and common in hips and knees, or any joints that have seen excessive use. The condition will greatly affect movement and results in pain, leading in many cases to a loss in the level of functional ability. It is generally localised to the joints affected and does not spread. This condition is brought on by obesity, repetitive movement patterns, impact through the joint, or trauma.
Rheumatoid arthritis - this is a progressive degenerative autoimmune disorder where the body attacks the cartilage in a joint because it sees it as an invader and something that needs to be destroyed. This then progresses through an ever-increasing number of joints in the body, with the ultimate result being a loss in function. This condition can eventually start to affect the wider systems of the body and result in the failure of organs. Currently there is little known about the true causes of this condition.
In both cases there will be a loss of function around the affected joints, with swelling, pain and muscular weakness occurring. This, in turn, can lead to the individual feeling less mobile which may have a large effect on their lives. A fitness professional can help to reduce the overall effect of this condition and help the individual maintain mobility and function. There are some guiding principles when it comes to the prescription of exercise for arthritic clients.
Aerobic Fitness – it is recommended that clients take part in aerobic activity three to five days per week, working at around 60-80% of maximum heart rate. It is recommended that this should done for 5-30 minutes per session, progressing slowly from a short session in the early stages of training. Non-weight bearing exercise would be preferable in most cases as this will reduce pressure on the affected joints.
Resistance Exercise – it is recommended that clients engage in some form of resistance training on two to three days per week. This should be done using a 2 to 3 sets of 8 to 12 reps. Resistance machines and an emphasis on circuit-style training works well with these populations. Machines can be a safer alternative to free weights in the early stages of training. The use of exercises that might help with functional ability should be considered.
Flexibility – a regular stretching routine should be implemented to help maintain and improve range of motion. A full stretching programme should be carried out 2 to 3 days per week aiming to improve usable ranges of motion, with daily routines to maintain the developments gained.
Functionality – functional training should be carried out on a daily basis. This should be aimed at maintaining independence for as long as possible. Key areas to be considered are the prevention of falls and the maintenance of gait. Again, the ability to maintain a good walking pattern will help to keep the individual moving and functional.
The key precautions are as follows:
- Avoid training during flare ups where joints may be more painful and swell up.
- Avoid exercise that would be considered high impact, being careful especially around affected joints. High impact can increase levels of damage and make the condition worse.
- Avoid prolonged, repetitive types of exercise, especially at joints where there has been damage.
- Avoid anything with rapid directional changes.
- Listen to the client and if they start to swell up following a given routine, look at ways to reduce the pressure on affected joints.
Working with arthritic clients can help to improve movement patterns, but most importantly can improve functionality and outlook. This can really improve the quality of life that the client experiences. As a fitness professional it is well within your power to change some people’s lives. When people have higher levels of functional ability, they are much more likely to keep moving and this in itself can be an important part of the treatment pathway for arthritis.
If you would like to know more about working with people with a range of conditions, have a look at the TRAINFITNESS Exercise Referral course.