Don't stay in a position too long if it hurts.

With a painful arthritic joint our instinct is to sit still and rest up, but hereʼs the news:  prolonged inactivity is not a good choice for your affected joint. It allows the joint and the supporting muscles around it to become stiff and weak and although inactivity helps reduce inflammation initially, it wonʼt help in the long run. Itʼs hard to believe any kind movement can help when you are in pain, but the right kind of movement can.

Yoga and Pilates can have a soothing effect on joints with osteoarthritis and help with their flexibility. The aim when exercising is to create space in and around the joint without force, the movements should be comfortable and never heavy on the joint. The changes of osteoarthritis cannot be reversed but you can help prevent further deterioration by coaxing the affected joint with gentle slow-paced stretching and strength work: strengthening the supportive muscles around the joint and easing tightened muscles and connective tissue. The more a joint bends the more fluid circulates through it, enabling the joint to open up more,synovial fluid is stimulated and fresh blood (nutrient and oxygen rich) nourishes the stiff and painful areas.

Studies involving yoga show promising results: The John Hopkins Arthritis Centre reported an improvement in joint health, functioning ability and in mental/emotional well-being. Other studies noted a  reduction in joint inflammation allowing some participants to lower their doses of medication. Scientists in Baltimore discovered rheumatoid arthritis sufferers can also benefit from a program of yoga poses, breathing and relaxation, reporting that jointʼs were less swollen and tender. A common thread in these studies has been the choice of participants to carry on practicing yoga afterwards, finding it an enjoyable alternative to other exercise regimes.

Good alignment is crucial for arthritic joints when exercising:
Calm “slow motion” exercises with attention on healthy alignment can have the effect of reducing pain in the joint, problems occur when movements are fast and jerky. Moving smoothly and fluidly throughout each exercise protects sore joints and with each repetition you can tenderly encourage a fuller range of movement. Pilates remedial studios use this gentle method to help injured athletes and dancers back to performance strength.

Stress and Pain:
The more uptight you feel, the tighter your body will get. The mind-body connection of yoga and Pilates helps you to de-stress and break that cycle. Endorphins, the bodyʼs natural pain killers are released. Yogic breathing can help you relax, help with managing pain and settle your bodys nervous system.

How to start exercising:  With a restorative yoga class (Iyengar or Anusara) or a Pilates beginners course. If your body is stiffer in the mornings, exercise in the afternoon or evening when your joints have eased. You may feel wary about starting a class and you donʼt want to step into a room that is fast paced. Tempos of general Pilates mat-work and Yoga classes can vary greatly depending on the teacher, so take the time to phone around. Ask for a teacher with a caring approach, with possible remedial or therapeutic experience. A good teacher will focus on discovering a healthy alignment of the joints whether youʼre standing, moving or seated. Poses and movements can be adjusted to suit your comfort zone, if a pose is too challenging for you right now ask the teacher for an alternative and give yourself permission to do everything at your own pace.

Keeping it safe in a class: If possible take a hot shower/bath to warm up beforehand.
1. Come to class a little early and let the teacher know your physical limits. A good teacher will cue you as the class flows, they may tell you to “sit this one out” or provide props/belts/blocks for comfort.
2. Donʼt stay in a stretch/position too long, move in and out of the pose whenever you want to. Motion helps keep the joints and muscles feeling easy, thatʼs your goal.
3. If it hurts - donʼt do it, relax into comfortable position/stretch and wait to join in with the next  exercise.
4. Aim to slowly increase your range of movement over several months, if you try too hard your body might let you know the following day.
5. Exercise even on days that feel achy and sore, be gentle, youʼll feel better for doing it.

If you have daily work/home movements that cause discomfort ask the teacher/bodyworker if thereʼs a healthier way to physically move through the postures. These are simple adjustments to apply: have your feet underneath you more, keep your elbows in, thumbs upwards etc. Have your questions ready: “I find it difficult to get out of the car, to stand for long periods, hold a hairdryer.” These easy changes can make a difference to your aching joints. Building an awareness of your personal movement patterns is the first step in helping your joints.


References:
- Yoga for Arthritis by Loren Fishman and Ellen Saltonstall
- The Womans book of Yoga and Health by Linda Sparrowe and Patricia Walden
- Yoga as Medicine: Yoga Journal by Timothy McCall, M.D.
- Effectiveness of Iyengar yoga for arthritis of the hands and finger joints - Marian Garfinkel
- Joint Support: Yoga Journal by Catherine Guthrie
- Vishwas Yoga for Arthritis: study funded by the Emirates Arthritis Foundation.
- Sport Injuries: Their Prevention and Treatment by Lars Peterson and Per    Renstrom

Amanda Musker studied classical ballet at the Royal Ballet School in London. She went on to enjoy 14 enormously successful years working in London’s West End, starring in productions such as “Cats,” “Joseph and the Amazing Technicolor Dream Coat” and “Oklahoma.” In 2000 Amanda decided to pursue her other great passions, Pilates and yoga. This led her to an equally successful career as one of the most sought-after teachers of these disciplines. Having experienced 30 years of career-related injuries, as well as working with hundreds of yoga and Pilates students, Amanda is uniquely qualified to bring a deeper understanding of our bodies and what helps to make us flourish in them. Send your questions to Amanda@smartnow.com.