Home Community Chat Transcripts-5/21/2001

Arthritis & Strength Training Exercises with Dr. Barry Waters

InsightHostKJ> Dr Waters is going to talk about Arthritis & Strength Training exercises tonight

InsightHostKJ> SO let's go into guest chat mode and hold the conversations

InsightHostKJ> Type a ? if you have a question and wait to be called on. Do not ask your question until I call on you

InsightHostKJ> ALrighty then. Dr W....is it possible for someone with RA to do major exercising?

DrWaters> Yes, but it takes creativity.

InsightHostKJ> Like?

DrWaters> One needs to spread the exercise out over the entire body to minimize too much stress on one area.

DrWaters> You also need to use the healthy areas more and the bad areas less.

InsightHostKJ> WHat types of exercises do that?

DrWaters> That's the whole point, there is no TYPE of exercise that is good or bad, it's the variety and individualization.

InsightHostKJ> Makes sense to me...ready for some questions?

DrWaters> Yes

panda> i just started aqua aerobics and i get a lot of tendon pain after it i wonder if i am doing more harm than good i have pa

DrWaters> This is a little radical, but there's no proof that some pain means increased joint damage. Severe pain is bad, worsening pain is bad, but stable moderately increased pain after exercise, there's no proof that's bad.

TEXAS> Dr. W. IF your answers are different for Fibromyalgia, Would you please say so. I crater when I do much exercise...with great pain

DrWaters> For FMS pain is even more important to ignore because there is no structural damage and within even greater certainty than for RA we believe that pain does not equate with increased damage.

rosebud2> does it not make sense to improve the not so good areas with excerise to improve the function of the bad area just to ans your first statements with RA in mind

DrWaters> We're not talking about physical therapy, we're talking about strength training and endurance training. If my feet are very bad from RA I'm not going to use jogging as my main exercise, but cycling or Body Trek might be great. That's what I'm referring to.

DrWaters> But I'm not going to totally ignore the bad areas either. They need exercise, too.

InsightHostKJ> Is cycling generally a good exercise?

DrWaters> But I'm not going to totally ignore the bad areas either. They need exercise, too.

DrWaters> All exercise is good when it fits ones body. Cycling too much might not be good for bad knees but it's relatively easy on the feet.

DrWaters> Skipping is great exercise

InsightHostKJ> skipping? I couldn't do that before RA! no coordination!

Gary> I think my question was answered, how much can i push free weight, i can bench 110-120 but im scared and stick around 80lb, can i push it more also i started tae bo, and do the snappy motions do harm, i feel it the next day

DrWaters> Gary's ? is great, and very difficult.

DrWaters> You really need to listen to your body. If I feel myself injuring something I back off. It's not competition. I bench around 155, and I could probably go higher, but 155 is a lot for a 5' 9" 45 year old, so I don't push it above that. 80 is probably more than enough to get a fantastic workout. You are doing the right thing.

swimmer> how important is the aerobic part of exercise? I feel like my sore joints prevent me from exercising hard enough to even raise my pulse rate. Is exercise still a benefit?

swimmer> I mean easy exercise

swimmer> or feeling like I am doing nothing?

DrWaters> Any exercise is better than none. You should shoot for a heart rate of around 120 -140 if you're middle aged, higher if you're in your 20's or younger, less if you're in your 60's or older.

Sheryl> My 2 year old has Still's and frankly, most of the time, runs around a lot. But are there specific strength training exercises which could help her fingers and hands?

DrWaters> If she's very active I doubt she needs additional exercise, but you could have her play with clay or Play Dough, that's very good, or catch a ball, pick things up, etc. tieing, or is it tying, is good for deterity.

InsightHostKJ> I just got a stationary bike and am riding everyday.....i understand pain is not bad...but is there a point i should stop if it hurts?

DrWaters> Only if it seems to be escalating. Arthritic joints are going to hurt when used. That's a given.

InsightHostKJ> so stubborn is good? LOL I keep telling people that

DrWaters> Yes, very little progress in anything comes without a little suffering.

InsightHostKJ> so very true!

DrWaters> I guess that's sort of like marriage.

InsightHostKJ> LOL LOL

TraY> Dr. Waters, I have had RA for about a year and I was told a while ago that I have "fibro tendancies." Right now I am in a lot of pain maybe because of the weather or stress, but I have horrible neck and shoulder pain. My physical therapist suggests heat, the exercise bike for ten minutes, the arm bike for six minutes and then weight lifting to strengthen my muscles. I've also been playing softball. When I was younger I was a very good athlete. Right now, 

TraY> Do you have any suggestions?

DrWaters> I would do weight lifting except not over the head exercises and don't strain on the last repetition. And 20 min of aerobics 3 -4 days per week.

DrWaters> Curls, bench presses, tricep exercises, sit ups, leg presses, etc.

TraY> and softball?

DrWaters> Softball is good but don't over throw the ball.

Gary> Should you be careful if on nsaids because they might mask the pain when excercising and can that cause you to over due without realising it

DrWaters> I don't really buy that at all. As you all unfortunately know, NSAID's don't mask much of anything.

InsightHostKJ> what about pred? i was told to be careful after a pred injection that i didnt hurt myself and not know it (not fom a doc...other patients)

DrWaters> Steroid injections weaken tendons and ligaments. But I wouldn't avoid the area entirely. And the maximum negative is probably a month or two after the shot, not a day or two after, so what's one going to do.

InsightHostKJ> lighten the exercise on the injected areas?

DrWaters> Maybe a little.

InsightHostKJ> What do you think about therabands?

DrWaters> I think weight training is very helpful in arthritis patients. I have 85 year old RA patients that have found new lives after weight training (using exercise machines, not free weights). The benefits are too often ignored.

InsightHostKJ> yeah but not everyone can afford a gym membership or home machine

InsightHostKJ> what are some home options?

DrWaters> Check the city park, or the Arthritis Foundation branch for programs. Exericse videos are great. You can buy dumbbells, like pairs of 5, 10 and 20 pounds and use them at home. They are very cheap. Therabands are very good, though they require a lot of discipline, because it's more isometric and you have to maintain propper speed.

Gary> free weight machines are reasonable, you use free weights and the machine makes it safe to workout alone

InsightHostKJ> walking is cheap..but is it enough?

DrWaters> Almost never. Walking is over rated. Walking with arm weights is better.

DrWaters> If cheap is important I'd recommend a strength training oriented video workout using light hand weights.

InsightHostKJ> cheap is very important for alot of us!

Gary> lol, sometimes the library has tapes

DrWaters> This exercise stuff really helps. I have some very strong and fit RA patients with BAD RA. It takes some ingenuity and luck not to get injured, but when successful it can really improve function and decrease dependency.

InsightHostKJ> blockbuster does too if you want to try befre you buy

Gary> I agree dr waters, weights have helped me a lot

TraY> I'm trying really hard to stay in shape, but I played Softbaall last week and threw out my back.

TraY> I'm only 27, what's that all about?

DrWaters> Everyone throws their backs out. It's not our fault, it's evolution's (or God's) fault. It's part of life.

TraY> okay. can I play on thurs??

DrWaters> Only 1st base. And no stretching for bad throws.

DrWaters> OK, I gotta go. Try not to harp on the aerobics too much, that's boring. Try for a fun variety of exercise. It's safer and better.

Gary> thanks dr waters

InsightHostRon> Nite DR W

InsightHostKJ> thanks Dr

bedipped> thanks Dr.

swimmer> Bye Dr. Waters

Harriette> thanksDr.