Here we would discuss about certain exercises in relation to Rheumatoid Arthritis an auto immune disorder we are concerned with here at Institute of Holistic Medicine and Allied Research and have a Research project ongoing of the same sanctioned by Ministry of Health and Family Welfare, Govt. of India (Readers can refer their cases of Rheumatoid Arthritis for Free Lab Investigations and Free Treatment).

When movement is difficult as it generally happens in Rheumatoid Arthritis, it is most tempting to be inactive but as the American arthritis foundation puts it - "Move it or Lose it". Exercise helps to maintain muscle strength, healthy cartilage and joint movement.

Research shows that most people with Rheumatoid arthritis can safely participate in many forms of exercises but remember Pain is a warning, if any exercise causes pain that lasts more than two hours that means the exercise was too vigorous or not appropriate and you need to either slow down, do less or change the exercise. Move your joints smoothly and slowly - don't jerk them. Warm up and cool down at the beginning and end of each exercise session- it means starting the session at an easy pace and gradually building up intensity, this gets the blood flowing throughout the body so that the muscles work better, cooling down allows the body to return gradually to its pre exercise state and helps prevent stiff and sore muscles.

In RA finding the right balance between rest and exercise is an important part of pain management - this takes time because of the fluctuating nature of RA. Rest is often needed to settle an inflamed joint or during a general flare up, but too much rest will weaken the muscles and increase stiffness.

• Joints that are stiff (and not painful) actually need more exercise
  
• Joints that are weak/unstable need more support e.g., a wrist splint
  
• Few commonly advised Exercises for Rheumatoid Arthritis
  
• Hands
  
• Touch tip of thumb to each finger tip in turn making an "O", then press.
  
• Stretch thumb away from palm as far as possible then try to touch the base of your little finger.
  
• Clench hands as hard as possible (with thumb outside) then stretch fingers hard.
  
• Forearms on table, lift hands as high as possible, stretching wrists.
  

ELBOWS :-

• Touch shoulder then stretch elbows as straight as possible.
  
• Forearms on table, twist forearm so that palm faces table and then it faces the ceiling.
  
  

SHOULDER :-

• Lying flat stretch arms as high as possible so that arms touch the side of the head, then lift both arms sideways and upward toward head.
  
• Hands on the shoulders circle elbow stretching in all directions.
  
  

NECK - EXERCISES :-

• In acute pain exercises are not advised, when the movements less painful, following exercises should be done:
  
• Bend the neck forward and backward slowly.
  
• Bend the neck sideways so as to try to touch the ear with shoulder.
  
• Turn the neck to right and to left so as to bring the chin to each shoulder in turn.
  

HIPS & KNEE JOINT :-

• Position lying on back.
  
• Bend one knee fully with the heel dragging on the mattress, then fully straighten- similarly do with other knee.
  
• Bring one leg out and then in, similarly do with other leg.
  
• Do straight leg raising 30-40 degree only.
  
  

ANKLE & FOOT JOINT :-position lying on back

• With the legs straight and heels touching the mattress, lift both feet up and down.
  
• With legs straight and heels touching the mattress, bring the feet in and out.
  
• Squeeze the toes inwards and then spread them fully.
  

NECESSARY TIPS :-

• The aim of the exercise is to maintain full range of motion of joints, to maintain and improve the strength of muscles and to avoid deformities.
  
• The exercise should never be done in a hurry.
  
• Avoid continuous postures like sitting and standing for long.
  
• Exercise must not cause pain or fatigue to the patient.

RCIAPCON 2005 - Conference Abstracts.Pediatric Oncall [serial online] 2006 [cited 15 June 2006(Supplement 6)];3. Available from:
http://www.pediatriconcall.com/fordoctor/Conference_abstracts/
exercises_rheumatoid_arthritis.asp