Does stretching help relieve arthritis pain?

DEAR DOCTOR K:

Will stretching exercises help to relieve my arthritis pain?

DEAR READER:

Yes, they will. That may seem strange. After all, arthritis affects the joints — the ends of two adjacent bones and the space between them. In contrast, stretching involves muscles. But the joints and the muscles around those joints are intimately connected.

A joint with arthritis hurts when it is asked to move. It is the muscles that move the bones that form a joint. When movement is painful, as it so often is for people with arthritis, it’s natural to limit movement. For example, if you straighten a leg, and feel pain owing to arthritis in a knee, you’ll tend to keep that knee bent.

Yet if you keep an arthritic joint bent, rather than moving it through its full range of motion, you allow muscles to stiffen in that position. Over time, the muscles shorten, limiting range of motion and prompting other problems.

Stretching can help people with osteoarthritis nip this sort of cycle in the bud. Stretches can also help people with rheumatoid arthritis improve their range of motion in damaged joints.

Before you begin, ask your doctor about stretching exercises to ease stiffness. Your doctor will probably advise you to work with a physical therapist who can design an exercise program tailored to your specific needs and goals. I also recommend that my arthritis patients do some resistance exercises to build or maintain strength in muscles that support key joints.

These tips can help as you get started:

  • WARM UP THOROUGHLY. Warming up your body before you start your stretching routine will pump more blood and oxygen to your muscles, loosening them and preparing them for more intense use. Use a hot shower or bath, a heated pool, or even warm compresses or a heating pad to warm stiff joints before you stretch.
  • STRETCH DURING YOUR LEAST PAINFUL TIME OF DAY. Morning, when stiffness tends to peak, won’t work for some people. Choosing a window of time after pain relievers take effect can help make stretching easier.
  • ADAPT STRETCHES. You may need to modify your stretches. For example, it may be better for you to choose stretches you can do while seated, instead of standing.
  • EXPECT SOME DISCOMFORT. I encourage everyone to stretch only to the point of mild tension, not pain. But some discomfort is to be expected with arthritis. Try the two-hour rule: If discomfort following stretches lasts longer than two hours, or is more severe than your usual pain, step down your routine. Try doing fewer reps and holding stretches for less time. As stretching becomes easier, gradually step it up again.

As with all types of exercise, you need to engage in stretching regularly in order to reap lasting benefits. A daily regimen is best, but do stretch at least two or three times a week. (I’ve put descriptions and photographs of two stretching exercises, below.)

 

Seated chest stretch

Primarily stretches the chest and shoulders

Reps: 2–4

Hold: 10–30 seconds

Starting position: Sit up straight facing sideways in a chair without arms.

Movement: Roll your shoulders down and back. Clasp your hands behind you. Gently lift your hands toward the ceiling to the point of tightness. Hold. Slowly return to the starting position.

Tips and techniques:

  • Stretch to the point of mild tension, not pain.
  • Keep your shoulders down and back during the stretch.
  • Breathe comfortably.

seated-chest-stretch

 

Calf stretch

Primarily stretches the calf, Achilles’ tendon, and ankle

Reps: 2–4

Hold: 10–30 seconds

Starting position: Stand up straight. Hold the back of a chair or press your hands against a wall, arms extended at shoulder height.

Movement: Extend your right leg straight back and press the heel toward the floor. Allow your left knee to bend as you do so, while keeping that heel grounded on the floor. Hold. Return to the starting position, then repeat with your left leg. This is one rep.

Tips and techniques:

  • Stretch to the point of mild tension, not pain.
  • Hold a full-body lean from the ankle as you stretch.
  • Maintain neutral posture with your shoulders down and back.

standing-calf-stretch