Bend A Bit

The joint shouldn’t be jumpin’ but low impact exercise is a good idea

Low Impact Exercises

As you plan to eat your way through Thanksgiving and Christmas, you also probably have vague ideas about undoing the damage to your weight come January. Save this story. If you have arthritis or other joint problems, you’ll need to take care how you get in shape, and we’re here to help.

Especially if you’ve never exercised before, check with your doctor before starting a rigorous program. Remember to start slow and stick with it.

“Too many people decide they’re going to do an exercise program, rush into it, and then two weeks later they quit,” says Dr. Bob Snyder of the Orthopaedic and Spine Center in Newport News. A further caution: if you feel tightness in your chest or are short of breath, stop immediately and be ready to call for help, Snyder says.

If you’re pre or post joint replacement, you’ll need to focus on low impact exercises, Snyder says. 

What about exercise classes?

“Zumba is hard on the knees and hips,” Snyder says. “If you have arthritis in the knees and hips, you probably want to stay away from it.” After a hip or knee replacement, you might be able to return to Zumba, but you’ll need to modify the moves, he says.

A yoga class can help increase flexibility, Snyder says. “A lot of our patients are just not very flexible—they can’t do true yoga poses,” he notes. “A class on yoga that would help them increase their flexibility and stretching is good. But if there’s any specific exercise that causes a lot of pain or is really difficult, the guideline is to try to avoid it or at least modify it.”

If your arthritis in your knee or hip is bad, “running is definitely out,” says Snyder, who gave up running after a partial knee replacement.

You’re already looking for a loophole, right? Suppose you have just a little arthritis in your hip or knee that doesn’t really bother you; your doctor may not tell you that you can’t jog at all, Snyder says. But your doctor will advise you to cross train. “If you’re going to run one day, then ride a bike, do water aerobics, go to the gym and do upper body weight training on other days,” Snyder says.

Weight training helps prevent osteoporosis in women, so it’s a good idea to incorporate weight training into your exercise plan, Snyder says. If you have arthritis, Snyder recommends weight machines as opposed to heavy free weights. Use lighter weight and then do more repetition, perhaps two sets of 15, he says.

For example, “People who don’t have arthritis can get on the leg press and do 200 pounds easily,” he says. “With knee replacement patients, I tell people to do 40 to 50 pounds on the leg press.” 

If you’ve had a knee replacement, steer clear of the weight machines where you are seated and extend the weight out, Snyder says. “That’s very hard on the kneecap,” he says.

Shoulder replacement patients should continue working out with the Thera-Band® Tubing that they likely used during physical therapy, Snyder says. If you get to the point where you can use weight machines, again stick to very low weight—30, 20 or even 10 pounds—on machines that work shoulder muscles, he says.

A patient needing a hip replacement should opt for swimming, water aerobics, riding a stationary bicycle or other low impact exercise, he says.

For overweight people with joint issues, exercise can be a Catch 22, Snyder acknowledges. Carrying too much weight on your body increases the load on your joints, he notes. “The biggest determinant to healthy joints is weight,” he says. If you’re overweight, whether you have a replaced joint or your normal joint, you increase the wear and tear on your joints. Your goal should be to get down to your ideal body weight. But if someone has arthritic knees and basically can’t walk across the room, there’s no way you can expect them to exercise and start losing weight.”

The goal should be to start being more active and lose weight, if necessary with the help of a nutritionist, after joint replacement surgery so that new joint will last longer.

“Part of our problem is some of our joint replacement patients are 80 or 85 years old,” Snyder says. “You have to be very slow and deliberate with them. Of course, you have the guys and gals who are younger, people in their 40s and a few in their 30s. They’re going to want to push the envelope a little more.”

Snyder, who plays competitive handball, understands the need to push that envelope.

“There are plenty of handball players and racquetball players who play with a replaced knee or a replaced hip even though they might have been told playing will cause things to wear out earlier,” he says. “They’re that fanatical about their sport. Their rationale is, if they couldn’t play that sport, they’d rather be dead. It becomes a quality of life issue.”