From healthcentral.com
Created in partnership with the pros from the Hospital for Special Surgery, HealthCentral’s exercise plan features 10 moves to support your joints—and your well-being, too
You know the feeling—that moment when you wake up, get out of bed, and realize you ache from head to toe. Nothing can slow your morning momentum like joint pain, and if you’re one of millions of people living with psoriatic arthritis (PsA), chances are the last thing you want to do during a flare-up is exercise. But in fact, a gentle, well-planned movement program could be some of the best medicine in alleviating the symptoms of this chronic joint condition.
“People with psoriatic arthritis have intermittent flare periods that can make them question whether they should be pushing through pain or discomfort,” says Jonathan Yu, a doctor of physical therapy at Hospital for Special Surgery in New York City. “It is very important to empower people to get into a regular exercise regimen and figure out what type of exercises can be used to manage pain.”
To help you find and keep the upper hand on PsA pain, HealthCentral teamed up with the Hospital for Special Surgery, the leading orthopaedic hospital in the country, to customize 10 basic made-for-you strength moves that you can do—starting now.
What Makes Movement Potent for PsA
While small joints are commonly impacted with psoriatic arthritis, the condition also can affect the large joints in your hips, knees, and lower back. No matter where you feel the pain, being proactive as you follow your doctor-prescribed treatment plan is the key to relief.
“Untreated psoriatic arthritis can cause joint damage, loss of motion, continuous pain, and swelling,” cautions Theodore Fields, M.D., a rheumatologist at Hospital for Special Surgery in New York City. “But exercise helps maintain the full range of motion of joints in those with psoriatic arthritis, while also strengthening the surrounding muscles that support the joints.”
The National Psoriasis Foundation recommends exercise to reduce inflammation and stay limber. Indeed, according to research, resistance training was shown reduce disease activity in those with PsA. Not only that, but a study published in Clinical Rheumatology reported that exercising regularly helped PsA warriors experience less pain and fatigue, better mobility, improved endurance, and a better quality of life.
That boost in quality of life is an important benefit beyond being able to touch your toes. Research shows that exercise can also help treat depression, something that one review found can affect up to 51% of people with psoriatic arthritis.
The message: Moving more can help you feel better both physically and mentally.
Even if you’ve been living with PsA for a while, it’s never too late to start. “Regular exercise even can improve lost range of motion in joints, and increase level of overall function,” says Dr. Fields.
10 Moves for Healthier Joints
To be at your best with psoriatic arthritis, the American Arthritis Foundation recommends a weekly blend of strength-building, stretching, and low-impact cardio such as walking, cycling, and yoga. With this in mind, Yu created the perfect strengthen-and-lengthen plan for those with PsA.
“I chose these exercises because they are weight bearing, helping strengthen the major muscle groups of the body, while also improving dynamic balance and increasing range of motion,” says Yu. “Stronger muscles can help support and reinforce your joints, and strength training has an additive effect of loosening up the joints, which helps decrease stiffness.”
Yu recommends doing this workout three to five times per week (the routine takes roughly 15 minutes from start to finish), depending on your schedule and current physical condition. “If you have never exercised before, choose four or five of these exercises to do each day, and complete one to two sets per move,” says Yu. “If you have more experience with exercise, perform three sets of each move, and complete the entire program each time you work out.”
Begin each workout with five to 10 minutes of gentle activity such as walking or cycling on a stationary bike to prepare your muscles and joints for the task at hand. Once you’re finished, cool down similarly with a gentle cardio activity to help reduce your heart rate and return to normal.
Squats
Why they work: “Squatting is a daily activity in life, and we perform this motion when sitting and lifting, for example,” says Yu. The squat engages the large muscles in the lower body, such as the glutes, quadriceps, hamstrings, and calves. Strengthening these muscles helps support PsA-inflamed joints in your hips, knees, and ankles.
How to do them: Stand with your feet just outside shoulder-width apart with your arms at your sides or in front of you for balance. Keep your chest lifted and your focus in front of you as you push your glutes back, then bend your knees. Slowly squat down as low as you can, ideally until your knees and hips come level, with your thighs parallel to the floor. Pause briefly, then extend your knees and hips to return to standing.
Do three sets of 10 repetitions.
Forward Step-Up
Why it works: Not only does this move strengthen the large muscles of the leg (quads, hamstrings, glutes), it also challenges your balance and improves stability in your knees and hips, says Yu—essential for reducing strain on joints impacted by psoriatic arthritis.
How to do it: Stand facing a bottom step that is six to eight inches high. If you need help balancing, use a staircase with a railing, advises Yu. Place your entire right foot on top of the step (don’t let your heel hang off the edge), then straighten your right leg to stand on top of the step. Bring your left foot up to meet the right, then step back down with your right foot first, following with your left. Complete all reps on one side, then switch.
Do three sets of 10 reps per leg.
Bridge Hold
Why it works: Strengthening your glutes with moves such as this helps support your body in standing positions, while also improving posture and stability, according to Yu.
How to do it: Lie face-up on the floor with your knees bent and your feet flat on the floor spaced about a foot apart. Extend your arms along your sides with your palms facing down. Drive through your heels, squeeze your glutes and press your hips upward until your thighs form a straight line from your knees to your hips. Hold here for 10 to 30 seconds, then lower back to the start under control.
Complete three 10- to 30-second holds.
Standing Hip Abduction
Why it works: Your hip abductors are muscles that lift your leg to the side. They help you maintain balance and stabilize you when standing on one leg. “The abductors also work when you step to the side, and when you get into and out of a car,” says Yu.
How to do it: Stand next to a wall, a sturdy pole, or another stable surface with your feet hip-width apart. Place your left hand on the wall for balance and shift your weight into your left leg. Keeping your right leg straight and your hips level, slowly lift your leg up and to the side as high as you can without tipping or leaning over. Pause briefly, then lower your leg to the start. Complete all reps on one side, then switch.
Do three sets of 12 to 15 reps on each leg.
Bed Hip Stretch
Why it works: Anyone with psoriatic arthritis will attest to the stiffness that results from sitting for long periods of time. Tightness in the hips, hip flexors, and lower back makes simply standing up a painful endeavour. This stretch helps release the muscles in those areas, working to alleviate pain and stiffness. “The psoas is the only muscle in the hip that has attachments into the lower vertebrae, so you get a two-for-one stretch here,” says Yu.
How to do it: Lie face-up along the left side of your bed. Dangle your left leg over the edge so you feel a stretch in the front of your left hip and lower back. Hold and breathe, relaxing as much as possible, for five to 10 seconds. Lift your leg back onto the bed, rest briefly, then repeat. Complete all reps on one leg, then switch sides and repeat.
Do three sets of 10 five- to 10-second holds per leg.
Standing Resistance-Band Row
Why it works: If your job involves spending the day in front of a computer, you also likely spend a good deal of that time slouching. This can lead to pain in your neck, shoulders, and upper back, exacerbating the battle with PsA. This exercise strengthens the muscles surrounding your shoulder blades, improving posture and alleviating pain.
How to do it: Secure the centre of a resistance band around the doorknob on the outside of a door, then close the door tightly to hold it in place. Grasp an end in each hand with your arms extended straight in front of you and your palms facing in toward each other. Stand with your feet hip-width apart and your knees slightly bent for balance. Keep your chest lifted and your arms in close to your sides as you drive your elbows back behind you. Imagine squeezing a pencil between your shoulder blades to help target the right muscles. Pause briefly, then slowly extend your arms to return to the start.
Do three sets of 15 to 20 reps.
Resistance-Band Shoulder Extension
Why it works: This exercise helps strengthen the muscles that support your scapulae as well as your mid-back. The better your posture, the less back and shoulder pain you will have, according to Yu.
How to do it: Secure the centre of a resistance band around the doorknob on the outside of a door, then close the door tightly to hold it in place. Grasp an end in each hand with your arms extended in front of you at shoulder height, and turn your palms downward to face the floor. Keep your arms straight and your chest lifted as you slowly press the band down toward your legs in a smooth arc. When your hands come just to the outside of your thighs, pause briefly, then slowly return to the start.
Do three sets of 15 to 20 reps.
Forearm Plank
Why it works: The stronger your core—the abdominal and lower back muscles around your midsection—the better your posture and body mechanics, relieving unnecessary tension around PsA joints that are trying to compensate for bad form.
How to do it: Get on your hands and knees, then place your elbows on the floor underneath your shoulders. Extend your legs behind you one at a time, then lift your hips so your head, hips, and heels are aligned. Tighten your abs, squeeze your glutes and press down into the floor through your elbows to help maintain this position. Hold and breathe for 30 to 45 seconds.
Complete three 30- to 45-second holds.
Calf Raise
Why it works: Your ankles are an oft-forgotten joint, but they can be negatively impacted by psoriatic arthritis, just like the rest of your body. This move simultaneously stretches your ankles while strengthening your calves and feet.
How to do it: Stand next to a wall or face a countertop with your feet hip-width apart and your toes pointing forward. Lightly place your hand(s) on the stable surface for balance, if needed. Keep your legs straight as you raise your heels off the floor and lift up onto your toes. Pause briefly at the top, then lower back to the start.
Do three sets of 15 reps.
Single-Leg Balance
Why it works: Balancing on one leg might sound simple, but doing so engages and strengthens dozens of smaller muscles in your hips, knees, and ankles, thereby improving dynamic balance, strengthening your lower body, and in turn easing joint strain.
How to do it: Stand next to a wall or countertop (for balance, if needed) with your feet hip-width apart and your arms at your sides or your hands on your hips. Shift your weight into your left leg and maintain a slight bend in your left knee as you lift your right foot off the floor. Hold as long as you can with the goal of balancing for 20 to 30 seconds. Replace your foot and repeat on the other side.
Do three sets of 20 to 30 seconds on each leg.
Making Exercise Work for You
Psoriatic arthritis affects people in different ways, so you may have to tailor this workout to meet your specific needs on a day-to-day basis. “For example, when there is a marked flare in a particular joint, people with psoriatic arthritis should limit exercise [in that area] until they can calm the inflammation down, but they can still exercise with other parts of the body,” says Dr. Fields.
Don’t be afraid to take longer breaks between exercises or dial back the intensity at any time, if needed. The goal is to move your body, no matter how slowly or carefully you do it, and any exercise is better than none. Ultimately, your goal is to be physically active most days of the week, with the target of accumulating 150 minutes weekly to reap the full spectrum of benefits that exercise can provide.
While 150 minutes might seem like a lot, if you break it down into smaller, bite-sized chunks it becomes instantly manageable. For example, if you take a 15-minute walk each morning you’re already more than halfway there! Add in this strength/stretch program most days per week, and you’ve reached your goal—and then some.
https://www.healthcentral.com/condition/psoriatic-arthritis/build-a-stronger-body-with-psa-workout
