Joan Poe felt the first symptoms of arthritis in 1962, at a time when physicians typically advised people with the disease to avoid exercise in an attempt to "save their joints."
Whenever the pain in her knees got bad, Poe would put her feet up and rest.
"By 1985, I couldn't walk more than a city block, I couldn't sleep from the pain and I couldn't reach my arms over my head to curl my hair, so I cut it off," recalls Poe, 61, who has two kinds of arthritis--osteoarthritis and rheumatoid arthritis--and a related condition called fibromyalgia. "I was sure I'd be in a wheelchair within a few years."
But Poe's rheumatologist urged her to participate in a study on the effect of exercise on people with arthritis at the University of Missouri, near her home in Columbia, Mo.
"People had been assuming the disability came from the disease itself," recalls the study's principal investigator, physical therapist Marian Minor, an associate professor at the university who holds a doctorate in human performance and aging. "We were challenging that assumption and trying to determine how much of the loss in function actually came from inactivity and deconditioning."
After three months of exercising regularly in chest-deep water, Poe could walk almost a mile without pain and could put her arms over her head to curl her hair, which she grew back.
"The exercise made a tremendous difference in how I looked, how I felt and whether it seemed like the disease was controlling me or I was controlling the disease," she says.
Today Poe works out at a gym at least three times a week, walking 30 minutes on the treadmill, pedaling 25 minutes on a stationary bike and stretching for 45 minutes.
"I still have problems with my spine when I do too much bending," she says. "But I can do almost everything I want to do. I tell other people with arthritis that if they don't exercise, they're a prisoner of the disease. But exercise will set them free."
Arthritis, which literally means joint inflammation, refers to more than 100 diseases that affect the joints and the tissues around the joints, including Sjogren's Syndrome and Scleroderma. Nearly 40 million Americans, or one in seven, have arthritis, says the Arthritis Foundation, a national nonprofit agency that supports research and provides community-based programs for people with arthritis.
The prevalence of arthritis increases rapidly after age 45, and nearly half of all people with the disease are 65 or older. As baby boomers age, the number of Americans with arthritis is expected to grow to 59.4 million (nearly one in five) by 2020. The main cause of disability in this country, arthritis frequently limits everyday activities such as dressing, climbing stairs and walking.
And half of those who suffer from the disease don't think anything can be done to help them. Yet during the past decade a growing body of research points to exercise as one of the best ways to keep joints in working order, boost overall health and, in some cases, prevent further damage.
For example, results of the Fitness, Arthritis and Seniors Trial, published in the Journal of the American Medical Assn. in January, concluded that "exercise is a safe and effective nonpharmacological therapy that improves both pain and function in older people with osteoarthritis of the knee."
The 18-month study of 365 seniors with that affliction found that participants who exercised showed significant improvements in tests of physical performance (such as climbing stairs, getting in and out of a car, and lifting and carrying 10 pounds), compared with seniors in a health education group who did not exercise. Those in the exercise groups also scored better on assessments of physical disability and self-reported knee pain.
Even high-intensity strength training "is feasible and safe in patients with well-controlled RA [rheumatoid arthritis] and leads to significant improvements in strength, pain and fatigue without exacerbating disease activity or joint damage," notes a recent article in Arthritis Care and Research, a journal of the American College of Rheumatology.
The federal Centers for Disease Control and Prevention highlighted the topic of exercise and arthritis in a recent issue of its Morbidity and Mortality Weekly Report.
"There is a mistaken belief that persons with arthritis should not exercise," the report notes. "Most persons with arthritis and other rheumatic conditions should engage in physical activity."
Exercise helps people with arthritis "maintain normal muscle strength and joint function . . . [and] reduce the risk of premature death, heart disease, diabetes, high blood pressure, colon cancer, overweight, depression and anxiety."
The U.S. Surgeon General's Report on Physical Activity and Health urges people with arthritis to exercise because "regular physical activity can help control joint swelling and pain."
