Being inside during the winter months does not have to mean being less active.  Dr. Aksa Ahmed, a Chiropractor in Toronto and an Advanced Clinician Practitioner in Arthritis Care, shares some tips on how older adults with arthritis can take charge of their health this winter and stay active while inside.

There are numerous research studies supporting the health benefits of exercise for older adults living with arthritis.  Staying active has a host of benefits.  Some of these benefits include the ability to improve strength, independence, energy levels, sleep, and mood, as well as reduce stress, anxiety and feelings of depression.  Individuals with arthritis often do not exercise enough for a variety of reasons including joint and muscle pain, weakness, fatigue, or joint swelling.  This can lead to stiffness, muscle weakness and tightness.  As a result, arthritis- related pain and associated symptoms can continue to worsen.

Individuals living with arthritis should exercise on a regular basis. When planning a weekly exercise routine, it’s important to ensure that you are incorporating four different types of exercise: endurance, strength, balance and flexibility.

With the cold weather in full effect and COVID-19 pandemic restrictions in place getting to a gym or exercise centre may not always be possible. You can easily exercise from the comfort of your home using home gyms, home-based video workouts or web-based exercise programs.  Many fitness organizations are currently offering free online workout classes to encourage activity due to the COVID-19 pandemic.  

Being engaged in a regular exercise routine can help reduce the pain of arthritis.  However, before starting any exercise routine, be sure to consult with your healthcare provider. You can also seek guidance from experts such as physical therapists, chiropractors, occupational therapists and personal trainers for proper form and technique- many of which may currently be offering virtual visits to make it more convenient for you.

Endurance Exercises

Endurance exercises are also referred to as aerobic or cardiovascular exercises. This form of exercise works to increase your breathing and heart rate.  As a result, endurance exercises can improve heart and lung health, lower blood pressure and improve your overall fitness.  Research studies show that incorporating endurance exercises into your regular workout regime, while not the only factor, can play a role in reducing your risk for many diseases that are common in older adults such as type 2 diabetes, osteoporosis, colon and breast cancers, heart disease and others.

Canadian physical activity guidelines recommend that older adults accumulate at least 150 minutes of moderate- to vigorous-intensity aerobic physical activity per week, in bouts of 10 minutes or more. Examples of endurance exercise include brisk walking, stationary biking, or swimming.  If you are just starting out, start slowly for a short duration and aim for a few days a week, then gradually increase this as you are able. In the winter months, and due to the current COVID-19 restrictions, older adults with arthritis can consider walking up and down the hallway of their homes as one form of exercise. You can also try marching on the spot while watching tv or listening to the radio, bringing your knees up higher than a regular walk, but where it is still comfortable and easy to maintain your balance.

Keep in mind that daily activities such as housework (including cleaning) can serve as a form of endurance activity.  Movement is essential to keeping your joints healthy.

Safety Tips:

  • Be sure to incorporate a warm up and cool down in your routine

  • Start slow and build up to moderate-intensity exercise.  Endurance activities can make you sweat but should never cause dizziness, chest pain or pressure.

  • Endurance exercises need not be strenuous.  During moderate-intensity exercise, you should be able to carry on a conversation without much difficulty.

  • Stay hydrated and drink lots of liquids when performing endurance activities. However, if your doctor has recommended you limit your fluids, be sure to check before increasing your fluid intake.

  • Utilize proper safety equipment (i.e. proper shoes while walking, even indoors).

  • If completing everyday activities such as mopping or tidying up as a form of endurance exercise, be sure to bend from the hips and not the back when leaning forward. Poor form can lead to injuries.

If you are not sure how much exercise or what type of exercise is right for you, seek guidance from a healthcare provider.

  1. Listen to your body and work within your own comfort zone.

  2. If you have an increase in joint pain after exercise or activity that lasts more than 2 hours, it means you have overdone it.  You may need to cut back on effort or number of repetitions.

  3. Some muscle discomfort, not sharp pain, is to be expected from new exercise.  It should improve after 24-48 hours of normal activity. 

If you’re experiencing a flare, it’s important to rest more and protect painful and swollen joints.  Don’t stop moving altogether, though.  Instead, you can focus on range of motion exercises and gentle stretches. You may also discuss with a health care provider for guidance on safe strengthening exercises to incorporate as well.

Strength Exercises

Strength exercises can also be referred to as resistance training.  Older adults with arthritis should include muscle strengthening in their exercise routines. Keeping your muscles strong can help people stay independent and make it easier to carry out daily activities such as getting in and out of bed, getting on and off the toilet, climbing stairs and grocery shopping.  It can also help improve balance and decrease pain.  As you strengthen the muscles that support the joint, you offload the pressure on the joints and in return can have decreased pain.

There are many body weight strengthening exercises that you can do to improve muscular strength.  For example, Pilates, Yoga and Tai Chi. There are many free online resources with these types of exercises to allow seniors to complete these exercises from the comfort of their homes.

You can also visit the “Strengthening Exercises” section of the Arthritis Society’s Staying Active online guide or printable PDF for examples of strength training exercises you can do at home.  The Arthritis Society also has a series of exercise videos for people living with osteoarthritis.    

Strength exercises can be advanced to include resistance bands or weights.  Resistance bands are stretchy elastic bands that come in a variety of levels of resistance and range from light to heavy.  You can use them in some strength exercises in place of weights.  When exercising at home, you can also use a full water bottle or a can of soup in place of hand-held dumbbells.

To improve balance and prevent falls, focus your strength training regime on strengthening knee and hip muscles.  It’s best to work with a healthcare professional (such as physical therapist, chiropractor or occupational therapist) to determine which exercises are best for you. For example, if you have osteoarthritis of the knee or hip, then it’s best to focus on strengthening your quadriceps, hamstrings, gluteal and low back muscles. Weight-bearing strengthening exercises such as walking, dancing, and Tai Chi have also been shown to slow the rate of bone loss and osteoporosis.

Safety Tips:

  • Complete the exercise in a slow and controlled manner.

  • Be sure to hold the weight/resistance tightly in order to prevent it from slipping and causing possible injury.

  • Always use smooth and steady movements when using weights.  

  • Keep your arm and leg joints slightly bent, avoid locking them in a completely straight position.

  • Starting with weights that are too heavy can cause injury.  Instead, try to gradually build strength over time.  Consider starting without weights and slowly adding 1- or 2- pound weights or use light resistance bands, when you are ready.

  • Make sure to breathe when you exercise.

Balance Exercises

Balance exercises can help prevent falls by improving stability.  Balance issues are common in older adults, especially those living with arthritis due to deconditioning of muscles.   The risk of falling in older adults is usually related to a combination of factors, including vision changes, vestibular problems, altered sensation in the feet, and the use of multiple medications.  Exercises that focus on balance and strength training can significantly reduce the risk of falls.  Balance exercises may involve activities that challenge walking patterns such as heel-to-toe walking, side stepping, and single-legged standing.  Balance exercises can also include exercises that focus on lower extremity strengthening such as sit-to-stand exercises. Many strength exercises that focus on improving lower body strength can improve balance. Tai Chi is a gentle, yet effective exercise that helps seniors improve balance.

Safety Tips:

  • Be extra cautious the first few times you try balance exercises.

  • Have a sturdy chair or piece of furniture nearby to hold on to in the case that you feel unsteady.

  • Use gait aids as needed. If you normally use a gait aid such as a walker, stand at the walker, position it against a wall or piece of furniture to keep it from moving and engage the brakes.

  • Wear comfortable and close-fitting clothing to avoid risk of tripping.

  • Wear shoes that have a high back collar for adequate ankle support and a firm sole.

Flexibility Exercises

Flexibility exercises can also be referred to as stretches. Improving flexibility allows joints to move over a wider range of motion and can make it easier to perform daily activities such as reaching down to tie your laces or turning your head to check the blind spot when driving.   

The first step in improving flexibility is to get moving more on a daily basis. The second step is to incorporate regular stretching exercises. Stretch before you get out of bed.  Joints stiffen up during the night when they’re not being used.  Start with gentle stretches while still lying on your back in bed (such as drawing one knee towards your chest and holding for a few seconds, then try drawing both knees towards your chest and holding for an additional few seconds) and then continue stretching while sitting on your bed (such as performing clockwise and counter-clockwise circles with your ankles and wrists) before you take your first step out of bed every morning. 

If you don’t normally stretch, it’s best to start slow and start with stretching at least 2-3 times a week. Once you start becoming more comfortable with stretching you can increase to 4-5 days per week.
 
You can visit the Arthritis Society’s 20-Minute Joint Warm Up video or visit the “Flexibility” section of the Staying Active online module for examples of stretching activities you can try.

Safety tips:

  • Be sure to warm up your muscles prior to stretching.

  • Relax into each stretch. Remember not to hold your breath. Your muscles need oxygen!

  • Incorporate stretching exercises into a cool down routine after completing endurance and strength exercises.

  • Stretching should not be taken to the point of pain.

  • Seniors should not bounce at the end of a stretch

  • Never stretch an injured muscle!


Staying active while indoors has many benefits.  Remember, it’s never too late to start. According to a recent study, adding physical activity at any age has benefits.  As you begin to incorporate exercise into your regular routine the exercises will get easier and you should begin to feel stronger and more energetic.  This tells you that your body is getting used to a higher level of activity and it’s time to build on those benefits by doing more (i.e. increasing the total number of minutes for endurance activity or increasing the weight for strengthening exercises).

Motivation while stuck indoors is not easy to achieve. For seniors living with arthritis the goal of exercising should ultimately be to make it part of your lifestyle.

Tips to stick with an exercise program long term:

  • Follow a simple exercise routine

  • Set attainable goals

  • Understand the importance and benefits of exercise

  • Interact with others while exercising (i.e. with video calling friends and loved ones)

  • Follow up with a healthcare provider to help make adjustments to your exercise routine, as needed

  • It is okay to break exercises down into a few 10-minute sessions per day

  • Remember, exercising only one or two days per week is better than not exercising at all. 

  • Lastly, have fun! Find exercises that you enjoy doing.

As you work on living an active lifestyle and incorporating regular exercise, don’t forget to congratulate yourself on your efforts.  The first step is always the hardest step in any journey.  Stay active and keep going.  You are doing great! 

Looking for more information on how to begin an exercise plan and to keep going? Visit the Arthritis Society’s Staying Active online module or their Osteoarthritis Exercise Videos for tips to stay motivated and exercise examples.
 

Content written by:

Aksa Ahmed, DC, ACPAC
Chiropractor, Advanced Clinician Practitioner in Arthritis Care
Rebecca MacDonald Centre for Arthritis & Autoimmune Disease, Mount Sinai Hospital
 
Special acknowledgement and thanks to Marlee Shloush, Physiotherapist, Arthritis Rehabilitation & Education Program, for reviewing this article for the Arthritis Society

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