How to Manage Your Shoulder Arthritis with Exercise

Shoulder arthritis is present in approximately 15% of people over the age of 65.  It is more common in women.  As with other forms of arthritis, most often it begins with a slow progressive loss of cartilage within the joint.  This leads to changes of the bone and joint lining.  Joint inflammation, stiffness, muscle weakness, pain, and deformities within the joint are common.  Despite popular belief, arthritis is not always a perpetual cycle of pain culminating in a joint replacement surgery.  Many people we work with who have shoulder arthritis achieve excellent results by committing to the right exercise program.

Osteoarthritis

Non-Surgical Treatment of Shoulder Arthritis

Lifestyle changes, activity modification, and adoption of strategies to protect the shoulder joint are important parts of treatment.  Activities that involve weight bearing or impact on the joint should be minimized or avoided.  Examples include push-ups and heavy overhead work.  In cases of acute pain, medications or injections can be helpful.  However they should be used sparingly due to their long-term adverse effects on the joint and other body systems.

Exercise is beneficial because it improves health of the existing cartilage, decreases joint stiffness, improves muscle strength, decreases pain, and improves function.  Gentle passive exercises are performed first.  These are usually performed lying down with the assistance of a cane or wand.  Manual therapy techniques performed by a physical therapist can enhance the benefits of exercise.  As pain and range of motion improve, stretching exercises are progressed and strengthening exercises are added.  The following 5 videos show examples of exercises we have used with excellent results for many people with shoulder arthritis.

Wand-Assisted Shoulder Flexion

Begin on your back holding a cane or wand in each hand.  Space your hands slightly wider than shoulder-width.  The cane or wand is grasped between your thumb and index finger with a thumb-up position.  The thumb-up position will maximize movement at your shoulder joint.  With both elbows straight, lift your arms overhead until a mild to moderate stretch is felt.  Hold this position for 5 to 10 seconds.  Then slowly lower back to the start position.  Perform 10 to 20 repetitions each day.

Wand-Assisted Shoulder External Rotation

Begin lying on your back with a small pillow or towel roll under the upper arm.  Hold a cane, golf club, or similar object in both hands.  Use the non-involved arm to passively rotate your involved arm out to the side.  Your elbow of the involved arm should be maintained at a 90-degree angle throughout the exercise.  When a mild stretch is felt, pause and hold the position for 5 to 10 seconds.  Perform 10 to 20 repetitions each day.  Avoid exercising through pain.

Waiter’s Bow

Begin standing with the hand of the involved arm resting on a table top or counter.  Relax the shoulder and neck muscles.  Slowly step backwards while keeping the hand on the table or counter.   When a mild stretch is felt, pause and hold the position for 5 to 10 seconds.  Perform 10 repetitions each day.  Avoid holding your breath, bouncing, or exercising through pain.

Wall Chest Stretch

This purpose of this exercise is to restore normal posture and position of your shoulder.  Most people with arthritis develop rounded shoulders and this further increases joint stress within the shoulder.  To begin, stand next to the corner of a wall or door jam.  Place the hand, forearm, and elbow on the wall.  Take a small step forward and slightly turn your body away from the wall.  You should feel a mild to moderate stretch in the front of your shoulder or chest.  Hold the stretch for 15 to 30 seconds and perform 3 to 5 repetitions daily.  If you experience pain, slightly lower the arm or decrease the intensity of the stretch.

2-Arm Band Row

The row is a great exercise to begin strengthening the muscles around the shoulder.  This exercise emphasizes the muscles that hold the shoulder blades back.  To perform this exercise, anchor a resistance band to a piece of furniture or door knob.  Grasp the ends of the band in each hand and step back so there is tension on the band with the arms stretched in front of you.  Pull the hands and elbows back.  The most important part of the movement involves squeezing or pinching the shoulder blades together.  Perform 10 to 20 repetitions for multiple sets 3 times per week.

Get Started

Exercise can not reverse or cure arthritis.  Nothing can, not even surgery.  But the pain and suffering from shoulder arthritis can be managed with the right exercise program.  Shoulder surgery can be extremely successful for some but it is not an option for everyone.  If you are looking for a different approach, your physical therapist can help you.  Begin with the strategies discussed in this article.  And if you need more help and are interested in teaming up with a physical therapist, give us a call.

Understanding Arthritis Pain and How You Can Best Manage It

Over 30 million people in the United States are affected by arthritis pain.  Osteoarthritis is the most common form of chronic painful joint disease.  The knee is the most frequently affected joint with up to 1 in 8 men and women over the age of 60 years having painful knee arthritis.  It is also common in the hips, spine, and hands.  Arthritis is a leading cause of impaired mobility and disability in older adults.

Osteoarthritis

Many people believe arthritis is a natural part of aging and little can be done for it.  This belief is false and unhelpful.  Understanding what arthritis is and why it can be painful will provide you with a sense of control.  The purpose of this article is to educate and inspire you to take action so you can manage your arthritis without medication, injections, or surgery.  We will start by explaining how the joints and nervous system change in people with arthritis.  Then we will briefly explain several methods of treatment that have been proven to work in people with arthritis.

Structural Changes In and Around Joints with Arthritis

In a typical joint, a layer of cartilage protects and cushions the ends of each bone.  The hallmark sign of arthritis is a loss of cartilage on the ends of each bone.  Cartilage has no nerve supply therefore it cannot be the direct source of pain.  In severe cases, the bone underneath the cartilage can trigger pain.  More often inflammation within the lining of the joints and ligaments trigger pain.

Over time, the inflamed joint lining and ligaments thicken and create stiffness of the joint.  This results in a cycle of pain and stiffness which begins to limit one’s use of the affected joint.  Reduced activity leads to weakness of the surrounding muscles.  Muscle weakness then contributes to increased stress through the arthritic joint.  The vicious cycle of inflammation, stiffness, pain, and weakness leads to more pain and a sense of hopelessness.

Changes within the Nervous System from Arthritis

Pain is a protective mechanism inherent in all of us.  It helps us escape danger.  However; pain is complex and sometimes can be overly protective when no danger is present.  The type, duration, and intensity of pain rarely can be explained by an x-ray or MRI.  This is because pain results from the interaction of many different factors.  These factors include changes in and around the joint.  However other social, cultural and psychological factors, including underlying anxiety and depression, are always interacting to produce pain. The term “neuromatrix” has been coined by world-renowned pain expert, Dr. Ronald Melzack.  This concept explains the complex interplay between the factors which lead to pain.

As a result of an injury or inflammation within a joint, nerve endings within the joint become stimulated.  Once stimulated, signals are transmitted up the spinal cord to your brain.  Your brain then processes these signals along with your past and present experiences, thoughts, beliefs, cultural factors, and social or work environment.  After considering all these influences, the brain determines whether or not you are in danger and if so, how much danger.  If the brain perceives a serious threat, it sends signals back down to your arthritic joint.  These signals result in an unpleasant experience of pain.  If no threat is determined, your brain produces no signals to create pain.  Read on and we will discuss how you can reduce any perceived threat.

How to Manage Pain from Arthritis

Understanding why arthritis causes pain allows us to identify treatments that can help.  During acute and painful times, treatments focus on reducing inflammation and stiffness.  Then gradually exercises to improve strength and mobility are added.  Finally, a holistic approach including the body and mind is needed to achieve long-lasting improvements in pain from arthritis.

Passive Treatments to Reduce Pain and Stiffness

Passive treatments provided by a healthcare professional or applied to the painful area can be helpful.  Many people experience temporary pain relief with moist heat treatments, massage, and topical creams.  Physicians utilize medications and injections to decrease inflammation and joint stiffness.  Physical therapists perform joint mobilization techniques and prescribe gentle range of motion exercises to achieve the same goals.  All of these treatments can be very beneficial in the short term but by themselves will not result in any long-lasting changes.

How to Exercise In Spite of Pain to Decrease Pain

The longer you experience pain, the more sensitive you become to experiencing more and more pain.  Contrary to popular belief, people with chronic pain from arthritis have low pain thresholds.  They actually begin to experience pain when little threat or danger is present.  This is because the body’s nervous system has been put on “high alert” to protect itself.  In this case, the body’s protective mechanisms are failing and becoming detrimental to its own health.  This is not a permanent state.  With practice, patience, and some help the body and mind can be re-trained to desensitize itself.

Active Adults Exercising

You must accept the fact that all pain is not a sign of damage or danger.  In order to overcome pain, some pain must be experienced when exercising.  The body and mind will never become less sensitive if all your actions are based on avoiding pain.  Instead, focus on the activity you would like to do like walking or gardening.  Perform the activity in small doses at first.  Walk for a few minutes each day for the first week.  Don’t overdo it.  Then add a minute or 2 next week.  Be patient.  Gradually, your nervous system will become less sensitive to the activity, your muscles with become stronger and your pain will begin to decrease.

Take Action and Get Some Help

There is no cure for arthritis.  However, pain and suffering can be managed if you choose to change your beliefs and actions.  Overcoming arthritis pain is not an easy endeavor.  Many are unwilling to commit and jump from one treatment to the next seeking the quick fix.  Joint replacements can work wonders for some.  However, they are not without serious risk and the outcomes are not always as promised.  If you are looking for a different, more holistic approach, your physical therapist can help.  Begin with the strategies discussed in this article. And if you need more help and are interested in teaming up with a physical therapist, give us a call.