by Jennifer Trizuto, MPT
Rheumatoid arthritis (RA) can also affect the shoulders. Unlike OA, RA is a body-wide condition, causing chronic inflammation that can lead to the destruction of cartilage and other structures in the joint. Both OA and RA can cause debilitating pain.
If you experience shoulder pain, your first inclination will probably be to keep your shoulder still. It is often the case that if you don’t move your shoulder, it won’t hurt. Of course, there are many reasons why your doctor would want you to rest your shoulder, and he or she will tell you when that is appropriate. However, for most causes of shoulder pain, immobility is the enemy because it can begin a vicious cycle. That is to say, the less you move your arm, the harder it becomes to move it.
So what is the best type of movement or exercise for your shoulders? There are three main types of exercise: range-of-motion or stretching exercises, strengthening exercises, and endurance or aerobic exercises. All three should be part of a program to keep shoulders strong and flexible. You can find examples of range-of-motion and strengthening exercises here.
Before you begin an exercise program for your shoulder, it is a good idea to check with your doctor. Your doctor may want to give you tests to make sure you don’t have any serious underlying problems. He or she may also want to refer you to a physical therapist or exercise physiologist, who can help you get started with a program of exercise. Once your doctor has examined your shoulder and told you that there is nothing to prevent you from exercising, it is time to get started.
Range-of-motion (stretching) exercises. Range-of-motion or stretching exercises are designed to take your shoulders through their maximum range of movement. These exercises can help you maintain your shoulders’ current mobility and, when done consistently, increase their mobility over time. Range-of-motion exercises can be done lying down, sitting, or standing. Unlike some strengthening exercises, range-of-motion exercises can and should be done every day. At first you may feel very stiff and sore after doing them. If the feeling doesn’t go beyond soreness, then you may only have to move more slowly or do fewer repetitions until your shoulders get used to the exercises — the soreness should decrease after a while. However, if you feel more pain after exercising than when you started, or if the pain persists for longer than two hours after you are finished exercising, you should see a doctor.
Strengthening exercises. Strengthening exercises can help the muscles in your shoulder better support the joint and decrease the wear that can come from overuse. The stronger your muscles are, the easier it is for them to do their job. As the muscles grow stronger over time, you may notice that you have less pain. These exercises can be done as often as every other day. It’s a good idea to aim for three strengthening sessions a week, with at least one day between each session.
Aerobic exercise. Endurance training, or aerobic conditioning, is important for heart health, and a healthy heart is better able to circulate the blood in the body and get necessary nutrients to your joints. Examples of aerobic exercise include walking, swimming, exercise classes, and bicycling. The American College of Sports Medicine recommends 30 minutes of aerobic exercise on five days a week. The 30 minutes does not have to be done all at once. For example, you can break it down into three separate 10-minute sessions.
No matter what, it is important to remember that your ability to use your arms to do everyday tasks depends on healthy shoulders. It only takes a little shoulder pain to make us realize how much we take these joints for granted. Not moving our shoulders because they hurt will only make them more difficult to use. Exercise can help improve the function of your shoulders and lead to less pain, and even small amounts of pain relief can make a huge difference in your quality of life. Don’t forget your shoulders in your everyday exercise routine.
Last Reviewed on February 23, 2011
Jennifer Trizuto is a senior physical therapist at Mills Health Center in San Mateo, California, and has worked with people with arthritis since 1994.
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