Thursday, October 7, 2010

Dealing with Lupus Fatigue (Part 3)

“Might as well jump. Jump!  Might as well jump. Jump! 
Go ahead, jump. Go ahead, jump. Jump!”


If your joints hurt, you may not feel like exercising. However, if you don't exercise, your joints can become even more stiff and painful. Exercise is beneficial because it keeps your muscles, bones and joints healthy. If pain is a limiting factor, gentle, slow, active or passive range of motion is important. This will keep the joints active and prevent them from getting stiff.

It is important to maintain strong muscles. The stronger the muscles and tissue around the joint, the better they will be able to support and protect those joints  even those that are weak and damaged. If you do not exercise, your muscles become smaller and weaker, and your bones can become more brittle and prone to fracture.

Many people with lupus keep painful joints in a bent position because at first it is a more comfortable position. If joints are left in one position for too long (without movement), they may lose their ability to straighten. Exercise helps keep joints mobile and flexible, which allows for daily tasks to be completed as independently as possible.

Risks of Exercise

The most common risk of exercise is aggravating your lupus by working your joints or muscles too much. This can happen if you exercise too long or too hard, especially when you are beginning an exercise program. It is important to start out slow and monitor how your body reacts to the exercise.

Three Main Types of Exercise

People with lupus often benefit from a balanced exercise program including different types of exercise. Three main types of exercise that should be included in your exercise program are range-of-motion, strengthening, and endurance exercises.

Range-of-motion (ROM) exercises reduce stiffness and help keep your joints flexible. ROM is the normal amount your joints can be moved in certain directions. There are two types of ROM exercises: passive range-of-motion and active range-of-motion.

Useful during a flare, passive range-of-motion (PROM) exercises involve someone assisting with performance of the movement and there is no muscle contraction. An example using the shoulder flexion exercise would be someone moving your arm forward and above your head.

Active range-of-motion (AROM) exercises are useful immediately following a flare. They involve you performing the movement without assistance throughout the full range of movement. A muscle contraction is present in this type. The shoulder flexion example would be actively raising your arm forward and above your head.

The second main type of exercise, strengthening exercises, help maintain or increase muscle strength. Strong muscles help keep your joints stable. Two common types of strengthening exercises for people with lupus are isometric exercises, in which you tighten the muscle but do not move the joint, and resistive isotonic exercises in which the joint is moved.

In an isometric exercise, there is no joint movement, the overall muscle length stays the same, and a muscle contraction is present. These exercises are useful for joint strengthening with joint protection. In the shoulder flexion, facing a wall, you would place your fist firmly against the wall and push forward.

Resistive isotonic exercises involve performing a movement with some form of external resistance (i.e. theraband, free weights, machines). A muscle contraction is present and this type is indicated for high level strengthening. In the shoulder flexion exercise, you would have a weight in your hand and raise your arm forward and above your head.

The third main type of exercise is aerobic or endurance exercises which improve cardiovascular fitness. They make your lungs more efficient and give you more stamina so that you can work longer without tiring as quickly. Some of the most beneficial endurance exercises for people with lupus are walking, water exercises, and riding a stationary bicycle.

Tomorrow, I will discuss how you start an exercise program…

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