Arthritis

1. Arthritis Joint pain, joint enlargement, joint stiffness. Bridging the gap to comfort.

2. Resistance training will have the greatest effect on… • Arthritis • Osteoporosis • Range of Motion • Balance & Stability

3. Putting the tongue to the roof of your mouth will help with • Resistance training • Osteoporosis • Range of motion • Balance & stability

4. What is the most versatile resistance training? • Band training • Body weight training • Pilates • Free weights

5. Inflammation • Though the Medicines prescribed for Arthritis fight inflammation the more help they get the more comfortable your patients will be. • Natural anti-inflammatory’s in the form of food and vitamin support will help the comfort level.

6. Reduce the onset of inflammation • Keeping selected items out of your diet will help with the amount of inflammation one experiences. • Sugar laden foods and foods that convert to sugars promote inflammation. • White potatoes can trigger inflammation. • The fresher the better, inform patients that processed foods can increase inflammation.

7. Things you as a doctor or healthcare provider should know • Many people do not know how to eat healthy. • My personal experience with many diabetic clients that have met with registered dietitians still do not understand how to put together a quality meal. • Many people with Arthritis do not realize some foods agitate their condition beyond the realm of their medicines. • Still, sedentary lifestyle compounds the above.

8. Check With Your Dr. Before You Start • An exercise program, • Taking vitamins, • A diet plan

9. Food Diary • A very effective way to find trigger foods, is to have patient log the food for 3 regular eating days, logging the joint pain on a scale from 1-10. Then have them log three days of eating as healthy as possible then log their joint pain by the same scale. • Finding the foods that trigger the worst inflammation can lead to better control of the medications.

10. Pro-Active Patients • Giving your patients something to do for their condition grants ownership, which hopefully will lead to better quality of life. • Western medicine is known for increasing longevity. Help your patients live to the fullest during those extra years. • Getting your patients on board the healthy lifestyle train will improve your relationship with your patients, along with their livelihood.

11. Movement and Pain • Though stiffness and pain are a good excuse to sit still, they will further agitate the joint and inflammation within. • Movement is key on keeping the joints functional. • Joint noises scare patients, however as synovial fluid enters a tight joint it creates creaking sounds. Patients want to hear that these noises are o.k. from their Doctors. Patients are afraid to exercise, older patients especially. Try to reassure exercise is beneficial. • Fear keeps many people out of the gym.

12. Inflammation and Exercise • Instant gratification can not be expected in this model. Time is required to reap the gains to be enjoyed. • Strength training tears down the muscle for it to grow back with added density. This tear down leads to inflammation. Short term inflammation that leads to long term reduced inflammation. • As strength and adaptation take place the chronic inflammation of arthritis should subside.

13. Muscle Atrophy • Sedentary life styles, lead to unfulfilled lives. • Replacing weak muscles with strong muscles, leads to thicker ligaments and tendons along with less painful joints. • The compound nature of muscle atrophy leads to a path of added chronic aliments. • Remind patients with a sprained ankle they can still exercise their core and upper body. Patients want to hear this from their Doctor.

14. What keeps people coming back to the gym? • Friends or work out buddies • Body composition • Improved quality of life • Improved self image

15. Doctors please let your patients know; • Start Slow and build up • Keep an eye on heart rate • Soreness is expected • Reassure when fear interferes • Acute pain needs to be addressed • Ask patient what might prevent • follow through

16. Remember Heart Rate Formula? • Baby is born with Heart Rate 220 • Take away for age (say 35y) -35 • ________ • 100 % Heart Rate 185 Max • 85 % Cardio Range 157 • Interval up to 95% 176 < 1min • Recover at least 1min to increase VO2max

17. Use Heart Rate as a Guide • Most cardio machines have heart rate indicators. • Moving is good, staying within the 80% heart rate range of ones age is great. The body gets a clear message ; exercise the cardiovascular system. Better cardiovascular health leads to reduced overall inflammation. • This tool is a long term goal tool.

18. Weight loss • Every pound you loose = 4(four) pounds less pressure on Each knee. • Recommending exercise along with a healthy diet will improve joint function, reduce inflammation and improve quality of life. • Just getting on the path will encourage a more satisfying life. • Goals can be small to encourage continued success.

19. What is the best way to improve overall fitness? • Strength training • Pilates • Interval training • Running

20. Osteoporosis • Affecting 44 million • 2 Million bone fractures per year • Hip fracture most debilitating • Do exercises to increase bone density • Age 35+ is time to start preventative maintenance and maintain bone density and building bone density

21. Sarcopenia • Sedentary lifestyle leading to a downhill slide • The frail ARE afraid to get back moving; they need to hear it is O.K. from their Doctor to start back exercising. • They are Afraid of strength training which is the answer to restore function. • Please Reassure patients that starting slow and progressively increasing intensity level will improve lifestyle.

22. Multi-Joint Weight Bearing

23. Weight Bearing • Add 10% of bodyweight to Multi-joint exercises for osteoblast stimulation • The bones must flex slightly to stimulate growth

24. Resistance Training can improve lung function to a greater effect than cardio exercise? • True • False

25. What is the reason for this? • Stronger skeletal muscle • Valsalva maneuver • Improved CNS function • Greater pulmonary perfusion

26. Goal of Exercise • Long term pain reduction • Added stability • Increased Mobility and function • Reduced inflammation • Reduced medications less side effects • Improved Quality of Life

27. Fear of Falling • Vital exercise minimizes the threat of falling • So Many people sit, thinking this prevents falling. • Get your patients up to minimize falling • lack of muscle increases the threat of falling • Encourage Strength or Resistance Training for your patients that are able.

28. Osteo Target Populations • Small frame, slender body individuals • Fair skinned and Asian have increased risk • Outdoor sunshine a calcium builder • Calcium rich foods and supplements • Watch for Calcium destroyers

29. Body PH and the Immune system • Remember our immune system when operating properly can heal and improve many ailments. • Foods sway our body PH in and out of the optimum range. • Some side effects from medications can interfere, as well as sugars in the diet. A good rule of thumb here is “A Vegetable with every meal”.

30. Can the side effects of medications be overcome with exercise? • Yes, with diligence • No, the medicine is controlling • Sometimes depending on chemistry • Sometimes depending on medication

31. Depression can be minimized • By running 1 mile a day • Interval training • Exercising 30 min. a day • Exercising for 10 min. three(3) times a day

32. All of the above are valid • Any kind of exercise that increases the heart rate will improve the brain chemistry balance. • Consistency over time can minimize the need for medication.

33. Range of Motion

34. Lost as we age unless maintained • Strength is built in the range we exercise in, reduced range reduced strength. • ROM is sometimes lost due to adhesions that form in muscles due to improper form. Stretching alone can sometimes restore functional range of motion. • Body alignment is key to keeping range of motion in tact

35. Balance and stability A function of strength in the range of motion. • Core strength has biggest impact here. • Water workouts focus on core. • Tongue to the roof of mouth stabilizes core. • Pilates is great for core strength and most populations can accomplish all of the exercises, even bed ridden, and extremity injured.

36. Joint health • Moving an extremity through the full rang of motion supports the tissues, minimizes inflammation and encourages healing. • Massage works along the same principle. Joint health is key in restoring range of motion, which leads to greater strength. • Resistance training improve and regenerate the joints function.

37. Range of motion for independence • Moving extremities through the full range of motion often throughout the day vs. no motion can change the rate of age related muscle disintegration • Resistance training in addition can reverse muscle aging at the gene level. • Moving and stretching can restore function via adaptation and demand. Use it or lose it.

38. Enthusiastically Support • Individualized, positive reinforcement. • Give suggestions for better quality of life with movement and exercise.

39. Medications and side effects • Remember the side effects sometimes can interfere with the positive direction of overall health improvement. Take this fact into considerations when prescribing medications. • When a patients is doing the work to reduce the medications try a reduced amount to see if the exercise, or/ better eating is requiring less medication. This can further assist a patient in getting back on the functional track.

40. We Share the Same Goal • Getting our client/patient to live a rewarding life. • Hope that they will have the time and energy and mobility to live life to the fullest on a whim. • To maintain a stable outlook for desired improvement and a functional, comfortable life.