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Exercising with Arthritis

by Fred Hahn on April 21, 2011

(This is what I am desperately trying to avoid!)

As many of you know, my knees are shot. Years of Karate, jogging, and growing up with bowed legs have left me with crippling medial compartment knee arthritis. I’m also certain that all the grains I’ve eaten (and drank) contributed to their early demise as well.

I want to share some ideas with you on how to exercise and strengthen the muscles that surround compromised joints. I’ll explain some things I’ve done with myself and my clients that will hopefully give you some practical solutions to make and keep you as strong as possible if you suffer from similar joint maladies.

Do What You Can Do
This may seem obvious, but the first thing you want to do is discover the exercises you can do throughout a full, pain-free range of motion. Do these exercises regularly.

For example, for some people who have tennis elbow (which is inflammation of the tendons that attach the biceps and other arm muscles to the forearm bones), it can be very painful when performing biceps curls but not triceps extensions. So, make sure to keep full-range, triceps extensions in your routine. Below is a video of me doing a set of Slow Burn, full-range, triceps extensions:

Limiting Range of Motion
A lot of people irritate and injure their tendons and some of the smaller “stabilizing” muscles when they start their exercises in a position where the joint or joints are completely extended – especially if they start the exercise in an explosive fashion.

There is a better way!

As an example, if you are doing a biceps curl, start from a slightly bent elbow position as seen below:

Granted, my elbows are a bit more bent than need be in this picture but you get the point.

Here is a video of me doing a set of biceps curls. Note the slight bend in my elbow at the start and note the very slow and deliberate start of each rep. No jerking!

This will take the strain off of the tendons when in a fully stretched position and still develop full-range strength and muscle mass.

Modify all your exercises to limit the range of motion so that the start is a few degrees shy of complete extension. My friend Bill DeSimone wrote a very good book on understanding proper biomechanics called Moment Arm Exercise. It’s a must for your training library. It is not overly heady.

To decrease the starting point, pin-off the weight stack as seen below by placing the stack pin where you need to to limit the range:

Piining off for blog

And when you increase your weights, use very small add-on plates so that the weight increases are barely felt. Increasing your weights by a mere half pound each session can add up to significant increase in weight over time. If you train twice weekly, and add a half pound to an exercise each session, that’s a whopping fifty two pound increase in weight in one year. Not too shabby!

Below is a picture of old style Nautilus “saddle plates” that range from one half to five pounds:

saddle plates.jpg

Weight or Reps?
I’ve also found that using heavier weights for less total reps can, for some people, be superior to lighter weight for more reps. Sometimes less joint articulation is better for certain arthritic conditions. You’ll need to use trial and error to see what works best for you.

Don’t automatically assume, as many well-meaning physical therapists often do, that arthritis means you must use light weights for high reps. Not always. Don’t be afraid to use heavy-ish weights even though you have arthritis. If your form is good and your rep speed controlled, you won’t hurt yourself.

And sometimes you’ll have to switch it up. Go with the flow and never ignore discomfort. Keep your mind on your muscles (and joints!).

Train hard, but train smart!

I've been involved in exercise ever since I became a member of The Charles Atlas Club when I was 10 years old. In 1998, I founded and established Serious Strength on the Upper West Side of NYC. My clients include kids, seniors (and everyone in between), top CEOs, celebrities, bestselling authors, journalists and TV personalities.
my book. my Gym.

in Arthritis,Health/Fitness,strength training · 11 comments

{ 11 comments }

Seán April 21, 2011 at 7:34 PM

I notice your curl machine allows you to bring in the curl nice and tight to the shoulder area. I think this is because the handle moves as you come into the end of your curve. The one I am using does not move and so the curve is a little wider than my reach and so at the end of the curve I kind of can’t get that last part. Should I keep on with this machine? Should I go to free weight curl? As a substitute I have been using a cable machine similar in execution to the tricep extension above, but opposite (and one arm each). I feel the burn, but I wonder if I am getting the full benefit, particular in the same range as I am having a problem with on the first machine. The machine (both arms) is set to 85 lbs currently. The other machine I do individual arm set to 22.5 lbs.

Anne April 22, 2011 at 3:16 AM

Thanks for this invaluable information Fred !

With my tennis elbow, I find I can do biceps curls but only concentration curls where my elbow is resting on my knee, I’ve not tried the biceps curl machine in a while so I might do that. But I can’t do triceps extensions: it doesn’t hurt while I do the triceps extensions but later the elbow becomes painful. I’m glad to know that we can still use heavy-ish weights with arthritis as long as form is good and speed controlled – I find it’s frustrating that my muscles seem to be too strong for my joints.

Dwayne Wimmer May 8, 2011 at 7:04 PM

Fred,

This is a GREAT post. I would like to repost it on the Vertex Fitness blog, with your permission. This is information that I think our clients could benefit from reading.

Thanks for the post, I am looking forward to more.

Dwayne Wimmer

Fred Hahn May 9, 2011 at 11:51 AM

Please do Dwayne and thanks for the kind words!

Edward Caiazzo September 9, 2011 at 3:25 PM

I’m very happy to report that lifting light weights with high reps (3 lbs. for 40-50 reps) completely cured my nagging arthritic condition in my elbow. I endured the terrible naggin “on & off” pain for almost 7 years. Finally, in desperation, I started lifting very light weights with high reps for relief. It became my medicine for a couple of years. The big surprise was that it eventually, TOTALLY CURED the condition! It has been almost three years since I “lifted for relief” and my right elbow has been 100% pain free since then. This was a most welcomed surprise, as I thought I would have to live with the intermittent pain for the rest of my life.

Once again….it’s almost three years since i’ve experienced any pain whatsoever. After a couple of years of lifting, my elbow continues to be completely PAIN FREE. Just thought I’d share this great news with anyone who is despondent.

mst April 11, 2012 at 9:33 AM

Fred,
If over 2-3 workouts your time until failure and weight has not gone up, should you go ahead and microload, or keep the weight the same until the TUF increases? Thanks so much for all the info.

Fred Hahn April 11, 2012 at 10:21 AM

MST –

The only way the weight will go up is of you raise it! 🙂 Yes, as long as your time to failure doesn’t dramatically lower, after raising the weight, raise it every time.

EX: You use 100 pounds in an exercise and your time to failure (success!) is 70 seconds. You raise it to 105 and your time to failure is 66 seconds. That’s fine. Raise the weight the next session. Now as you go along if your times stay around 60-70 or so keep adding weight and consider micro-loading too.

BUT if your time goes down to say 50 secs, keep the weight the same.

Hope that helps!

mst April 11, 2012 at 3:07 PM

Thanks!

Michelle February 8, 2013 at 2:05 PM

I just came across this page looking for info for others. I myself have arthritis in my elbows, among other places, and tennis elbow in my left arm, which I did get from playing tennis lol, but last year, I began weight lifting for my over all health, and the tennis elbow was the biggest issue, yet after massaging it a certain way before each set, I was able to complete everything, although with minor pain, but I was able to increase the weight after a couple of weeks went by. I was also able to continue increasing the weights and the pain virtually went away. It does come back from time to time when I stop lifting for health reasons, or the weather pressure may activate it, but for the most part, it is under control. I love your videos. I wish I had them prior to lifting. It would have really helped me instead of going through trial and error. I used those methods for a while in the beginning of lifting, and it worked wonders in my growth.

john Waters August 5, 2015 at 10:49 PM

Thank you for posting this article about problems in your elbow. I also have them. Will try light weigh tricept work.

john

Alessio Ventura May 14, 2016 at 1:28 PM

I am surprised that you mention heavy weights as potentially being helpful for arthritis.

I played football thru the college level and heavy weight training was mandatory. Many of us wound up with dabilitating arthritis in our later years as a consequence. Now, heavy lifting is done in Crossfit and it is applied equally across all participants. I see more people now developing arthritis.

I truly believe that light weight, full range of motion, with high reps is the best way to go. You achieve strength gains, increase endurance, and you look much better. Go heavy once a week, if that.

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