Hi, everyone and welcome to the Health video
series, Physical Activity and Inflammatory Arthritis,
sponsored by the Inflammatory Arthritis Support and Education
programs for the Latinx Community.
I'm Anna Belakrishnan, social work coordinator
for this program
Hi, everyone.
I'm Zach Rogers, physical therapist at HSS.
Hi, everyone.
I'm Sonia Ronacher, Spanish interpreter at HHS.
This video is in English, but if you are looking for Spanish,
please click the link in the description on the video,
and you will find the video translated and dubbed
in Spanish by our HSS interpreters.
[SPEAKING SPANISH]
Thank you all so much for being here.
Let's get started.
[SPEAKING SPANISH]
Zach, thank you so much for being with us again today.
Many patients have shared with us
that they want to know more about what
physical activity looks like when
they're experiencing chronic pain or chronic fatigue.
And as you know, all of the things
that we're going to talk about today
are in response to questions that patients
have shared with us.
Well, that's great.
I get a lot of those questions, and I'm happy to help.
Wonderful.
So let's go ahead and dive right in.
Let's do it.
So our first question is, should people with IA
exercise when they are having a flare
or experiencing pain and swelling?
Should they push through?
That's a great question, Anna.
It really depends.
Every patient knows his or her body best.
If you're having a flare-up, and you're
feeling more pain than you're used to feeling,
but the pain is manageable and pain is not sharp,
then yes, that patient can continue
to exercise when they have a flare-up.
But they should keep the exercises gentle,
and focus on bodyweight exercises only,
without additional resistance.
Now, what do I mean by the pain is manageable?
To me that means that a patient can complete
all of their daily activities without changing
the way that patient does them or without avoiding them.
If that's the case, then to me, the pain is manageable,
and they can continue to exercise with the modifications
I just mentioned.
But if the flare-up is more severe and the pain is sharp,
then they should just focus on gentle movements and ways
to decrease pain.
If the flare is much higher than baseline discomfort,
and the pain is sharp, then we don't
want to push through this.
OK, that's so important, thank you.
What about when someone with IA is experiencing chronic
fatigue?
Should they still exercise?
You know, that's another great question,
and the answer is yes.
In fact, actually research has shown
that regular exercise can actually
help to reduce chronic fatigue.
Wow.
OK, that's really good to know.
And it can be very difficult to exercise when you're
fatigued or experiencing pain.
And one patient shared with us that's it's
often hard to get out of bed, let alone
think about exercising.
So what do you recommend to patients
that are experiencing this?
That's a great question, and I get that question quite often.
My first recommendation is do exercises lying on your back.
If it's tough to get out of bed, there
are still ways to exercise and move
while lying on your back in bed.
You can do some stretching and mobility exercises,
and I'll demonstrate some of these.
We can also do some gentle strengthening exercises.
You can do exercises with high repetitions and less
resistance.
Usually that helps with chronic fatigue
and also helps patients move through the exercise
a little bit easier.
The other option which I find very helpful for patients
is to exercise for a short period of time.
Take a little rest break, exercise a little more,
take another rest break.
Exercises don't have to be all done at one time.
You can take rest breaks in between
to allow you to exercise more frequently, but not all
at once.
OK, great.
Could you give us some examples of those gentle exercises
you were talking about so we can see what they look like?
Sure, I'd love to.
I'll demonstrate those now.
Wonderful, thank you.
All right, so these are some gentle mobility
exercises you could do if you're experiencing a flare-up
or having a lot of fatigue.
The first one is just a simple side-to-side motion
with your knees while you're lying on your back.
So you'll be on your back flat in your bed,
and you'll bring your knees up to this position.
And you'll just gently move your knees side
to side, rocking back and forth, nice and slowly,
just a nice, gentle mobility exercise for your lower back
and your hips, just rocking back and forth, nice and slowly.
Now, the next exercise we're going to do is a clamshell.
And a clamshell is, again, something
you could do while you're on your back in your bed.
So you'll be lying on your back with your knees
in this position.
And what you'll do is you'll bring the knees apart just
like this, and then bring them back
to the center, nice, easy, controlled motion.
Move the knees back, bring them back to center.
Bring the knees out, bring them back to center again,
knees out, bring them back to center, yet
another great exercise you can do if you're having a flare-up
or having a lot of fatigue for one day.
So another exercise that can be done in bed
is double leg bridges exercise.
And what you can do for that is lie
on your back, feet and knees in this position, hands
at your sides, pushing through your feet
to lift your buttocks in the air and then down nice and slowly.
Again, pushing through your feet to lift your buttocks
in the air, down nice and slowly.
One other nice, gentle stretching
exercise that I like if you're experiencing a flare-up
or having some symptoms of fatigue is to lie on your back
and pulling your knees to your chest.
So you can lie on your back just like this.
Knees will be bent.
And you can pull one knee to your chest
like so, holding that for 30 seconds,
then bringing your other knees to your chest like so,
holding that for 30 seconds.
It is easier to do one leg at a time.
But if you're feeling up to it, you can try two legs at a time
and pulling both knees to your chest,
holding that for 30 seconds.
Thank you so much for showing us those.
And before we close, could you take a moment
to talk about icing or heat to relieve pain?
Sure, I'd be happy to.
That's a great question.
Icing can help to reduce inflammation.
This should help to relieve pain associated
with inflammatory arthritis.
Ice is great to use in an acute flare-up phase.
An acute flare-up phase means within the first 72
hours of a flare-up.
Flare-up to me means in general, as compared to your baseline
status.
You can also use ice directly after exercising
if your muscles are sore.
However, some patients with inflammatory arthritis
do respond better to using heat, especially if the pain
is more chronic and not acute.
To me this means acute pain is a flare-up
of three to seven days, where chronic pain means
more pain that's greater than three months
at the current time.
For me, I would try ice first for 15 to 20 minutes,
once or twice a day.
If this does not help, then I would try using heat next.
You could also go back and forth between these two options,
and you should try both of them if the ice isn't helping.
If you're not sure, contact your primary care physician
or your physical therapist, and that person can help guide you.
Thank you so much for sharing all of this information, Zach.
And thank you, everybody, for watching at home.
If you could just take a moment to share your feedback
by clicking on the link found in the description,
this helps us create programs and videos
that are most relevant to you.
Stay tuned for our next video.
Next time we're going to be talking
about what physical activity can look like when
you are at home or outside.
Thank you all so much.
Thank you for having me today.
Bye, everyone.