Instructions
Thanks to many previous studies, it is possible to identify the main groups of joints that need development. Undoubtedly, following a diet with limited salt and extractives is the key to the success of these measures.
Hand development
Exercise 1. Clasp your hands in a “lock”. You need to try to squeeze your finger as tightly as possible. We begin slow rotations in the wrists without releasing the hands. Five one way, five the other. We opened our hands.
Exercise 2. Take a small sponge and a cup of water, as shown in the picture. We connect the tips of all five fingers together on the sponge. Open your hand over the cup. Sponge in water. We connect our fingertips and press the sponge with a little effort. We take it out of the cup, only lightly holding it with all five fingers. Squeeze the water out of the sponge, gradually increasing the pressure. Repeat the exercise 5 times with one
hand, 5 times with the other.
Movements in small joints are more often impaired due to their incomplete use. The situation is simpler with large ones - the knee joints are developed one way or another while walking, the hip joints - sitting, standing up, elbow and shoulder joints - any movements of the arms.
The above exercises can be repeated up to 20 times a day. A few minutes are enough, but the load should be distributed evenly: if you did it in the morning, do it again in the afternoon and evening.
Leg development
We will pay special attention to the metatarsal joints and spine, and to a lesser extent to the knee and hip.
Exercise 1. We stand with our left foot, the right one stands perpendicular to the floor throughout. If difficulties arise, then at first you can get into a comfortable position, gradually approaching the desired starting position. We gradually and smoothly move the right leg back. At the same time, there will be a desire to lift your heel off the floor and place your foot on your toes. Resist to the last. Then smoothly move onto your toes. Rotate your heel in a circle as shown in the figure. 5 rotations clockwise, 5 counter-clockwise. Finished
rotation and continue to move the right leg back. We try to keep the pelvis moving as little as possible. We repeat the same with the other leg.
Exercise 2. We have known it for a long time since childhood. We develop the ankle joint. Place your feet 10 cm apart from each other. Raise yourself on your toes and bring your heels together. They rose again and spread their heels to the sides. Repeat 15 times. We rested on exercise 1 and started again on the second.
When performing exercises, you should always observe moderation. No one can guarantee that if you do them 100 times, you will recover. However, your health will definitely improve.
Rheumatism is a systemic inflammatory disease of connective tissues that causes complications on the central nervous system, cardiovascular system and joints. This disease most often affects school-age children from 7 to 15 years old. Rheumatism can occur with infectious diseases such as tonsillitis, scarlet fever.
Therapeutic exercise for childhood rheumatism
Main tasks and goals of exercise therapy
The main objectives of physical therapy for childhood rheumatism are to increase tone and reduce sensitization of the body, improve compensation due to the activity of extracardiac circulatory factors, as well as adaptation to physical activity.
The goal of exercise therapy is to increase the emotional tone of a child with rheumatism, through physical exercise to strengthen the nervous system, respiratory function, joint mobility, improve blood circulation and normalize the metabolism of the child’s body.
A set of therapeutic exercises for children:
- In combination with breathing, we begin a set of exercises with walking for up to 1-2 minutes.
- One hand is at the top and clenched into a fist, the other is at the bottom and for each step we alternately make jerks with our hands, then we changed hands - up to 6-8 times.
- Arms extended forward: we make two jerks to the sides with bent arms, then two straight jerks - 4-6 times.
- We move our arms to the sides, bending our elbows: we make four circular movements forward, then four back – 2-3 times.
- We clasp our shoulders with our fingers: we make four circular movements with our shoulders forward, then four back – 2-3 times.
- Race walking 1 minute.
- Easy running: - hands on the belt and twist the shins back;
Hands behind the head, side step, alternately first with the right side, then with the left. Repeat for 2-3 minutes.
- Race walking 1 minute.
- We restore breathing in the usual steps of 1-2 minutes.
Standing exercises:
- At the same time, we rise on our toes, arms up through the sides - inhale, then lower ourselves - exhale - and so on 3-4 times.
- We place our hands on the waist with our legs apart: we tilt the body first to the left - exhale, then return - inhale, repeat only tilting the body to the right - exhale, return - inhale - 4-6 times.
- Hands up - legs apart: bend forward - inhale, make springy bends towards the toes - exhale, return - inhale - 4-6 times
- Hands moved to the sides - legs apart: alternately we pull up with our hands first the left knee to the chest, then the right one, not forgetting about breathing when pulling up - exhale, at the starting point - inhale - do the exercise 6-8 times.
- arms and legs in the same way as the previous exercise: bend forward and touch the left toe with your right hand - exhale, return - inhale, then bend forward and touch the right toe with your left hand - exhale, return - inhale - 6-8 times.
- Hands placed on the belt - legs apart: at the same time bending forward, and arms to the sides - exhale, touch the floor - exhale, then arms to the sides - exhale, return as you inhale - do 4-6 times.
- The position of the arms and legs is as in exercise 6: we stretch our arms in front of us, rise on our toes, then move our arms to the sides, return – from 4 to 6 times.
Lie on your back:
- They clasped their shoulders with their fingers: inhaled with their arms to the sides, exhaled to the starting position, 3-4 too - from 4 to 6 times.
- The arms are moved to the sides: we bend the knees to the chest, then straighten the legs up, then bend them, lower them – 4-6 times.
- Hands in the same position: we move our right leg to the side, then we move it behind our left leg - we touch the floor, again to the side, and repeat the same with the other leg - 4-6 times.
- The arms are moved to the sides, the legs are placed on the feet: we raise the pelvis, then lower it, then lower the knees to the right - we touch the floor, and repeat with the knees to the left - 4-6 times.
- Arms to the sides - legs extended: we lift the legs up, then spread them to the sides, then bring them together, lower them - repeat 4-6 times.
- Hands behind your head, riding a “bicycle” - 30-50 times.
- Diaphragmatic breathing - place one hand on the stomach, the other on the chest - when inhaling, inflate the stomach, when exhaling, lower it - 2 to 3 times.
- Hands up: lifting your head with your hands, first pull your right knee to your chest, lower it, then your left knee – 4-6 times.
Side exercises:
- We lie down on our right side, our right hand under our head, our left hand on our palm, resting in front of our chest: we raise our left leg, move it back, and swing forward - 4-6 times.
- The position is similar to the previous one: raise the left leg, right, hold, lower – repeat 4-6 times.
- The position is the same as in the first and second: we lift parallel legs from the floor with the “scissors” exercise, then we turn over to the other side and do a similar exercise - 10-20.
Laying on your stomach:
- Hands under the chin: lift with straight legs, then spread to the sides, bring together, lower - 4-6 times.
- Place your hands in a lock behind your back: raise your head and chest, connect your shoulder blades, shoulders back, hold, lower - from 4 to 6 times.
- Hands in front: raise your legs, raise your arms, bend over (raise your legs and arms a little higher), lower them - 4-6 times.
- We place our hands under the chin: slowly rise on your hands until your elbows are straight, and also slowly lower yourself – 4-6 times.
- Hands under the chin: we “swim” with our legs in a crawl style, our knees do not touch the floor - repeat 10-20 times.
- Hands forward: “swim” with breaststroke with your hands – from 10 to 15 times.
- The arms were extended forward: raise the arms and legs at the same time, spread them to the sides, then bring them together, lower them - 4-6 times.
- Hands behind your head: raise your arms and legs, elbows to the sides, lower - repeat 4-6 times.
- Push-ups from the floor 10 times.
- The most important component in the treatment and restoration of a child’s body with rheumatism is proper balanced nutrition. Depending on the severity of the disease, you should follow diet therapy, which is selected by your attending physician. Products must contain vitamins: A, C, E (vegetables and fruits, nuts, olive oil, etc.). As practice has shown, in most cases, rheumatism develops more often in children with a deficiency of these vitamins. You should include lemon or rhubarb in your diet as a dressing for vegetable dishes. Foods containing polyunsaturated fatty acids have an anti-inflammatory effect: salmon, sardines, mackerel. Selenium is indicated to reduce muscle pain: brewer's yeast, chicken eggs, cereals, fish oil, etc. You should not consume products containing, sugar, white bread, hard-to-digest food, fatty foods, you should refrain from foods containing salt and hot spices, and also exclude strong black tea.
- Among therapeutic and preventive measures, an important role for rheumatism is given to sanatorium-resort treatment, but this decision must again be agreed with the attending physician and in the inactive phase of the disease 6-8 months after the initial or re-diagnosis. Only a doctor can give recommendations on what period of illness a trip is advisable.
- For preventive purposes, it is necessary to use the method of hardening the child’s body. It should be remembered that the procedure should be regular, with a gradual increase in dosage and duration. The child learns to adapt to sudden changes in temperature, humidity, and physical and mental stress. With systematic hardening, the body's resistance to colds increases, which means it is possible to eliminate repeated complications.
If you have been diagnosed with rheumatism, one of the best ways to combat the disease is physical therapy. This treatment method is considered as effective as taking medications. For rheumatism, a physical therapist will use a variety of treatment methods: electrical stimulation, heat and cold, exercise therapy, and adaptive equipment. All measures will be aimed at eliminating swelling, inflammatory processes, as well as improving the general condition of patients.
In most cases, physical therapy is long-term. Therefore, the patient must select a treatment and exercise program with his physiotherapist, and think through a training plan that is suitable specifically for this patient.
Exercises during physiotherapy
As a rule, rheumatism occurs in patients as a chronic disease, which has an active and inactive phase. Rheumatism reduces the standard of living, can lead to incapacity for work, and in some cases even disability. Therefore, in practice, patients undergo step-by-step rehabilitation. Initially, the patient is sent for treatment to a cardio-rheumatological sanatorium, hospital or clinic, then he is registered with a doctor, during which observation is carried out, preventive measures are carried out and massage and exercise therapy - therapeutic physical education - are recommended. After the active phase of the disease subsides, patients are recommended to undergo sanatorium-resort treatment, which expands the motor mode.
The main exercises for expanding the motor regime are: walking, exercise therapy, exercise on exercise bikes, swimming. With a strictly established regimen, exercises are prescribed that improve blood circulation. Movements are performed with incomplete amplitude and are supplemented with imitations of exercises, games, game tasks, and exercises that improve posture.
Stretching complexes
A well-designed exercise therapy program is extremely beneficial for the overall well-being and functioning of an individual diagnosed with rheumatism. This program includes exercises designed to stretch, strengthen and improve mobility.
Sets of tasks aimed at stretching can be prescribed for rheumatism that has passed from the active to the inactive stage. Physical therapy is contraindicated for painful, inflamed joints, as it will not help provoke an exacerbation of symptoms. Active or passive exercises aimed at stretching all major joints and muscles can prevent the formation of new lesions in non-inflamed joints and help maintain the range of motion that a healthy person performs in everyday life.
Yoga offers the best stretching techniques to patients today. Her methods include concentration and meditation, breathing complexes. Some of the types of exercises offered by yoga, qigong and other eastern healing cultures allow patients to experience pain relief while also improving flexibility, mood and quality of life at the same time.
Strengthening complexes
Strengthening exercises, like stretching exercises, should be used by patients during the inactive phase of rheumatism. While isometric exercises, which can be done even in a strict exercise regime, will help maintain strength, prevent injury and eliminate fatigue. Isometric exercises are static and aim to tense muscles without visible movement. Isometric exercises strengthen the muscles of the chest, hips, and shoulders.
Water exercises
They are very useful for rheumatism. Swimming is a great way to improve the condition of your joints and strengthen the muscles of your back, hips and limbs. You should start aquatic physical exercises in water with 5-6 minutes in a pool with warm water. To perform the exercises correctly, you can use special water equipment: swimming boards, inflatable rings, mattresses, arm cuffs. Gradually, the duration of training should be increased to 30 minutes. You can stay in the water longer under the supervision of a doctor if the patient enjoys water exercises. Each time, the intensity of the exercises should be increased in order to more actively move towards recovery.
Cardio training
Cardiophysical training develops performance, strengthens bones and skeletal muscles. It contains light aerobic exercises: walking up steps, hiking, rhythmic dancing, exercises.
Aerobic cardio exercises are initially best done for a few minutes, then gradually increase the duration of the workouts, speed up the pace and dynamics. Cardio exercises should be performed every day in separate blocks.
Physical exercise allows patients to achieve not only excellent athletic shape, but also significantly strengthens the heart. In addition, exercise therapy reduces high blood pressure and normalizes cholesterol levels in the blood. Walking and dancing prevent osteoporosis, which is common in rheumatism.
Power training
They can significantly strengthen muscles and bones. It is recommended to perform exercises no more than 2 times a week. Strength therapeutic exercises help strengthen the body and improve joint mobility. It also relieves pain. This phenomenon is observed due to the fact that a strong body holds joints better. In addition, strength exercises improve metabolism, burn excess calories, and normalize weight. A set of strength exercises is performed using dumbbells, an expander, strength training equipment and a barbell.
Alternative methods that physical therapy includes
Physiotherapy includes alternative methods such as acupuncture and massage. Acupuncture is an ancient oriental healing culture. It stimulates certain points in the body using very thin needles. Proponents of acupuncture claim that the method releases the body's hidden power, activates beneficial hormones known as endorphins, thereby healing the body and eliminating pain.
Depending on the patient’s well-being, doctors may prescribe a massage, which in some cases can bring relaxing and pleasant sensations, and sometimes will force you to endure excruciating pain. Therefore, the qualifications and experience of a massage therapist for this procedure are very important. If joints and muscles are in an inflamed and painful state, they will benefit from a relaxing, high-quality muscle massage, which will relieve stress, help the patient relax and feel much better.
One of the most important things for rheumatism is moderation in treatment and proper selection of exercises. If you have rheumatism, you should not overdo it. If the patient needs rest, he should always get it in the amount he needs. Excessive stress can cause fatigue and only worsen the treatment situation. With a chronic course of the disease, you cannot isolate yourself and distance yourself from life. It is necessary to be open with family, friends, and medical professionals. If you need urgent help, it will come to you in a timely manner and in the required amount.
Be sure to consult your doctor before treating any illness. This will help take into account individual tolerance, confirm the diagnosis, ensure the correctness of treatment and eliminate negative drug interactions. If you use prescriptions without consulting your doctor, it is entirely at your own risk. All information on the site is presented for informational purposes and is not a medical aid. All responsibility for use lies with you.
Article publication date: 03/18/2014
Article updated date: 06/04/2019
Rheumatoid arthritis is characterized by joint deformation, limited mobility and the development of contractures (immobility). To reduce symptoms, treatment includes exercise therapy, massage, swimming and physiotherapy. Therapeutic exercise for rheumatoid arthritis is aimed at strengthening ligaments and muscles, increasing range of motion in joints and slowing down pathological reactions.
Indications and contraindications for physical education
Exercise therapy is indicated for almost all patients. With significant restrictions, it is possible to perform breathing exercises or positional treatment (more details -).
The main contraindications for prescribing physical education:
- exacerbation of rheumatoid arthritis, accompanied by severe pain and inflammation;
- systemic manifestations of the disease with serious damage to internal organs (vessels, kidneys, heart, lungs);
- some concomitant chronic pathologies (infections, cardiovascular and respiratory failure).
Basic methods and stages of classes
All approaches to physical therapy for rheumatoid arthritis can be divided into three groups:
Individual classes are ideal for patients with the most severe stage of the disease, as well as for rehabilitation after surgical treatment.
Group classes are the most accessible and rational approach. Patients are grouped according to the degree of mobility limitation.
During consultations, patients are taught techniques and exercises that they can use at home.
The main condition for exercise therapy is regularity of classes and a systematic increase in load. Exercises should not be performed with force: after proper physical activity, the patient should experience an increase in strength and a decrease in stiffness.
During inpatient treatment, three periods of rehabilitation can be distinguished:
Preparatory, when the doctor teaches the patient relaxation and breathing techniques. The duration of these exercises is about 10 minutes, the duration of training is 1–2 days.
During the main period, a basic set of exercises is performed. Classes take place daily for two weeks, each lasting about half an hour.
The final stage is carried out before discharge: the doctor teaches the patient exercises that he can do at home.
Treatment by position
The “position” method of treating rheumatoid arthritis is also classified as exercise therapy and is used for severe lesions, when the patient is practically unable to move and is mainly in bed. It should also be carried out during periods of exacerbation of the disease.
What is its essence? The mattress on which the patient lies must be smooth and hard; it is advisable to use a special orthopedic one. The feet should have support; for this you can use either a moving headboard or a stand. You need to change your body position at least once an hour, if necessary with the help of another person.
If contractures begin to form, special splints (hard strips of plaster-impregnated bandages) are applied. If this is difficult to do, you can use rollers, weights and other devices. For example, if the hip joint is affected, a two-level mattress is made, allowing the leg to be extended in a relaxed position.
Hand exercises
In rheumatoid arthritis, the joints of the fingers are most often affected. Usually the hand takes on the characteristic appearance of a flipper, which leads to limited functionality and disability.
To reduce the strain rate it is advisable to:
- do not move your fingers towards the little finger;
- reduce the load on the fingertips;
- when at rest, ensure the correct position of the hand;
- write only with cone-shaped thickened pens;
- perform everyday activities correctly: trying to ensure that the axis of movement in the joints does not deviate to the side;
- at night, use orthoses - devices that limit mobility.
Here is one set of exercise therapy exercises for hand injuries:
Starting position: hands in front of you, next to each other. Alternately turn your palms up and down.
Place your hands on the table and raise and lower them first, and then only your fingers.
Stretch your hands clenched into fists forward. Rotate the brushes clockwise and counterclockwise.
Place your elbows on the table, clasp your palms, spread and bring your elbows together without lifting them from the surface.
Make up-down, left-right and circular movements with each finger in turn.
Touch each finger to the thumb, as if grasping something round.
Squeeze and unclench the soft ball in your hand, roll it over the surface.
Rotate your hands at the wrist joint, while trying to relax your palm.
Move your fingers along the stick from bottom to top.
Rub your palms together.
Each exercise should be performed 5–7 times, depending on the patient’s condition. There should be no pain during exercise.
Click on the picture to enlarge
Exercises for lesions of the shoulder girdle
Raise and lower your shoulders, make circular movements forward and backward.
Place your palms on your shoulders, alternately bringing your elbows forward.
Clasping your elbows with your palms, raise them and lower them.
Lying on your back, bend, raise and lower your straightened arms.
Place your hands on your belt and alternately place them behind your head.
Hug yourself.
During exercises, it is very important to maintain the correct breathing rhythm.
The above exercises are called dynamic, that is, related to the movement of the body in space. They are mainly aimed at restoring mobility and preventing contractures.
There is another type of load in which muscle work is not accompanied by movement of the limb, since it is fixed: isometric. Isometric exercise helps strengthen muscle fibers, even with severe mobility limitations. An example of such an exercise: lying on your back, press with straightened arms on the surface.
Leg exercises
Lying on your back, bend your leg at the knee joint without lifting the soles from the surface (sliding steps).
Exercise bike.
Move your legs bent at the knees to the sides and bring them back.
Swing with a straight leg while lying and standing, holding onto a support.
Circular movements in the hip joint with the leg bent at the knee.
Raising straight legs to the sides in a lying position.
Circular movements with a straight leg.
Isometric exercises are performed with the help of an assistant, who provides resistance and prevents the limb from moving.
Ankle exercises
With rheumatoid, it is not often affected, but its deformation quite quickly leads to limitation of movements and disability. To prevent contracture, it is recommended to perform the following complex:
While sitting, bend and straighten your feet and toes.
Roll from heel to toe and back.
Stand on your toes against a support.
Try to lift various objects from the floor with your toes.
Roll a stick or ball with your feet.
Walk across the stick, stepping on it with the middle part of the sole.
Make circular movements with your feet.
When performing any complex of therapeutic exercises, it is advisable to alternate isometric and dynamic exercises, breathe correctly, and at the end of the session, conduct a muscle relaxation session.
To increase the load, you can gradually increase the range of motion in the affected joints and the number of repetitions.
Exercises in water
Of all the sports, swimming is most suitable for the treatment of rheumatoid arthritis, since in water there is no stress on the joints due to the weight of the body. With a weight of 60 kg, completely immersed in water, a person feels only 7 kg. Therefore, exercises in the pool can be performed even by patients who practically do not move.
The intensity of the load is determined by the degree of immersion, which allows you to gradually restore motor activity. Higher water density requires greater effort to overcome resistance.
The temperature in the pool also has a positive effect: with thermal exposure, the pain syndrome is significantly reduced.
Contraindications to water activities:
- open damage to the skin;
- allergy to chlorine;
- eye diseases (conjunctivitis);
- lesions of the ear, nose and throat;
- venereal diseases;
- some chronic pathologies of other organs and systems.
In the pool you can perform the following complex:
Walking with straight and bent legs. It is advisable to spread your arms to the sides so as not to lose balance; if necessary, you can hold on to the support. The water level is adjusted depending on the required load.
Swing your legs back and forth, to the side, in circular movements.
Squats with legs wide apart (it is important to keep your back straight).
Having immersed yourself in water up to your neck, spread your straight arms to the sides and perform circular movements in the shoulder, elbow and wrist joints.
The swimming itself can be free or facilitated (using fins, special foam boards or inflatable objects). Depending on the goals pursued, you can increase the load on your legs or arms.
Functional motor test
Before the start of the rehabilitation period, the physical therapy doctor assesses the degree of damage to the patient’s motor system. To do this, you can use various tests, but the most popular is the functional motor study, which lasts only 5–6 minutes. The doctor asks the patient to perform various actions, for each of which a certain number of points is assigned. The test results allow you to objectively assess the dysfunction:
- No functional limitations.
- Maintaining professional ability to work.
- The ability to work is completely lost.
- Cannot take care of himself.
Based on the results obtained, patients are divided into groups and the optimal complex of exercise therapy is selected.
If you have rheumatoid arthritis, don’t give up on yourself. Start doing special exercises. Daily physical therapy exercises will tone your muscles, improve your well-being and increase your mobility. Before starting gymnastics, you should consult your doctor.
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