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Rheumatoid arthritis (RA) is defined as a chronic, autoimmune, inflammatory disease that affects multiple joints in the body that are lined with synovial fluid. Physical therapy interventions can benefit rheumatoid arthritis patients who suffer from the major problems of the condition. With rheumatoid arthritis described as a chronic autoimmune disorder, the consequences to joint surfaces and increased morbidity make patients susceptible to loss of muscle mass, range of motion and diminished aerobic endurance. Since the marker of this disease is joint destruction, the most important benefit to note is the impact exercise has on improving joint health.
Transcutaneous electrical nerve stimulation (TENS) is a therapeutic intervention indicated for pain control and muscle stimulation. The ambiguity of the effectiveness of TENS can be related to the type of intensity and frequency administered.
A Cochrane Review in 2010 evaluated the effectiveness of continuous ultrasound in the treatment of RA. Patients with rheumatoid arthritis often have joint deformity and severe pain manifesting in the great toe, heel, and lesser toe. The use of splints may be able to provide relief for a rheumatoid patient in acute stage of the disease. Physical therapists can employ the use of assistive devices for patients with RA to improve functional ability and independence in daily activities.
Sources such as the Mayo Clinic and the Cleveland Clinic discuss that there are other ways to promote joint health in RA patients.
By James Smith Here are some free stretching programmes to help keep your lower back in good order. How successful an exercise program is in relieving back pain depends on whether other factors that are contributing to back pain have been corrected  particularly chronic poor posture, which increases stress on the back muscles, ligaments and discs. NOTE: Starting out with exercises that are too difficult (for your current level of fitness) or doing too many can cause back pain. Note: If you have a back injury or condition or back pain, consult a physiotherapist who can advise you what exercises and how many repetitions of each exercise would be the safest and most beneficial for you.
Back Exercises to strengthen the muscles that support the spine can prevent, reduce and in some cases eliminate lower back pain. Side plank exercise is another effective back strengthening exercise that is effective in ensuring the ultimate strength and endurance of the entire core and usually beneficial in helping the lower back to be quite stable. Bird dog back exercise is another vital back strengthening exercise that is known for its ability to improve the balance of spine muscles thus resulting in a stable spine when one is engaged daily activities such as walking and running or lifting light loads.
Romanian dead lift is usually a good back strengthening exercise that is of high beneficial for both the lower and upper back, with these exercise one will require a set of dumbbells or a barbell. Back strengthening exercises ought to be part and parcel of one’s life as they tend to determine how one will be able to live a normal life, lack of back strengthening exercises is many a times known to lead to severe back pain of which tend to render the flexibility of one’s self.
Back strengthening exercises are also known to lead well balanced muscles along the spine thus aiding normal movements, this exercises area also good at stretching the hip flexors thus ensuring stabilization of the spine. As people age they may notice that their balance seems to become more of a problem to maintain. The first step is to make the decision to do what you can to prevent or minimize balance problems. Lower Back Exercises – Lower back stretching exercises should be done prior to lower back strengthening exercises.
Lower Extremity Exercises – Hamstring and pelvic muscle stretches are performed with the lower back exercises. Exercise Ball – Sitting on a ball and going through a balance routine is very helpful not only for balance, but to help with strength and proprioception of the spine. The next and more involved exercise includes getting 5-6 cones and placing them in a line about 6-8 feet apart.
The doctors at Coon Rapids Chiropractic Office have experience in assisting with exercise recommendations and suggestions to help improve your balance. Originally published in Yoga Journal Magazine, this article has been translated into Spanish and published in Om Yoga Venezuela Magazine, available online on page 31.
Supta Padangusthasana is my go-to pose for lower back pain.  In this asana the back muscles and hamstrings are safely stretched while the back is supported by the floor, preventing it from rounding or pushing backwards. Tight hamstrings should not deter you from practicing this wonderful asana and using the belt in the first variation makes it accessible for all.  The second variation stretches the inner thigh adductor muscles and can be very helpful for setting an uneven sacrum as well provide relief for those in the throws of sciatica pain. Press the front of your left thigh straight down into the floor.  Turn the left thigh inwards so that the inner thigh and knee remain grounded. If you aren’t able to completely straighten both legs or if in the process of lifting your right leg higher your right buttock rises from the floor, slide your hands down the belt and take your right foot further away from your head. Now you can start to bend your elbows and see whether or not you can bring your right foot closer to your head. Hold for up to one minute and then bend your right knee and release your right leg down to the floor.
Press the front of your right thigh towards the back of the leg to fully straighten your right leg.  Pull the top of your right thigh down into the right hip socket to ground the right hip on the floor.
Check out my latest class to be posted: 60-minute intermediate class building up to Parivrtta Paschimottanasana.
Marla, a Senior Intermediate Level certified Iyengar Yoga teacher, is based in Los Angeles, where she teaches public classes and conducts teacher training in addition to teaching workshops in the US and internationally. Combating rheumatoid arthritis normally consists of medicinal interventions, lifestyle changes, and conservative treatments to manage symptoms and provide pain relief for patients.
An exercise program is essential to prevent joint destruction and combat the symptoms associated with the disease, but comes with a multitude of challenges. During the course of the disease, tendon sheaths, ligaments and cartilage can be affected and exercise can maintain their integrity.
The most commonly used physical agents in combating rheumatoid arthritis are thermotherapy and cryotherapy. While the literature on the use of TENS in patients with rheumatoid arthritis is rather conflicting, it can be supported using the modality for this patient population as TENS does not cause any adverse side effects. Research suggests that TENS for patients with this condition, mainly in treating RA of the hand, provides pain relief when the method is administered, but upon its completion, shows little to no residual benefit.
This review showed that ultrasound applied to the dorsal and palmar surfaces of hand increased grip strength and to a lesser extent improve wrist flexion and reduce swelling in joints.
Appropriate assistive devices that benefit patients range from work chairs, rolling walkers, canes, and reachers. Stretching after strengthening exercises helps relieve the muscle tightness that can occur from strengthening exercises and may be more beneficial that stretching before strengthening exercise (you can either do all your strength exercises first and follow with all your stretches or alternate strength and stretching exercises, stretching the same muscles just strengthened). Are there any exercises I can do to strengthen my back advanced pilates exercises prevent this. The back strengthening exercises women back is an important part of the core of the body as is at risk of injury if a weakness.
Strengthening exercises help stabilize the spine and decrease stress on the lower back and pelvis.
The procedure involves one lying on the side of the body with the elbow directly under the shoulders; the left hand should be the one supporting the entire body mass from the floor with the help of the left leg. The procedure of doing this back strengthening exercise involves one being on all fours with both knees and hands tight forged to the ground with the hip width apart the hands should be flat on the floor.


While standing straight and tall with the arm in front ;one will be required to push the butt back, the chest should essentially be in the upward position at the hip so that the weight is able to glide down gently back strengthening exercises women front of the legs. This is usually due to the buildup of tension and stress in the spine of which has to be removed for one to enjoy a healthy life free of back pain. The best thing about back strengthening exercises is that they do not require any gym registration so as to be carried but can be carried out at the comfort of one’s home at any particular time of the day. Statistics have shown that the elderly fall far more often than any other age group except for children learning to walk. A fear of falling may result in reducing the activities you engage in and can perpetuate the deterioration of your balance. If your imbalance is due to aging and you continue to live with the problem and not make an effort to stop or significantly manage it, you can expect a continued deterioration of your balance issues. In cold weather many enclosed shopping malls allow walkers access to a level surface and safe environment. Obtain some small orange cones like the ones used by your grandchildren for soccer or football drills. Get up as quickly as you can, go clockwise around the cone and then go back to the chair and sit down. Weave between them, starting to the right of the first cone and to the left of the second cone and so on to the end.
It is the amount of time and the frequency of repetition that will be the most helpful for you.
The correct actions in the pose help create traction in the lower back while the asymmetrical nature of the stretch can balance tension and distortion on the two sides of the back. Although it seems like all of the action occurs in the top leg, the real life and benefits of the pose come from the proper extension of the leg on the floor and the interplay between the two legs. Both variations help to teach the interaction between the legs, hips and lower back, principles that can be translated into your practice of standing, seated forward bending, and inverted asanas. If you feel that the front of the left thigh is popping up, take your right foot further away from your head. Go slowly so that you don’t lose the extension of your left inner leg and the length on the right side of the waist. Begin as in the previous variation adjusting the sacrum with both hands and extending both legs straight on the floor before placing the belt around the right foot. Lie down on your back, adjust the buttocks with your hands as you did in the previous variations and straighten your legs on the floor. Move the right buttock away from your head so that the right side of your waist feels as long as the left side waist. As you exhale, keep your right leg straight, as you pull the right shoulder down towards the floor and broaden your chest. Formats range from 5-45 minute tutorials and practice sessions to 90 minute classes.  Videos include an introductory beginner series to learn the basics as well as classes of varying levels. Those who are diagnosed with RA may be unsure of beginning an exercise regimen due a lack of confidence in abilities and the pain it may cause.
Range of motion and flexibility deficits that hinder a patients productivity can be improved with regular exercise, and combat RA-related fatigue. Thermotherapy modalities can increase blood flow and elasticity of tissues and can be applied as hot packs, paraffin wax, or hydrotherapy. It is safe to say at this time TENS is a short-acting therapy and the beneficial frequency to deliver is 70Hz. Patients with RA can be prescribed foot orthoses or specialist footwear to combat these issues, and receive education for care of skin and nails. Splinting can provide pain relief, reduce inflammation, increase range of motion, and prevent deformities. Research suggests reasons for using assistive devices also reduce amount of load placed on the joint, reduce pain, fatigue and inflammation. Tai Chi, Yoga, and Pilates are also effective disciplines that can increase range of motion, flexibility, strength, and cardiovascular endurance without putting a large amount of force on joint surfaces. Transcutaneous electrical nerve stimulation (TENS) for the treatment of rheumatoid arthritis in the hand. Continuous ultrasound to the hand benefits grip strength in people with rheumatoid arthritis. Weight-bearing aerobic exercise (legs support weight of body) such as brisk walking also improves bone density of the legs, hips and lower spine. The body adapts to gradual increases in exercise, increasing exercise too quickly can cause injury and cause or increase back pain.
However it is largely a matter of personal preference - stretching and strengthening exercises can also each be done on separate days if desired.
The low back exercise program is a series of stretching exercises and strengthening exercises prescribed by. In this stable condition the abdominals will need to be tightened while one lifts the hips off the floor, while lifting up and down the neck should be aligned with the spine while the hips maintained in the square position.
While in this position one should tighten the abs and extend the right arm fully as if trying to get hold of something and the left leg fully back as if kicking something with the leg sole, this position should be maintained for at least 10 seconds and then interchanged with the right hand and left leg. One should go all the way down until a sensation of a nice stretch is felt on the hamstring and then return back to the starting position. Falling is far more troublesome for seniors as it can produce serious injuries such as hip fractures. However, maintaining an active lifestyle as we age provides confidence in our ability to perform not only the activities of daily living, but recreational and working activities. Unfortunately, when people retire there is a tendency to reduce activity and basically slow down.
As your balance improves work towards performing the activities without holding on to the wall.
It not only includes balance games, but it has yoga, muscle strength, aerobic and advanced aerobic activity. Start at cone number one with your left foot (moving clockwise) walking towards the second cone. According to yoga philosophy, our consciousness is comprised of three components: ego, mind and intelligence.
Slide your sacrum and buttocks towards the wall with your hands as if smoothing out and lengthening your lower back.
Extend your calves towards your heels as you press the inner edges of your heels into the wall.
Without disturbing your left leg on the floor, stretch your right leg straight towards the ceiling. Extend from the inner left thigh into the inner left heel into the wall.  Intelligence is connected to the sense of touch in the skin so see if you can maintain the sensitivity to the stretch in the left inner leg as you start to bring the right leg higher up toward the ceiling, closer to a 90 degree angle.
If not, move the right outer hip away from your head towards the wall to lengthen the right side of your back and waist on the floor.
The more your right foot comes towards your head, the more you have to press your left thigh down, inner left heel into the wall and the right hip down into the floor and away from your head.
Now hold both sides of the belt with your right hand.  Press your left thigh strongly into the floor and heel into the wall and keeping both legs straight take your right leg out to the right side, in line with your hip.


On the inhalation, bring your right leg back up into the first variation, bend your right knee and place the leg on the floor to repeat on the left side. Press both thighs straight down into the floor and extend from your calves to your heels as if you were still pushing the heels into a wall. Press the inner edge of your left leg into the floor and keep extending from the inner thigh towards your left inner heel.  Again, keep your awareness sharp on the left leg. Continue to spread your awareness through the whole body, to the parts that are both seen and unseen so that no aspect of the pose is untouched by your intelligence. This section will focus on the physical therapy management of rheumatoid arthritis without surgical intervention.
In a review article on the benefits of exercise in this patient population, it is shown that assistance from instructors and social interaction boost motivation for involvement in regular exercise routines.
During a flare up of rheumatoid arthritis, a patient may prefer cryotherapy over thermotherapy to cool the joint down, attempt to numb the pain and control inflammation.
Aerobics also improve also relieves stress and improves sleep, which helps to reduce chronic pain. Remember to warm up first for at least 5 minutes of light to moderate aerobic activity such as walking.
While on the upward trend one should maintain the position for about 3 seconds and then lower down gently. Repetition of this exercise 4 times a day is known to increase the coordination and balance of the spine muscles. Not only will balance suffer, but muscle deterioration and cardiovascular health can be reduced.
The joints of the spine and lower extremities are very important in maintaining your balance and joint position. This is a very safe, gentle and easy way to improve your balance but also your cardiovascular and muscle conditioning. Normally, our ego, which identifies with what moves, what is seen and what is known predominates.
Then push your heels into the wall and straighten your legs without losing the adjustment you just gave yourself.  This adjustment gives an important sense of direction for you throughout the pose so feel free to repeat it if you have lost the sensation of the lengthening of the sides of your lower back towards the wall.
Start with your right leg further away from your head than a 90-degree angle from the floor, closer to a 60 degree angle. Don’t allow your ego’s impulse to bring your foot close to your head to overpower your intelligence in the left leg.
Let all of these actions be your guide to help you determine how high to take the right leg.
Pause for a moment when your right leg is halfway down and again charge your left heel into the wall, keeping your left hip on the floor so that you don’t topple to the right side. Place your left hand on top of the left thigh.  Bend the right knee towards your chest and reach your right arm along the inside edge of your right leg to hook the right big toe with your index finger and middle finger in between the big toe and second toe and your thumb around the outside edge of the big toe.
If you feel like the top front of your left thigh is bulging towards the ceiling, push it strongly down again.
Hold for a minute and then bend the right knee towards your chest, release the right leg to the floor and change sides. A cold-pack, ice chips, ice massage or nitrogen spray can be applied to areas where calming inflammation and pain are desired. This set of back strengthening exercise should be performed three times on each side of the body for effective strengthening of the back.
This will ensure that one is able to maintain a highly stable spine that is able to aid daily activities such running or walking. We cannot stop aging, but we can fight back and significantly minimize the risk of deteriorating balance. It also minimizes the amount of worry that family members may have about parents or grandparents suffering a serious injury from a fall.
In the beginning have someone with you to offer encouragement and to watch to make sure you don’t fall.
When you reach the third cone, switch facing in towards the square and do the same shuffle movement.
However, as BKS Iyengar says “the practice of asana is meant to bring the unknown into the sphere of the known,”1 balancing the components of consciousness in the process.
It should be easy to straighten both legs here, if not, slide your hands down the belt and move the right foot even closer to the wall.
Rather than focusing on bringing your right leg to a particular angle from the torso, spread your awareness throughout all aspects of the pose while stretching the right leg. Extend from your inner right thigh to your inner right heel and move your outer right hip and buttock away from your head towards the wall, as you had adjusted with your hands earlier.
Keep the left thigh pressing down into the floor as you stretch your right foot towards the ceiling and straighten your right leg. Unknowingly, the left leg may turn outwards which causes a distortion in your pelvis and back so you have to turn it from outside in to keep the front of the leg facing straight up towards the ceiling. According to a Cochrane Review of these physical agents, in treating rheumatoid arthritis, there was no significance for hot and cold packs in objective measures of disease activity (pain, ROM, grip strength, etc) but paraffin wax paths showed positive results in reducing pain and objective measures of range of motion in the arthritic hand.
As you age you owe it to yourself to maintain your health and productivity in order to continue to enjoy life.
Keeping the legs straight and the left side grounded, lower the right leg further to the right and pull the foot slightly away from the wall to place the outside edge of your right foot on a block. If you cannot straighten both legs or if in order to do so your right buttock lifts off the floor, use the belt around the foot again to give your arm and legs more length.
As the back of the left thigh descends towards the floor, you will be able to feel the stretch the left leg as if it originating in the left side of the lower back, not just the knee. It is recommended that these methods be used in conjunction with medical management and exercise programs for patients with rheumatoid arthritis. Talk to your physician prior to beginning any aggressive activity to be sure it is safe for you. Intelligence cultivates discrimination; it is the ability to make connections grounded in a comprehensive understanding of the whole. If the block is not tall enough or if your left hip lifts off of the floor in order to reach the block, add a block or blanket or two or alternatively use the seat of a chair as a support.  As in the previous variation, let the intelligence in your left leg be your guide as to how far you can move the right leg and foot to the floor. If you’re using the belt this time, hold both sides of the belt with your right hand walk your hand up the belt so that your arm is straight. While the ego may be gratified by bringing the foot close to your head or catching hold of the big toe with your hand, instead let the intelligence in your bottom leg be your guide as to how far to extend in the pose. In addition to keeping the left hip down, the left inner leg should remain extended towards the inner heel into the wall while the thighbone presses straight down into the floor.  Extend both inner legs away from the pelvis, away from each other. The result is not just a safer and more beneficial pose for your legs, hips and back but your mind will have the opportunity to spread throughout the entire system bringing you towards a union of body and mind.



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