Rheumatoid arthritis is an autoimmune disease that affects the joints. The American Academy of Orthopaedic Surgeons reports that about 90% of people suffering from rheumatoid arthritis will develop foot or ankle problems. Exercise can help prevent the formation of ankle lock and help improve the flexibility of a locked ankle. Consult your doctor or physical therapist before starting any type of exercise program.
Rheumatoid Arthritis
Rheumatoid arthritis, or RA, results when the body's immune system attacks the joints by causing inflammation. RA begins destroying the soft tissues around the joint, then invades the lining of the joint and eventually affects the actual bones of the joint. Joint stiffness and joint pain increase as the disease progresses. An ankle lock occurs when RA causes joint deterioration and muscle atrophy around the ankle joint. Permanent damage to the ankle could occur if the inflammation caused by RA is not controlled.
Benefits of Exercise
Exercise provides both physical and psychological benefits. An exercise program that includes cardiovascular exercise, strength training exercise and flexibility exercise will reduce your risk of cardiovascular disease, increase your joint stability, preserve or increase your joint mobility, and lessen the physical pain caused by RA, according to the American Council on Exercise. Exercise can also improve your sense of well-being and decrease the psychological pain associated with a diagnosis of RA.
Ankle Lock Exercise
All forms of exercise will help improve the mobility of your ankle. Prevent ankle lock by incorporating moderate intensity aerobic exercise, strength training and range of motion exercise into your daily life, advises Dr. Michael Nirenberg, a podiatric physician and surgeon at Friendly Foot Care in Crown Point, Indiana. "Prevention is better than playing catch-up, but you can still make progress after a joint locks," he says.
If you do experience ankle lock, focus on increasing your ankle's mobility by pulling your toes toward your head, pointing your toe, turning your foot inward and turning your foot outward. As your flexibility improves, add resistance by using resistance bands or placing your foot in a towel and holding the ends of the towel to add the proper amount of resistance. Exercise should not cause you pain.
Walking or water exercise are appropriate forms of moderate intensity aerobic exercise. "Rocker bottom shoes," those with a curved heal and curved toe, will help take the stress off the ankle during walking and other land-based exercise, explains Dr. Brian Bacot, an orthopedic surgeon at Comprehensive Orthopedic Global in the US Virgin Islands.
Exercises to Avoid
Some exercises can cause increased damage to your joints and thus worsen your RA. Avoid exercises that cause excessive stress on your ankles such as running, jumping and any exercise the requires rapid starts, turns or stops. These exercises cause strain on already weakened muscles, ligaments and tendons and could result in serious ankle injuries.
Considerations
Focus on ankle movement by increasing ankle strength and range of motion. Do not focus on the number of repetitions you can complete. Even a 5 minute session of range of motion or strengthening exercise three to four times a week can help prevent ankle locks, but once your ankle locks, you need daily exercise, advises Nirenberg. Do not let pain stop you from exercising. Bacot advises working with your healthcare team to devise a plan that includes a healthy diet, anti-inflammatory medications and hot and cold pack applications to help control your pain and increase your desire to exercise. A warm bath or topical analgesic may help decrease your pain before exercise.
References
- The American Academy of Orthopaedic Surgeons: Rheumatoid Arthritis of the Foot and Ankle
- American Council on Exercise: Exercise and Arthritis
- Dr. Michael Nirenberg; Friendly Foot Care; Crown Point, Indiana
- Dr. Brian Bacot; Comprehensive Orthopedic Global; US Virgin Islands
