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Range-of-Motion (ROM)  Exercises For Arthritis

ROM exercises help maintain or restore normal joint movement and relieve stiffness. They differ from stretching exercises that help maintain or restore normal flexibility to the joint's muscles and tendons.

ROM Repetitions

How many times should you repeat a given exercise? That depends on you, and whether or not a joint is swollen, hot or painful.

If the joint you're moving is healthy or has arthritis but isn't currently painful, you can repeat ROM exercises five to 10 times, holding a position no more than two to three seconds. Stretching exercises can be repeated two to three times and are held for 20 to 30 seconds. However, if the joint you're moving is slightly swollen, but neither hot nor painful, cut the repetitions in half.

If the joint you're moving is hot, swollen and painful, do no more than one or two repetitions of the ROM exercises and avoid the stretching exercises for the time being.

Finally, if your arthritis affects your neck or low-back, or if any joint appears aggravated by a particular exercise, consult with your physiotherapist.

ACTIVE RANGE OF MOTION EXERCISES GENERAL INFORMATION:

What are active range of motion exercises?

Range of motion exercises are also called "ROM" exercises. ROM exercises help keep your muscles and joints as healthy as possible. ROM exercises may be active or passive. Active ROM exercises are done by a person who can do the exercises all by himself. Active-assisted ROM exercises are done by the person and a helper. Passive ROM exercises are done for a person by a helper. The helper does the ROM exercises because a person cannot do them by himself. Do not do active ROM exercises without first talking to your caregiver. Together you can decide what exercise plan is best for you.

Why is it important to do active ROM exercises?

ROM exercises are very important if you have been ill, injured, or must stay in bed or in a wheelchair.

Active ROM exercises help build up or keep your muscles as strong as possible. They help keep your joints flexible (bending and moving in the right way). Doing ROM exercises will help keep good blood flow going to the joint area that is being exercised. They may help prevent blood clots.

 

• Exercising is natural and needed for the body to stay well.

Your heart pumps stronger and easier when you exercise regularly. You also breathe quicker and more often while exercising. This helps prevent infections that happen if you do not breathe or cough deeply enough. With your heart and lungs working stronger, more blood gets to the muscles, bones, and skin. Increasing blood flow brings more oxygen and other good things to your body tissues and organs. Walking and other exercises help make your BMs and urine more regular. Exercising can also make you feel better, more relaxed, and happier.

How do I get started?

• Do all ROM exercises smoothly and gently.

Never force, jerk, or over-stretch a muscle. This can hurt the muscle or joint instead of helping.
 

• Move your joints slowly.

This is especially important if you have muscle spasms (tightening). Move the joint only to the point of resistance. This is the point where you cannot bend the joint any further. Put slow, steady pressure on the joint until the muscle relaxes.
 

• Stop ROM exercises if you feel pain.

The exercises should never cause pain or go beyond the normal movement of that joint. Call your caregiver if the pain does not go away after you finish your exercises.

 

• Set aside time to exercise every day.

Do ROM exercises at the same times every day. Include the exercises in your normal activities, such as while watching TV or bathing. This will make the time go faster and help you relax more. You may want to break your exercise program into 2 or 3 sessions. You can then do the sessions at different times of the day instead of doing them all at once.
 

• If you are confined to a  wheelchair lock your wheels before you start doing your exercises.
   
• Ask for help

If you feel weak, or think you may become tired or dizzy, ask someone to help you. This will help keep you from falling or getting hurt while doing your ROM exercises. Working with someone during your exercises may also help you do them in the right way.

• Follow your caregiver's orders. 

If you are under the care of a physican, phyiscal therapist or other caregiver ask them about the exercises you are planning to do. They  will tell you how many times per day you should do ROM exercises. Your caregiver will tell you how many repetitions (number of times) you should do exercises on each joint.

• Rest after an exercise that is very tiring.
   
• Drink enough water or other clear liquids.

How are active ROM exercises done?

Do the exercises in the same order to keep it simple and easy to remember. Start exercises at your neck and work down toward your toes. Use good posture while doing ROM exercises. Standing or sitting as straight as possible will help your breathing while doing the exercises. It will also make your back, neck, and stomach muscles stronger. Keep your stomach muscles tight and pull your hips into a straight line under your shoulders.

* IF YOU HAVE HAD SURGERY OR AN INJURY ALWAYS CONSULT YOUR PHYSICIAN BEFORE STARTING AN EXERCISE ROUTINE

Always return to your starting position after finishing each exercise.

Head and Neck exercises:

Starting position: You may sit or stand. Face forward. Your shoulders should be straight and relaxed.

• Chin-to-chest.

Gently bow your head and try to touch your chin to your chest. Raise your chin back to the starting position.
 

• Head turns.

Turn your head toward the right to look over your right shoulder. Tilt your chin down and try to touch your right shoulder. Do not raise your shoulder to your chin. Face forward again. Next, turn your head to look over your left shoulder. Tilt your chin down and try to touch your left shoulder.
 

• Head Tilts.

Tilt your head to the side, bringing your right ear toward your right shoulder. Then slowly tilt your head to bring your left ear toward your left shoulder. Bend your head backward as far as possible so you are looking up toward the ceiling.

Shoulder and Elbow exercises:

Starting position: Stand or sit. Hold your arm straight down at your side. Face palms in toward your body. It is best to use a chair without arms if you are in a sitting position.

• Shoulder movement, up and down.

Raise your right arm forward and upward over your head. Try to raise it so that your inner arm touches your ear. Bring your arm back down to your side. Bring it back as far as possible behind your body. Return your arm to the starting position.
 

• Shoulder movement, side to side.

Raise your right arm sideways and upward over your head as far as possible. Return your arm to your side. Bring your arm across the front of your body toward your left shoulder. Return your arm to the starting position.
 

• Shoulder rotation (ro-TAY-shun).

Raise your shoulders up toward your ears, as if you were trying to shrug. Drop them down again and relax your shoulders. Pull your shoulders back, then relax them again. Rotate (move) your shoulders forward, down, back, and then up in one smooth circle. Next, move your shoulders in reverse, moving them up, back, down, forward, and up again in a circle.
 

• Elbow bends.

With your palm facing forward, bend your right elbow. Bring your fingertips forward and try to touch your right shoulder. Return your arm to the starting position.

Repeat the above exercises with your left arm.

Forearm exercises:

Starting position: Your forearm is the part of your arm between your elbow and wrist. Sit down to do this exercise. Bend your elbow and keep it tucked against your side. Rest your right forearm on your right thigh (your lap) or on a flat surface like a table.

• Palm up, palm down.

Face your palm down. Rotate (turn) your palm so that it faces up toward the ceiling. Rotate your palm again so it faces down.

Repeat the above exercises with your left arm.

Wrist exercises:

Starting position: Sit down. Bend your right elbow and rest your forearm on a flat surface, like a table. Make sure your wrist hangs loosely over the side of the table.

• Wrist bends.

Bend your hand back toward your wrist so that your fingers point toward the ceiling. Bend your hand down so that your fingers point toward the floor.
 

• Wrist rotation.

Rock your hand back and forth sideways. Gently rotate (turn) your hand in circles.

Repeat the above exercises with your left arm.

Hand and Finger exercises: 

Starting position: Sit or stand. Place your hand out in front of you.

• Finger bends. Make a tight fist. Then open and relax your hand.
   
• Finger spreads. Open your hand and stretch the fingers as far apart as possible. Bring your fingers together again.
   
• Finger-to-thumb touches. One at a time, touch each fingertip to pad of the thumb.
   
• Thumb-to-palm. Move your thumb and rest it across your palm. Move it out to the side again.

Repeat the above exercises with your left hand and fingers.

Hip and Knee exercises:

Starting position: Lie flat on the bed with your legs flat and straight.

• Hip and knee bends.

Point your toes. Slowly bend your right knee up as close to your chest as possible. Straighten your leg and return it to a flat position on the bed.
 

• Leg lifts.

Raise your right leg upward so that your foot is 6 to 12 inches (15 to 31 centimeters) off the bed. Hold it in the air. Return your leg back to the bed.
 

• Leg movement, side to side.

Flex your foot so your toes point up toward the ceiling. Move your right leg out to the right as far as possible. Bring your leg back to the middle.
 

• Leg rotation, in and out.

With your right leg flat on the bed, roll your leg toward the middle so the big toe touches the bed. Roll your leg outward. Try to make your smallest toe touch the bed.
 

• Knee rotation, in and out.

Bend your knee so the bottom of your right foot is flat on the bed. Roll your leg inward as far as possible. Try to touch the bed with your big toe. Return to the starting position.

Repeat the above exercises with your left leg.

Ankle and Foot exercises:

Starting position: Sit in a chair with both feet flat on the floor.

• Ankle bends. Keep your toes on the floor and raise your heel as high as you can. Lower your heel and relax. Keep your heel on the floor and try to raise your toes as high as you can.
   
• Ankle rotation. Raise your foot slightly off the floor. Rotate (turn) it in circles.
   
• Toe bends. Curl your toes down toward the sole (bottom) of your foot. Straighten them. Curl them up toward the ceiling, then straighten them again.
   
• Toe spreads. Spread your toes apart. Bring them together again.

Repeat the above exercises with your left foot.

 

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