I am an 82 year old woman with arthritis in my hand. Is it all right to continue to use a three pound weight in my three times a week exercise class?

A: Show Answer

The first question to ask when exercising with arthritis is "do I hurt afterward in my joints?" Exercise has been shown to help people with arthritis by improving joint nutrition and blood flow. However, there is a fine line between exercising enough to help the joint and causing inflammation.

In severe arthritic conditions such as rheumatoid arthritis or advanced osteoarthritis, the prolonged inflammation causes weakening of the joint's support structures (ligaments, tendons and joint capsule). The weakened joint is then prone to becoming deformed (especially in the fingers).

If using a three pound weight in the hand is causing the hand to hurt or swell after exercise, then I would suggest changing the exercise. Suggestions include using a "cuff" weight that straps to the wrist and takes the force off the hand. Another suggestion would be to experiment with a weight with a larger grip that is easier to grasp. Lastly, there are also weighted gloves that can be worn but these are harder to come by.

Studies have shown that resistive or strengthening exercises can benefit the elderly by maintaining or improving muscle strength, coordination, function and especially by helping maintain bone integrity. However, general group exercise programs often have a "one size fits none" aspect to them. If you have concerns whether a specific exercise program can safely meet your needs, please see a health care specialist such as a physical therapist who can evaluate you and make specific exercise recommendations.

Thank you,

Glenn Dodge DPT


My back has been hurting. How would you be able to help me (versus) going to a chiropractor?

A: Show Answer

First let me say that the quality of medical services always comes down to the expertise and experience of the individual practitioner. So the efficacy of chiropractic services or physical therapy services often depends on the skills of the individual chiropractor or therapist.

Both chiropractic care and physical therapy can improve patients with back pain. I work closely with chiropractors and receive a number of patients from them. Both chiropractors and physical therapists utilize spinal mobilization and/or manipulation to improve patients with back pain. In the field of physical therapy, there is scientific evidence supporting the use of spinal mobilization for certain types of back conditions. However, since I am not a chiropractor, I am reluctant to try to speak to the whole of chiropractic philosophy, so I will try to explain how a physical therapist would approach a patient with back pain.

The most important aspect of treatment is the physical therapy evaluation. The therapist uses a whole range of tests and measures to determine the root cause of the problem and potential treatments. Back pain can originate from multiple sources. It can be referred from internal organs such as the bladder, kidneys or even the heart. It can also result from infection of the spine (a condition called diskitis). In cases where the therapist feels the pain does not originate from a musculoskeletal disorder, a referral to a medical physician is in order.

If the back pain is from a musculoskeletal origin, multiple structures can be involved. Pain can originate from vertebral displacement/malalignment, disc irritation or herniation, muscle strain, nerve root compression or irritation, ligament sprain, or some combination of the above. Once the painful structures are identified, the next step is to identify the CAUSE of the irritation. In cases involving trauma (such as car accidents), the cause is usually easily identified. However, in chronic cases in which the patient has several episodes of back pain, the cause can be hard to discern. A classic case of this is the patient who has to go several times to a clinician to have their back put back in. The question I try to answer is why does it go out in the first place? and then how can we keep this in? or at least teach the patient a way to manage these episodes at home before the pain becomes excruciating. In most chronic cases, the problem is a muscle tightness or weakness that allows the vertebrae, or other structures to move or become irritated while doing an activity (like prolonged standing). In these cases, studies show that addressing the muscle imbalance with specific stretching and strengthening will decrease chronic back pain and decrease the chances of continued back problems. In my experience, the approach of reducing the initial cause of irritation coupled with improving the surrounding supporting structures offers the client the best chance at long term relief.

Now that all the technical jargon is aside lets some it all up.

  1. Discover the root cause of the pain!
  2. If it can be fixed.fix it!
  3. After you fix it do something to keep it fixed!
  4. And this is where Physical Therapy really shines
  5. If it cant be fixedimprove the other areas (posture, muscles, ligaments etc) to compensate for the bad part so you can get back to living!

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