It never ceases to amaze me, how poorly designed most therapy programs for patients with arthritis are. The classic mistake is providing the wrong splint and the wrong exercises.
Arthritis is a condition where the inside of the joint is deteriorating. In Rheumatoid arthritis, it is a genetic auto-destructive mechanism. In Osteo-arthritis it is weight baring or age that leads to swollen painful joints.
Once the joint is swollen, the alignment is off and normal movement leads to deformity, more destruction and eventually complete loss of function. The key, however, is that it is normal day activities on a swollen joint that exacerbates the destruction. The disease itself is only half of the problem. In other words, if you can protect the joint, you slow and often stop the destruction.
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So we use medications to reduce the inflammation. We use splints to protect the joint at night, special assistive devises to protect the joint during the day and isometric exercises to stabilize the joint.
So what is so complicated? The problem is that many doctors and therapists who do not specialize in arthritis, do not recognize the unique features of Arthritis and prescribe the wrong treatments. What works in other conditions is completely wrong in arthritis.
For example, most therapists simply give everyone the same basic isotonic exercises. That means the standard exercise where you move a weight through space. Specifically, a biceps curl where you hold a weight in your hand and bend your elbow to lift the weight. That, however, puts tremendous strain on the elbow joint. If it is lose from arthritis, that exercise is destructive, not helpful. Instead, patients with arthritis should only be allowed to do isometric exercises. That means you contract the biceps but you do not move the arm. You tighten the muscle and protect the joint!
Another example involves patients who presents with a “resting splint” designed for stroke patients. A stroke patient needs a heavy rigid splint that holds the wrist up. They are paralyzed and you are trying to hold their wrist in proper position. But an arthritis patient is not paralyzed! They should have a dynamic splint that allows movement in the proper direction while preventing movement in the wrong direction.
I spent one entire year training with Dr. Lynn Gerber at the National Institute of Health. At the time, she was the world expert in arthritis and rehabilitation. She taught me that arthritis is unique. You need a customized program designed for your specific condition. That is what we do.
Dr. Rosenberg on Arthritis
Specializing in non-surgical treatment of low back pain, neck pain, carpal tunnel and sports injuries in Rhode Island (RI).Home ° Our Philosophy ° Conditions and Disorders ° Patient Care ° Our Program ° EMG's ° About Dr. Rosenberg ° About Our Staff ° News and Events
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