How To Treat Rheumatoid Arthritis With Natural Treatment - Reversing Pain & Toxic Drug Dependency
Don’t Lose Your Grip: Rheumatoid Arthritis and Grip Strength
Learn why hand and grip strengthening, improving finger range of motion, and general hand rehab is so important for people with RA.
By Donna Fennessy
Medically Reviewed by Alexa Meara, MD
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You’ve probably considered how you can, literally and figuratively, get a grip on rheumatoid arthritis (RA). It is an autoimmune disease in which the body attacks the joints, especially of the hands, feet, wrists, elbows, knees, and ankles. Once joint damage occurs, it cannot be reversed, so prevention is absolutely critical. Hand exercises can help keep surrounding muscles strong and prevent joint damage, but research suggests that five years after rheumatoid arthritis diagnosis, grip strength of the hands may still be significantly impaired. So, what can you do to keep yourself healthy and your strength up? Read on.
Basic Facts About Hand Grip Strength
First, a quick look at the basics: What exactly is grip strength? It’s the amount of force one is able to generate when grabbing something. There are various ways to test grip strength. In the study mentioned above, researchers used an electronic gadget called Grippit, a hand dynamometer, which you squeeze. The gadget has a gauge that records the force of the squeeze.
“When someone has trouble bending their fingers because they don't have full range of motion (ROM), they’ll have a harder time getting any force behind [their grip], and hence record a lower score,” explains Mary Ann Wilmarth, a doctor of physical therapy and the CEO of Back2BackWellness, located outside Boston.
Recent Findings About Grip Strength Tests in People With RA
A study published in July 2019 in Arthritis Care & Research might be somewhat discouraging for people living with RA.The researchers found that although grip strength increased in 225 men and women with early RA in the first year of the study, it was lower than expected five years after diagnosis, even in those who were in remission or who had limited disability.
The initial increase in strength was “likely to be partly due to effects of anti-rheumatic treatment, with reduced synovitis of wrists and finger joints,” explains Carl Turesson MD, PhD, a professor at Lund University in Lund, Sweden, and a coauthor of the study. “Hand training may also have contributed.” The folks in the study may have been participating in training as part of rehabilitation, and most likely some performed home exercises, Dr. Turesson explains, though it was not formally part of the study nor was this information collected by researchers. Over time, however, deterioration of the joints can lead to a loss of grip strength.
RA Hand Grip Strength Challenges: A Silver Lining in the Results
Wilmarth takes a positive approach to the research and offers some encouraging words to people living with RA: “This is just one study — one piece of a very large puzzle with many variables and moving parts. We need to continue to move forward and perform additional studies, taking into account medications, function, exercise, pain level, control groups, and as many variables as possible. This is not simple with such a dynamic area of the body as the wrists and hands,” she explains. And ultimately, the good news is that there was some good news: “Grip strengthdidimprove in the first year,” Wilmarth says.
Looking Ahead: Hand Strength Research
“We have to figure out how to maintain grip strength with a disease that’s not predictable,” she says. “When we’re working with orthopedic issues, the condition is usually predictable. RA is more difficult to deal with — no question about it — but that doesn’t mean we can’t deal with it. It just means we have to be patient and continue to work on strengthening.”
The Overall Importance of Strength
The bottom line: Strength is important not only for your hands, but your whole body — it helps decrease the risk for injuries. “It’s not an option to not keep up our strength,” Wilmarth stresses.
Takeaway Advice for Researchers and People Living With RA
Turesson agrees. “With more intensive pharmacologic treatment and structured rehab training, even more pronounced improvement could be possible. My advice is to be active and work together with health professionals to find ways to improve function and reduce long-term disease impact.”
To help you do that, consider Wilmarth's beginner approach to hand grip strengthening.
Rest Your Hands, Fingers, and the Small Joints Within
Your hands rarely get a break. Think about it: There’s a time during the day when you’re sitting and your legs get a rest. Even your upper arms get some downtime when resting on an armrest for a minute here and there. When you’re typing or texting — your arms are not really engaged. But the hands — whether you’re doing dishes, writing, drinking, lifting, or grabbing — are constantly in motion.
To give them a bit of a break, when you’re feeling weak or are in flare, be sure to use assistive devices so you avoid further weakening or injuring the joints. “There are so many [aids] you can buy that can take stress off your hands,” Wilmarth says. “Be sure to use them when you’re not strong enough. If you need to wear a resting splint when you’re flared up or having problems, or when you’re asleep, for instance, be sure to do so.”
And, she stresses, "Don’t forget that activities of daily living (ADL) which incorporate everything you do in between formal exercise — driving, holding groceries, carrying laundry — affect your hands.”
Exercise Your Hands
If you're living with RA, you must maintain your strength so you don’t further injure the joints in your hands. “If you don’t have strength to support the joints in the correct, neutral position, you are at greater risk of injuring them,” says Wilmarth.
Take Medications and Work to Strengthen Hand Muscles
“We now take a two-pronged approach to treatment: Medications help systemically so you don’t get any erosion of the joints. And you also have to strengthen and work all muscles, so muscles become strong, balanced, and in the optimal position to prevent deterioration of the joints,” Wilmarth says. “When you have an issue of weakness, or an even bigger issue, pain, the symptoms exist almost 24/7 for your hands. Women may have weaker grip strength as noted in some of these studies. And unfortunately, it doesn’t take long for grip to deteriorate.”
Grip Strength Training
An important note: Check with your rheumatologist, physical therapist, or occupational therapist before starting any exercise plan or making changes to your current routine. “It’s essential to make sure it’s the right time to start,” Wilmarth says. Once you get the green light, give the following grip-strengthening routine a shot.
• Begin with a warm up. This can be something as easy as walking around the house, riding a stationary bike or doing some tai chi — anything that gets the body warm and the blood pumping — for about five minutes. “You just don’t want to start with cold hands,” Wilmarth says. “Some people with RA can have Raynaud’s [a condition that causes the blood vessels to narrow, preventing the blood from getting to the surface of the skin, turning affected areas white, blue, and cold], so don’t skip this step.”
• Follow up with some gentle ROM and stretching exercises. Sometimes putting your hands in a bucket of warm water while doing some easy ROM exercises can be helpful. It could be as simple as opening and closing your hands.
Then progress to touching your fingers tip to tip. You may not be able to make it at first — but go as close to it as possible.
Then try making a little bit of a fist — try to get your fingers down to your palm.
Next, move your wrist up and down (either with your fingers straight or bent), as far as you comfortably can.
Finally, make nice, easy circles. “Always stay within your comfort zone. If necessary, do a half circle and reverse direction,” Wilmarth says.
“If you’re having a bad day, don’t force anything. Remember, every day can be different and every person is different. Don’t compare your progress with anyone else's.”
• Do some strengthening.Use a soft Nerf ball or stress ball, a towel, or a clean sponge. You can try this in or out of warm water. Grip the ball or towel, hold for 3 to 5 seconds and relax. “Think of this as a bell curve,” Wilmarth says. “Gently squeeze in, hold, and gently release.”
You can spread out your exercise over the course of the day — it’s okay to start with just one minute at a time, if that’s all you can tolerate. Your goal is to build up to 10 minutes, three times a day. Eventually, you want to be able to perform 30 minutes at a time, after building up to this slowly over a few days or weeks.
Try the Routine Often and Keep Comparing How You Feel
“See how you feel when you do it, later that night and then again the next day," Wilmarth says. “Make sure nothing has gotten worse for you. After you’ve done it one day, repeat the routine a couple of days later. Then try the moves twice. If you’re still doing okay, then try it a few days later, three times a day,” she says, adding, "Try every other day, building up for one to two to three times a day until you are doing 10 minutes of exercise three times a day as tolerated.”
If all goes well, you can increase the amount of resistance you’re using.
“As you progress along, try different types of gripping exercises,” Wilmarth suggests. “Gripping a pulley, when doing upper back exercises, working on grip strength when holding free weights when doing a biceps curls, or exercises with forearms when doing wrist flexion or extension. There are other ways to improve grip strength without working purely on grip strength.”
• End with a cool down. This can be a mirror of your warm up.
Video: 👍 8 Hand EXERCISES to Ease ARTHRITIS Pain
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