Pain-Free Living

Chair Exercise

by Jennifer Trizuto, M.P.T.

To many people, growing older means that life will slowly go downhill — but it doesn’t have to be that way. The picture we have of normal aging as a time of gradual loss of function isn’t necessarily accurate. While aging is inevitable, loss of function isn’t. Much of the decline in our ability to walk, get out of a chair, climb stairs, or make meals is due to inactivity, not aging, and can be prevented. When it comes to strength, energy, and fitness, the old saying still applies: “Use it or lose it.”

Getting active

The benefits of regular activity have been studied and documented widely. Exercise strengthens muscles and maintains joint flexibility. It can lower cholesterol, blood pressure, and the risk of osteoporosis and help maintain healthy blood glucose levels. Exercise can also help you lose weight, reduce stress, and improve sleep, digestion, circulation, energy levels, and self-esteem. Finally, regular exercise can help you to function better and remain independent in spite of health problems.

The good news is that it is never too late to start exercising. Everyone can benefit from regular physical activity. But it is older people who have more at stake as they struggle to manage chronic health issues and maintain independence. The people most successful at aging are those who are physically active. Even a little physical activity can have great benefits for health and well-being.

What does “physically active” mean? The Surgeon General recommends 30 minutes of moderately intense activity (for example, brisk walking) on 5 or more days of the week. The 30 minutes can be accomplished in one stretch or in a few short bouts. Muscle strengthening and flexibility exercises are also important to a complete activity program. However, these recommendations may not be feasible for people with limited mobility. What if you cannot walk? What if getting out of a chair is difficult? What if you have been sedentary most of your life and are just now noticing the decrease in function described above? More good news is that there are exercises you can do without getting up from your chair.

Take a seat

Exercise classes and publications designed for those who cannot get out of a chair or who have limited mobility are gaining in popularity. Research has shown that people who participate in a seated exercise program two times a week increase leg strength compared with those who don’t participate. This is great news for people who experience arthritis-related mobility problems and are unable to participate in standard exercise classes.

What does a chair exercise program involve? Many of the same features as a standard exercise program, it turns out. Even though you are exercising in a seated position, you must still incorporate the three key elements of any exercise program: strengthening, stretching, and conditioning.

Strengthening the muscles surrounding your joints can help decrease pain and increase your ability to get out of your chair or go up and down stairs. To strengthen a muscle, you need to challenge it to work harder than it is used to working. The more you work it, the stronger it becomes. Stronger muscles are better able to support your joints and absorb the stress put on the joints when you move.

Keeping your muscles flexible helps your joints maintain the range of motion needed to complete daily activities such as reaching for something in a cabinet or bending over to tie your shoes. In stretching exercises, you need to bend and straighten your joints as far as they can comfortably go.

Lastly, conditioning builds your endurance so that you feel fatigue less quickly and are better able to tolerate prolonged activity. Conditioning assures that you have enough energy to complete your everyday tasks and those activities that bring joy to your life, such as gardening or golf. Conditioning involves continuous movement of your arms and legs to get your blood pumping. Some common examples are walking, running, and dance classes. However, these are not appropriate for people who are unable to stand for exercise. For these people, sitting down to exercise is the next best thing.

Conditioning while sitting

When exercising in a seated position, it is relatively easy to do strengthening and stretching. You will see some basic examples of these types of exercises in Seated Exercises. Conditioning in a seated position, however, can be a little more difficult.

Some gyms offer equipment especially for people who need to sit to do their conditioning. There are recumbent bikes — essentially stationary bikes except that you sit against a backrest with your legs pedaling out in front of you. There are also “arm cycles” with cranks that you sit in front of and move with your arms like the pedals of a bike. These are both good options for people who have access to a gym. Another good way to complete the conditioning portion of your exercise program is to exercise in a pool. You can swim or use flotation devices in the deep end and even lightly “jog” on the pool floor. For people who do not have access to a gym or a pool, a portable pedal system is a good idea. These lightweight devices are like stationary bikes without the seat or handles. You just sit on a chair, place the pedal device in front of you on the floor, and pedal away. (The device may also be put on a table and pedaled with the arms.) All of these exercises require you to move continuously. The longer you do them, the more efficient your lungs and heart will be, and the more energy you will have.

If none of these conditioning examples work for you, you can “dance” in your chair by tapping your toes, lifting your heels, and clapping. Then add 1–2 minutes of chair “jogging” by raising your feet a little off the ground as if you were jogging. If you do these moves three times a day for 10 minutes, you have a total of the recommended 30 minutes advised. If you put it all to music, it can be a lot
of fun. Even if you can’t tolerate conditioning in a chair yet, you can still benefit from stretching and strengthening alone.

As always, it is imperative that you talk with your doctor before starting this or any exercise program. There may be some activities or exercises that you should avoid, and you should know about them ahead of time.

Practical tips

When exercising at home, choose a chair that has no wheels and, preferably, no armrests, although the exercises I’ve chosen for you can be done in a chair with armrests as well. One of the most important things to remember is to sit up straight. If you slouch while doing these exercises you can cause increased shoulder problems or pain and decrease your ability to take deep breaths. Taking steady breaths while you exercise is important, too. Try not to hold your breath while completing the exercises as this can raise your blood pressure. Faintness or shortness of breath, decreased joint range of motion, increased joint swelling, or increased weakness are all signs that you should stop the exercises and check with your doctor.

It is important when you start an exercise program of any kind that you start slow and work your way up. If you use the exercises outlined in this article, I recommend that you begin with 3–5 repetitions of each exercise and gradually work up to 10. When 10 becomes easy and does not cause additional pain, work up to two sets of 10, and then three sets of 10. By slowly increasing the number of repetitions, you gradually strengthen your muscles or increase the ease with which you can move your joints. The exercises listed in this article are beginner exercises and can be done daily, but to start, I recommend trying them three times a week and working toward doing them every day. An important factor to remember is the “two hour rule.” If your pain is greater than usual for longer than two hours after completing your exercise program, then you have done too much and should cut back a bit the next time you do it.

Flares are always a problem when it comes to exercise. The best way to deal with a flare and still maintain your exercise program is to cut back the repetitions to 3–5 for each exercise until you feel the flare is under control. During a flare, you can use a heating pad before you exercise and/or an ice pack after you are finished. Choose the most comfortable position to apply heat or cold and do so for only 10–20 minutes.

Resources

There are many resources out there should you have any questions or concerns about your exercise program. A physical therapist, occupational therapist, or exercise physiologist can help you get started on a chair exercise program designed specifically for you. These professionals have special training in creating exercise routines and can teach you how to do your program correctly and safely. You need a referral from your doctor to see a physical or occupational therapist. Most gyms have athletic trainers, but before making an appointment ensure that they have experience working with clients who have arthritis or related problems.

You can get an exercise video, called Take Control with Exercise, online or through your local chapter of the Arthritis Foundation. If you like yoga, some yoga centers and senior centers are beginning to offer chair yoga. But since this is a new and growing area of yoga and may not be readily available everywhere, videos may be your best option. Options include Liz Franklin’s Yoga in Chairs and Carol Dickman’s Seated Yoga. Sit and Be Fit is a nationally syndicated television show that airs on public television stations across the nation. This is a wonderful program that has been around since 1985. You can buy videos or DVDs of program episodes if you wish. Otherwise, check your TV guide to see when Sit and Be Fit is on.

I always tell my clients that exercising with a friend is much more enjoyable than exercising alone. You get the added benefit of having a conversation while you exercise. There is no better way than talking to keep you breathing while you exercise, rather than holding your breath. Or join a class. Check with your local Arthritis Foundation chapter for sponsored classes or check with your gym, hospital wellness center, yoga center, senior center, or recreational center. All of these are good places to look for a chair exercise class. And always remember that even if you can’t get out of your chair, you can still work on becoming more physically and functionally fit.

Last Reviewed August 8, 2012

Jennifer Trizuto is a physical therapist who has worked with people who have arthritis since 1994.

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