Fitness Testing with Arthritis

Cardiovascular fitness testing provides valuable information:

• Baseline Cardiovascular Fitness: Arthritis pain often reduces activity leading to deconditioning. Know your current fitness level
• Joint-Appropriate Exercise Zones: Get heart rate zones for cardiovascular training that challenges your heart without overloading painful joints
• Equipment Selection: Choose modality that minimizes joint stress while allowing cardiovascular assessment
• Track Improvements: As arthritis management improves (medication, weight loss, strengthening), fitness often increases. Retest every 8 to 12 weeks
• Separate Joint Pain from Cardiovascular Limitation: Testing helps distinguish if you stop due to joint pain vs. cardiovascular exhaustion

Testing Process: 45 to 60 minute appointment with equipment choice based on affected joints. Gradual warm-up to prepare joints. Same day results with exercise recommendations.

We modify equipment selection based on affected joints:

• Knee or Hip Osteoarthritis:
  • • Stationary Bike (Wahoo KICKR): Best option. Seated, no impact, smooth motion. Adjustable resistance allows gradual progression
  • • WaterRower: Low impact, seated, works multiple muscle groups
  • • Treadmill: Only if weight-bearing tolerated. Can walk if running too painful
• Shoulder or Hand Arthritis:
  • • Treadmill: Best option. Minimal upper body involvement
  • • Bike: Possible with modified hand position on handlebars
  • • Avoid: Rowing machine (significant upper body load)
• Spine/Back Arthritis:
  • • Bike: Often most comfortable. Forward lean position may be better or worse depending on individual
  • • Walking: Upright position usually well tolerated
• Multiple Joint Involvement:
  • • We will discuss best option based on your specific joint limitations
  • • Can modify protocols mid-test if needed

Special accommodations for arthritis:

• Extended Warm-Up: 10 minutes of gentle movement to warm up joints and reduce stiffness before progressive testing
• Gradual Progression: Smaller workload increments than standard protocols. Allows joints to adapt to increasing demands
• Pain Monitoring: Distinguish between normal exercise discomfort and joint pain. Stop if joint pain significantly worsens
• Range of Motion Accommodation: Adjust bike seat height, pedal straps, or treadmill speed to stay within comfortable ROM
• Medication Timing: Schedule testing when arthritis medications providing optimal pain relief (typically a few hours after morning dose)
• Joint Protection: Use of knee sleeves, wrist braces, or other supportive gear as needed

Schedule testing when arthritis is well controlled:

• Avoid During Flares: Wait until active flare subsides. Inflammation increases pain and reduces function
• Time of Day: Morning stiffness is common. Schedule when joints feel most limber (often late morning or afternoon)
• Weather Considerations: Some people report weather affects joint pain. Choose a day when feeling relatively good
• Medication Timing: Take usual arthritis medications as prescribed. Test when medications providing good pain control

Based on American College of Rheumatology and Arthritis Foundation guidelines:

• Aerobic Exercise:
  • • Target: 150 minutes per week moderate intensity (Zone 2)
  • • Low-impact activities preferred: walking, cycling, swimming, water aerobics
  • • Start with 10 minute bouts if needed, gradually increase
• Resistance Training:
  • • 2 to 3 days per week
  • • Strengthens muscles supporting joints
  • • Reduces load on joints during daily activities
  • • Work with physical therapist for joint-specific exercises
• Flexibility and Range of Motion:
  • • Daily stretching and ROM exercises
  • • Maintains joint mobility
  • • Yoga or tai chi can be beneficial

VO₂ max testing provides YOUR specific heart rate zones for the aerobic exercise component.

Guidelines for safe exercise with arthritis:

• Two-Hour Pain Rule: If joint pain persists more than 2 hours after exercise or is worse the next day, reduce intensity or duration
• Some Discomfort is Normal: Mild to moderate discomfort during exercise is okay and often improves with regular activity
• Sharp Pain is a Warning: Stop if experiencing sharp, severe pain
• Ice After Exercise: 15 to 20 minutes of ice on painful joints after exercise can reduce inflammation
• Warm-Up and Cool-Down: Essential for joint preparation and recovery

Weight loss significantly reduces arthritis pain:

• Load Reduction: Every 1 pound of weight loss removes 4 pounds of pressure from knees
• Pain Reduction: 10% weight loss can reduce knee osteoarthritis pain by 20 to 30%
• Function Improvement: Weight loss improves mobility and reduces disability
• RMR Testing: Know your exact calorie needs for weight loss ($75 test or $300 Performance Pack with VO₂ max)

Additional factors for inflammatory arthritis:

• Disease Activity: Avoid testing during high disease activity. Wait until inflammation controlled with medications
• Fatigue: Common in RA. Choose time of day when energy is best
• Medications: Disease-modifying drugs (methotrexate, biologics) do not affect exercise capacity
• Cardiovascular Risk: RA increases heart disease risk. Aerobic exercise provides protection
• Bone Health: RA and steroids increase osteoporosis risk. Weight-bearing exercise helps

Share your testing results with:

• Rheumatologist: Manages inflammatory arthritis medications and disease monitoring
• Orthopedist: Manages osteoarthritis, performs injections or surgery if needed
• Physical Therapist: Uses VO₂ max data to design comprehensive exercise programs addressing both cardiovascular fitness and joint-specific strengthening
• Registered Dietitian: If pursuing weight loss, uses RMR data for meal planning
• Personal Trainer: Certified in arthritis exercise programming can use zones to design workouts (visit rockurbody.com)

VO₂ Max Test: $250

RMR Test: $75

Performance Pack (Both): $300

Fit Evaluations
311 Soquel Ave
Santa Cruz, CA 95062

Behind Hindquarter restaurant (second entrance off Dakota St.)

Phone: 831-400-9227
Email: info@fitevals.com

Call to discuss your arthritis and which equipment option would be most comfortable for you.