The Exercise Experience in Adults with Arthritis

This October 3rd I will be representing GCMC, along with my father and Matt, at the Women's Health Summit for the Arthritis Foundation. The topic we will be presenting is the importance of exercise with Arthritis. It almost would seem counter-intuitive that someone with a degenerative or inflamed joint should be moving that joint freely, but it is in fact true. And not just true, but imperative. The subject touched me and I feel it is important to help shed light on the facts.

Studies have shown that despite the importance of exercise, 31% of those with arthritis live completely sedentary lives. Those that were athletic before the arthritis tend to remain active after the diagnoses. They seem to have better handle on how to exercise and how to modify an exercise due to pain. However, those that were not athletic to begin with tend to be fearful of exercise, especially if they attempt exercise and experience an copeless amount of pain.

There are over 100 types of arthritis, the most common being osteoarthritis followed by rheumatoid arthritis. Osteoarthritis (OA)is the leading cause of disability, affecting more than 22 million adults in the United States. There is no cure; however, there is a lot you can do to slow down the progression and manage the pain. I have a busy class and work schedule, so in the interest of time I will list the evidence supporting exercise and provide a link to the Arthritis Foundation for further information on how to be healthy with arthritis. Besides, the journals could not be any more to the point.

Harvard's Women's Health Watch stated that regular exercise strengthens muscles and improves flexibility and balance. It not only eases pain and stiffness but improves overall health. New research suggests that older women may be able to prevent OA pain by getting as little as one to two hours of moderately intense exercise per week.

The American Journal of Health and Behavior stated that, "regular exercise by people with arthritis delays disability; improves physical function; improves quality of life, mental health, aerobic capacity and muscle strength; promotes functional independence; and reduces pain." (Am J Health Behav. 2006;30(6):731-744)


The Journal of Rheumatology printed, "it is now established that well-designed physical exercise programs promote prolonged improvements without inducing harmful effects on disease activity and joint damage” Rheumatoid arthritis, cardiovascular disease and physical exercise: a systematic review." (Rheumatology 2008;47:239-248)

Archives of Internal Medicine stated that, “Aerobic and resistance exercise may reduce the incidence of ADL disability in older persons with knee OA. Our study suggests that a physical exercise program may be an effective strategy for increasing the active life expectancy of older adults.”(Arch Intern Med. 2001 (161). 2309-2316)

Link for Arthritis Foundation

Primary Care: The Bastard Child of the Health Care Industry

With the economy in a recession and health care as the main topic of conversation, one thing is for certain: you can believe in change, even if it won’t be a change you believe in. There are a variety of ideas on how to improve the cost of health care and while I admittedly have not ready all of them, I will make the assumption that none involve pay increases for doctors.

Recently released in the Modern Physician’s 16^th annual Physician Compensation Survey was that more than half of the specialties that were tracked had compensation increases less than the rate of inflation . Primary care doctors were at the very bottom of that list, which should come as no surprise. It’s no wonder that the AAMC is forecasting a shortage of 124,000 physicians by 2025. How does this affect a universal health care plan, you might ask? Well when you decrease the number of physicians but increase the number of patients you find yourself in a predicament much like Massachusetts in 2006. 26 percent of residents had difficulty finding care and 35 percent of doctors stopped accepting new patients.

The Annals of Family Medicine reported that nearly one half of a primary care physician’s is spent on activities outside the examination room, predominately focused on follow-up and documentation of care for patients not physically present. Health Affairs that doctor interactions with insurers costs $23.2 billion to $31 billion a year. That is an average of $68,274 per physician per year for interactions with insurance companies.

Who is going to fill the void in primary care? It seems that either we would need 124,000 Mother Teresa's or that we would need the health care industry to brush up on it’s parental skills and coddle the primary care field. I personally do not know the answer on how to cure America’s health care woes, but it does not take a genius to see the problem. We have a rising cost for health care, a growing number of uninsured Americans, an increase in reimbursement below that of the rate of inflation and a shortage of graduating doctors willing to gamble their +$300,000 school debt on an under-appreciated and under-valued specialty. Just a fun closing fact, the top seven CEO’s for health care insurance policies earned a total of $14.2 million in 2008-2009. One source reported that over the past five years, health care insurance companies have posted 1000 percent increases in profits. Not to point fingers or anything but that increased health care money has to be going somewhere and it's certainly not going to the primary care doctor's pocket.