The role of a health and fitness professional for people with musculoskeletal conditions

By Wayne Johnson, Fitness Supervisor at the University of Birmingham 

Taken from NRAS magazine, Spring 2013 

There are approximately 400,000 people thought to be living with rheumatoid arthritis (RA) in the UK. Currently, there is no cure, and the management of this long-term condition heavily relies on pharmacological therapies. There is evidence to suggest that the inclusion of physical exercise enhances patients’ overall health. Introducing exercise into lives of patients living with RA may help reduce the impact of the disease, as well as reducing the risk of other health-related diseases such as coronary heart disease, strokes and type 2 diabetes, by reducing cholesterol, blood sugar and resting blood pressure levels. 
 
People with medical conditions sometimes tend not to take up physical activity either in the belief that it may cause more harm than good (particularly in patients with joint problems) and partly, because they do not know who to turn to for help. On the surface of it, the thought of gyms and health clubs can be an intimidating place. The idea of seeing fit, young, healthy people, can be daunting, but when you delve a little deeper, you begin to realise that this is not the case. 
 
Exercise can help a great deal to all. For example, posture can be improved by resistance training, which strengthens muscles and stretching exercises, which improve flexibility. By strengthening the muscles, patients can feel better because support for the joints can be improved. Stretching also helps to reduce biomechanical pressure on your joints. A mixture of swimming, walking and cycling (low impact exercises, which are also great exercises for RA), combined with stretching eases stiffness and can provide pain relief. 
 
The benefits of exercise are not just about how it can help joints but also about negating any unwanted side effects of medication. For example, weight gain can be an unwanted side effect, particularly when using steroids. The increase in body mass can often put joints under great stress, which could result in more pain. A fitness professional will consider these factors and aim to devise a programme that will help you manage exercise around your condition. They will ensure that you work through your exercise session safely and at a level that allows you to exercise pain-free, as well as recover from the session. 
 
Depending on the gym you use the services provided may vary. For those with musculoskeletal conditions devising an exercise programme may require a little more expert knowledge from your health professional, given that there could be many other factors to consider. 
 
If the health club you choose can ensure that their facilities have fully qualified staff to deal with you, then you are in safe hands. These professionals tend to be specifically qualified to deal with conditions such as RA, stroke, diabetes and a wide range of other health conditions, in some cases where we cannot help personally, we will always signpost you in the right direction. Health professionals understand that you are, or maybe, more intrinsically aware of how your condition affects you personally and therefore they should regularly enquire about feedback in case an adjustment to your programme or a referral to a medical professional is needed. 
 
Where I work as a trainer, a variety of people from different backgrounds attend to exercise. This includes those in retirement, academics, students, staff and members of the public. In this environment, you will find that everybody has a common goal, and that is to improve and maintain their health to be able to perform their own daily tasks, whatever these may be. This can range from being able to kneel down to do the gardening, or to be able to climb the stairs unaided in the home, or more ambitiously, run a half marathon. Whatever your goal, please join a local gym to improve your health and fitness. 
 
Patient testimony: 
I started to exercise with a trainer. The arthritis affected virtually every joint in my body, including my knees, ankles, shoulders, wrists and most of all my hands. My psychological health has also improved vastly; I have much more self-belief and confidence, and as a result, I am much happier within myself. My trainer has not only been an unending source of support and advice but has also encouraged me to try new forms of exercises that I thought I would never be able to take part in. He has also encouraged me to change my diet, and I now follow a healthy eating plan with an excellent result. The progress and improvements made since the start have been remarkable.