If you have been diagnosed with arthritis, it's wise to protect your hands right away. Approximately 40% of arthritis patients must eventually restrict their daily activities because of joint pain or stiffness—and the hands often get the worst of it.

Both osteoarthritis (known as "wear-and-tear" arthritis and rheumatoid arthritis (an autoimmune disease) can damage cartilage and sometimes the bones themselves. (For natural remedies to help ease arthritis, see page 330.)

What's missing from the typical arthritis prescription: Unfortunately, most patients with either type of arthritis do not recognize the importance of simple daily hand exercises, which can improve joint lubrication...increase your range of motion and hand strength...and maintain or restore function. These exercises also are helpful for people who have a hand injury or who heavily use their hands.

Save Your Hands With Exercise

Most hand and wrist exercises can be done at home without equipment. But don't exercise during flare-ups, particularly if you have rheumatoid arthritis. Patients who ignore the pain and overuse their hands and wrists are more likely to suffer long-term damage, including joint deformity.

Important: Warm the joints before doing these exercises-this helps prevent microtears that can occur when stretching cold tissue. Simply run warm water over your hands in the sink for a few minutes right before the exercises, Or you can warm them with a heating pad.

Before doing the hand exercises here, it also helps to use the fingers of the other hand to rub and knead the area you'll be exercising. This self-massage improves circulation to the area and reduces swelling.

If you have osteoarthritis or rheumatoid arthritis, do the following exercises five times on each hand-and work up to 10 times, if possible. The entire sequence should take no more than five minutes. Perform the sequence two to three times a day.*

#1: Tendon Glides

Purpose: keeps the tendons functioning well to help move all the finger joints through their full range of motion.

What to do: Rest your elbow on a table with your forearm and hand raised (fingertips pointed to the ceiling) Bend the fingers at the middle joint (form a hook with your fingers), and hold this position for a moment. Then bend the fingers into a fist, hiding your nails. Don't clench-just fold your fingers gently while keeping the wrist in a "neutral position. Now make a modified fist with your nails showing. Next, raise your fingers so that they are bent at a 90-degree angle and your thumb is resting against your index finger (your hand will look similar to a bird's beak). Hold each position for three seconds.

*For more exercises, see an occupational therapist. To find one, consult the American Occupational Therapy As. sociation, www.aota.org.

#2: Thumb Active Range Of Motion

Purpose: Improves your ability to move your thumb in all directions. Do the movements gently so that you don't feel any pain.

What to do: Rest your elbow on a table with your forearm and hand in the air. Touch the tip of the thumb to the tip of each finger (or get as close as you can). Then, flex the tip of your thumb toward the palm. Hold each of these positions for three seconds.

#3: Web-Space Massage

Purpose: Using one hand to massage the other hand strengthens muscles in the "active" hand while increasing circulation in the "passive hand.

What to do: Clasp your left hand with your right hand as if you are shaking hands. With firm but gentle pressure, use the length of your left thumb to massage the web (space between the thumb and the index finger) next to your right thumb. Then, reverse the position and massage the web next to your left thumb. Massage each web for 30 seconds.

#4: Wrist Active Range Of Motion

Purpose: To maintain proper positioning of the wrist, which helps keep the fingers in correct alignment.

What to do: Rest your right forearm on a table with your wrist hanging off the edge and your palm pointing downward-you'll only be moving your wrist. Then place your left hand on top of your right forearm to keep it stable. With the fingers on your right hand held together gently, raise the wrist as high as it will comfortably go. Hold for three seconds.

Next, make a fist and raise it so the knuckles point upward. Now, lower the fist toward the floor. Hold each position for three seconds.

#5: Digit Extension

Purpose: Strengthens the muscles that pull the fingers straight--the movement prevents chronic contractions that can lead to joint deformity.

What to do: Warm up by placing the palms and fingers of both hands together and pressing the hands gently for five seconds. Then place your palms flat on a table. One at a time, raise each finger. Then lift all the fingers on one hand simultaneously while keeping your palm flat on the table. Hold each movement for five seconds.

#6: Wrist Flexion/Extension

Purpose: Stretches and promotes muscle length in the forearm. Forearm muscles move the wrist and fingers. Flexion (bending your wrist so that your palm approaches the forearm) and extension (bending your wrist in the opposite direction) help maintain wrist strength and range of motion.

What to do: Hold your right hand in the air, palm down. Bend the wrist upward so that the tips of your fingers are pointed toward the ceiling. Place your left hand against the fingers (on the palm side) and gently push so that the back of your right hand moves toward the top of your right forearm. Hold for 15 seconds. Switch hands and repeat.

Now, bend your right wrist downward so that the fingers are pointed at the floor. Place your left hand against the back of your right hand and gently push so your palm moves toward the bottom of the forearm. Hold 15 seconds. Switch and repeat.

#7: Finger-Walking Exercise

Purpose: Strengthens fingers in the opposite direction of a deformity. This exercise is particularly helpful for rheumatoid arthritis patients.

What to do: Put one hand on a flat surface. Lift the index finger up and move it toward the thumb, then place the finger down. Next, lift the middle finger and move it toward the index finger. Lift the ring finger and move it toward the middle finger. Finally, lift the little finger and move it toward the ring finger. Repeat on your other hand.

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