There is a variety of rheumatic diseases that can be divided into different categories. In physiotherapy, especially rheumatic diseases affecting the joints are treated. For example, chronic polyarthritis and ankylosing spondylitis belong to this category.
Other structures can also be affected by rheumatic diseases. Frequently patients are also found in physiotherapy with fibromyalgia, the so-called “soft tissue rheumatism“. Joint rheumatism often affects the joints of the hands or feet.
Mostly the basic joints are affected. Frequent inflammations cause wear and tear of the joints, the cartilage changes and is degraded, bony attachments develop and typical deformities occur, which can massively restrict mobility. Exercises for the hands should only be carried out in intervals free of inflammation.
During a rheumatic attack, the therapy should be gentle and in any case painless. If necessary, no mobilizing therapy can take place. It is important to prepare and warm up the joints gently.
Overloading is very bad in rheumatic diseases, as it can cause an inflammatory reaction. 1st ExerciseFirst you can start by gently closing and opening your hands to your fist. A distinction is made here between the so-called large and small fist.
With the small fist only the fingers in the 2nd joint are closed. With the large fist the fingers are bent in the basic joints. The two movements can be performed alternately.
2nd ExerciseAnother mobilizing exercise for the finger joints is the so-called lumbrical grip. Here only the basic joints are lifted, a kind of cave is formed under the hand. Each individual joint of the fingers should be moved several times in a row, if possible with a final movement.
Movements that cannot be actively performed by the patient himself can also be trained at home with the help of the other hand. It should never be pressed with force in one direction. 3rd exerciseAnother exercise for the hand in rheumatism is finger tapping.
Each finger is alternately tapped to the thumb and then the finger is stretched out again, the hand is opened again completely. The thumb should also be mobilized in all movements. However, combination movements should be avoided in order not to overstrain the joint.
It is also very important to mobilize the wrist, since a deformity often manifests itself here in which the wrist deviates towards the ulnar side (the small finger side). For this reason, we do not train this direction of movement during the exercises. In the therapy of rheumatism in the hand a variety of aids can be used, hedgehog balls, therapy clay, cloths and much more.
The use of aids for everyday life can also serve as exercises. More exercises can be found in the article Exercises Finger Arthrosis. In the rheumatic clinical picture of ankylosing spondylitis, the inflammatory process is mainly concentrated on the spine.
Starting from the sacroiliac joint, inflammation of the spine occurs and the deformities increasingly lead to stiffening. This results in a hunchback that can be so pronounced that the patient cannot look forward when in a physiological cervical spine position or breathing is severely restricted. In order to prevent the progression of Bekhterev’s disease, a physiotherapeutic exercise program must be carried out consistently, which promotes spinal mobility and trains straightening.
In acute phases of the disease, a gentle, pain-relieving therapy should be carried out. Straightening exercises for the spine are for example rowing or butterfly-reverse. These can also be performed without equipment.
Mobility comes before strength. If the arms are moved backwards, the spine straightens up, the chest stretches, and the movement is best combined with inhalation. When breathing out, the tension is released and the muscles are relaxed.
Exercise RowingThe Theraband is fixed around a door handle and gripped at both ends. In hip-widened position and under abdominal tension, both ends are pulled sideways/tightly with bent elbow joint towards the torso. Method: 3 x 15 whl.
Exercise Butterfly-reverseThe Theraband is fixed around a door handle and grasped at both ends. In hip-wide position and under abdominal tension both ends are pulled backwards at shoulder level with stretched arms. Method: 3 x 15 whl.
For both exercises it is important to lift the sternum under abdominal tension (lumbar spine endless dosing) and to pull the shoulder blades backwards/downwards so that the BWS can stand upright.The lateral inclination and rotation should also be mobilized. As with all rheumatic illnesses, training should be gentle on the joints. Combination exercises should therefore be avoided, i.e. if the rotation is trained, no lateral inclination should be performed.
This restriction is not generally valid and depends on the findings. The therapist should assess whether the patient is allowed to perform combination exercises or whether they could be harmful to him or her. In addition to strengthening the erection, it is also important to stretch the usually shortened chest muscles.
In Bekhterev’s disease, breathing should be included in the training as well as in the physiotherapy, as it usually leads to a restriction of rib mobility due to the increased hunchback. Further exercises and information can be found on the pages Physiotherapy Bekhterev’s disease and Exercises against hunchback. Since rheumatism is a systemic disease, the whole body plays a role.
Thus also the nutrition is important with rheumatic diseases. Certain foods are said to promote inflammatory processes in the intestines. Rheumatism is an autoimmune disease and can be intensified by such inflammatory processes in the body.
It is important to avoid such foods as far as possible. A predominantly vegetable diet is recommended, which should be supplemented with low-fat dairy products and fish. Often the symptoms of the rheumatic disease can be greatly improved by a change in diet.
The change should be carried out by a specialist. There are rheumatism clinics that offer such diets and at the same time adjust the drug regimen. A healthy, balanced, anti-rheumatic diet can improve the symptoms and influence the need for medication, but must be medically adjusted.
Rheumatic fever is a rheumatic disease that results from an untreated streptococcal infection and later develops arthritis or inflammation of the kidney, heart, brain or skin. Arthritis is the common consequence in adults and usually affects the large joints. If the heart is affected, it can lead to myocarditis (inflammation of the heart muscle) or endocarditis (inflammation of the pericardium), which can result in cardiac arrhythmia. In the case of bacterial streptococcal infections, it is therefore urgently necessary to wait until the infection has healed completely before exerting pressure!
