Hi, I'm a 43-year-old working mom looking to make the most of my limited exercise time.  My mother has had three back surgeries and one knee replacement primarily due to arthritis.  I would like to avoid a similar fate.  I wouldn't mind losing ten pounds, but prevention is my primary goal rather than weight loss.  I have heard that Pilates is an excellent approach to avoiding back problems.  What recommendations do you have?  Thanks! —Cheryl in Asheboro, NC

It is good that you have thought about your family history and want to work specifically for prevention.  However, part of prevention for arthritis and any kind of joint disease is maintaining a healthy weight.  The less strain from added weight that your body has to carry, the longer you will put off the effects of a family history of arthritis.

To protect your knees, avoid running if you are not already engaged in this activity regularly.  If you do run, make sure to cross train.  Arthritis can sometimes be coupled with forms of osteoporosis so make sure to get some weight-bearing exercise regularly.  Maybe try a couple of days of walking and mix in a couple of days of biking, swimming, or cardio equipment. 

If you can lose any excess weight and strengthen your muscles surrounding the joints of concern, prevention is possible.  Muscle imbalances can lead to back pain and alignment issues that cause pinched nerves, sciatica, and herniated or ruptured disks.  To overcome muscle imbalances, make sure to do some back and abdominal strengthening exercises on most days of the week.  Pilates and yoga have some good strengthening and balance aspects so definitely try them out.  Start with basic classes taught by certified trainers.  Remember that strict attention to form will make any exercise you do much more effective.  Also try to add in some of the following exercises:

1. Lie on your back with your knees bent and feet flat on the floor.  Squeeze your abdominals to push your back down flat to the ground and hold for 2 seconds.  Perform this exercise 20 times for 2 sets.
2. Stay on your back with your knees bent.  Bring one bent leg up so that your foot is about 10 inches off the floor and then switch legs making sure to just touch your toe down to the floor before lifting off again.  Be mindful of your back; push it flat toward the floor each time you lift one of your legs. Repeat with each leg 20 times for 2 sets.
3. Stay on your back and bring both legs off the floor.  Hold them with bent knees above you while you push your back flat toward the floor.  Hold it there for 30 seconds.  Perform 2 sets.

—Wellness Coach Kelly Geppi, MS, CES

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