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Amsterdam Amstel
13-09-2016 / 11:00

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rheuma

learning to live and move with rheuma

Rheuma has a huge effect on your daily life. Complaints mostly reveal themselves physically, such as morning stiffness in joints and/or muscles, tiredness, pain and damage to the joints. If inflammation develops in the joints, then the joints become thick and warm. As a result movement becomes more difficult and you can experience disruption in your daily activities. It can also have an effect on your surroundings, job possibilities and your emotions.

Keep moving and accept
Keeping moving and strengthening the body has a huge positive impact on the course of rheumatic ailments. By moving the affected joint, you strengthen the muscles surrounding the joint which lessens the deterioration and pain. It is advisable to exercise in a manner that trains the muscles without putting to much pressure on the joints. Training in the cabin, as well as the added benefit of the warmth, means you don't have to burden the legs with your body weight. Continuing your daily activities (such as work), and remaining independant and an active member of the community is important for the quality of life. Rheuma is an erratic condition. This means that one day can go really well and the next day not so good. This is something you have to learn to deal with. Acceptance of this is essential.

Food and lifestyle
It is, therefore, very important to pay attention to your lifestyle and to maintain a healthy weight. Losing weight by paying attention to your nutrition and ensuring enough exercise has many positive benefits.

Mind
Rheuma can often lead to stress and strong emotions. Through the use of tools and making adjustments you can often help this.

  • Do you experience a lack of understanding? Talk about it with the people around you.
  • Become aware of the effect a healthy lifestyle has on your body and rheuma. The more you understand and support, the easier it is to make changes in your life. Changes in behaviour are not easy and require internal motivation and time. Would you like to exchange your thoughts on this with a bbb coach? Plan a lifestylecoaching. Do you require a more indepth approach to help with breaking through patterns? Make an appointment for a free intake with our psycologist via info@bbbpsychologie.nl.
  • Sometimes your self-image can change due to physical changes. It is important to allow yourself time. Discover new qualities or become creative with thinking of ways to adapt. A bbb coach can help you with this or read through the tool self-image. (All our tools can be found on the website or in the app.)
  • Make sure you get enough sleep. During your nights sleep your body has the chance to recover. A flat and sturdy mattresss and a good pillow can help to ensure a good nights sleep.
  • Remain working for as long as possible. It is important to discuss possible adjustments with your employer.

Body
It is important to focus on maintaining exercise. It is possible that you can't or don't want to exercise due to rheuma. It is important to understand that maintaining exercise is very good for strengthening the muscles and joints and keeping them supple. This can result in a lightening of the symptoms and slowing down the progession of the sickness. It also increases your energy level, decreases tiredness and can help improve your sleeping pattern.

  • Make sure you are well informed regarding rheuma. A bbb coach can help you with this. Would you like more indepth knowledge? This is possible via your rheumatologist, rheuma consultant or physiotherapist.
  • Exercising in the heated cabins is advised.
  • The heat can ensure lesser stiffness in the joints, less pain experience and can help increase the blood flow. Because less pain is experienced, it is easier to exercise and strengthen your body.
  • It is understandable that some movements are not possible or are painfull. It is, though, important to keep exercising regularly to prevent loss of strength and mobility. Do the things you can! And at times when you have the most energy to train.
  • Find a sport or class that you enjoy. The chance that you will then keep at it is bigger. Other sports that you can partake of are walking, bicycling or swimming. Sports that involve a large impact are not advised, such as running, climbing and contact sports. This advice is not for everybody. If you have no complaints then you can follow these sports. Discuss with a coach what is possible.
  • You can train with weights and power exercises but not in the cabin with the heat on. Heat can have an effect on the synoviale fluid in between the joints. The warmer it is, the more fluid the synovia is, resulting in lesser cushioning between the joints. It is not exactly known from which temperature this occurs. This is why we don't advise strength training in the cabin. You can perform these exercises, after a good warm-up, in the power corner. With strength/power training, focus on the large muscle groups.
  • It is important that you are aware of what you are using during your training: muscles or joints. Muscle pain after the workout is fine. If the next day, though, you suffer from increased pain in the joints then you have trained incorectly and you need to adjust your programmes. If you don't do this you increase the chance of damaging your cartilage.
  • If you experience pain after training then it is perhaps better not to train in the warmth (or to lower the temperature). You need to be careful of this especially if you are in a later stage of rheuma. If you experience pain, plan a coaching in to see what is best for you. Everyone is different.
  • In addition to your workout it is also good to work on your flexibility. This helps improve the movement range of your joints. Yoga is a good class for this. The hot cabin yoga can feel lovely due to the heat.
  • Do you experience a lot of pain and restriction in your movements? Then it is sensible to start with the rheuma programme in the hot cabin. There is not too much pressure on the joints which make it accessible to everybody.
  • You can slowly build up the resistance. Discuss with a coach how you can increase the resistance through the use of ankle weights or dumbells.
  • It is also important in the case of pain and limited movement possibilities to train for a short period (30 minutes in the cabin) and at set times when you feel the least amount of pain and hinder. It is also important to breath regularly and deeply during the exercises as well as relaxing.
  • Specific points of attention in the inflammation phase are: avoid heavy training and lower the heat of the cabin. By heavy inflammation it is sometimes better to just rest.
  • Be aware that you can also suffer pain and feel uncomfortable during and after the training. Your body needs to get accustomed to exercising. Be careful: the pain may not increase ,more than 2 hours after training. If this is the case then let this be known.
  • Are you physically healthy and just really want to strengthen and look after your body? Then you can follow all the activities that you enjoy.

Food
A healthy and balanced nutrition is important for everybody but especially for you. Not much is known regarding the specific effects of nutrition concerning rheuma conditions. There is also no specific diet. There are however a few points of attention regarding nutrition that can have an effect on rheuma.

  • First, it is important to eat healthy and varied. Enough protein, vitamins and calcium is especially important. Vegetables and fruit also have the effect of slowing down inflammations. Try and consume at least 250 grams of vegetables and two portions (200 grams) of fruit daily.
  • Sausage and fatty meats are not advised, especially pork and red meat. This can have a negative effect on the rheuma complaints due to the acid levels. Dairy products, sugar, coffee and alcohol are also not advised. You can replace these through basic nutritional products such as vegetables, fruit (not too ripe due to the sugars), potatoes, seeds (in small amounts) and wheat grass.
  • You can eat lean meat but no more than three times a week. Good alternatives are fish, eggs and vegetable based products such as organic vegetables and legumes.
  • Eat (fatty) fish twice a week, especially omega 3 fatty acids. These reduce the risk of cardiovascular disease. Inflammations caused by rheuma can not be reduced. You need the required daily intake as that is good for your heart and veins. Omega 3 fatty acids can be found in fatty fish such as mackerel, herring, sardines and salmon. If you eat fatty fish twice a week then you consume enough fatty acids. Omega 6 is not advised as this can cause inflammations. This is especially important in the case of fibromyalgia.
  • Try to avoid alcohol (preferably none). This is especially advised in the case of gout.
  • Drink enough water.
  • Do you suffer from overweight? Then it is important to lose weight. By losing weight you put less pressure on the joints. Plan a foodcoaching in if you require more information about losing weight.
  • Unsaturated fats may help to diminish the inflammation pain so that you can reduce your pain killers and anti-inflammatories. Choose products that contain (more) unsaturated fats. Examples of these are plant-based oils, nuts and fatty fish such as salmon, herring or mackerel. Try to limit the use of saturated fats.
  • In the case of a gout patient that has not yet or recently been treated, it is advisable to avoid the consumption of nutrients that are rich in purine (predecessor of uric acid).
  • Animal products such as anchovies, herring, lamb, offal (chicken liver) and red meat contain a lot of purine (>150 grams purine per 100 grams) and are known to often cause gout attacks. Avoid these products as much as possible. Wholegrain products, wheat germ, soya beans, soya flour also contain purine but not as much. So also be careful with these products.
  • In the case of rheuma, like arthritis, plants such as nettle, meadowsweet and willow are often used. There are signs that external use of nettle extract can reduce the pain of patients suffering from arthritis.
  • You can make herbal tea from dried nettle. It is also good to drink a cup of fresh nettle twice a day, in the form of soup or juice.
  • Regular use of kurkuma can improve morning stiffness and swelling of the joints. Kurkuma has a clear anti-inflammatory effect by post operative patients. It is interesting to note that kurkuma is a cheap, tasty and safe spice that can be used daily.

Vitamins and minerals

  • People with rheuma often lack enough vitamin A and B. In the case of active rheumatoid arthritis there is a need for a higher level of vitamin A, B and D.
  • Vitamin D is important for healthy bones and muscles. Vitamin D also acts as an anti-inflammatory in the case of inflammatory rheumatism and possibly arthritis. This is especially important for women between the ages of 50 and 70 years. They often require extra vitamin D. They are given the advice to take an extra 10 microgram of vitamin D daily. For people suffering from osteoporosis, the advice is to take an extra 20 microgram daily.
  • Calcium and vitamin D are often prescribed for sufferers of osteoporosis. People taking prednison as medicine for rheuma have an increased chance of osteoporosis. It is then helpful to take extra calcium tablets and vitamin D. These tablets require a doctors prescription.
  • If using methtrexaat as medicine then you need to increase your intake of folic acid (vitamin B11). This medicine requires an increase in folic acid.
  • There is often a shortage of manganese and zinc. This is often present by RA but also in the case of growing pains in children, joint pain and back pain. Manganese can be found in leafy vegetables, wholegrain products and walnuts. Zinc can mainly be found in oysters (very rich in zinc), egg yolks, fish, legumes, pumpkin seeds, wholegrain products, liver, veal and lamb and horse meat.
  • Ensure that you consume enough calcium or calcium rich products. This is important for the development of strong bones and to slow down the process of bone degeneration.
  • Glucosamine can have a mild pain killing effect in the case of mild arthritis of the knee. Glucosamine is a protein that is found in cartilage, connective tissue and in the fluid in your joints. It is a product that is already present in the body. The body produces this itself.
  • Unfortunately, as you get older, the body, often, does not produce so much. Glucosamine can not be found in our nutrition. If you purchase it as a supplement then it is made out of shells, crab shells and prawns.
  • Do you require extra supplements? Choose then a (multi-) vitamin supplement with no more than the required daily dosis (ADH). Check with your doctor before using a supplement. Too much of fat soluable vitamins such as vitamin A,D and K can have a negative effect on the body. If needed, you can also ask for a referral to a dietist. They can check if your nutrition contains everything.