A proper exercise program should consist of stretching, strengthening, and non-impact or low impact aerobic exercises. Neglecting one of these components not only makes your program incomplete, it also may lead to unnecessary injury.

Patients should start out slow depending on their level of conditioning. People who are used to exercising can probably maintain and improve upon what they already have been doing while people who aren’t used to exercise may want to start out with 5 minutes a day and build up.

Proper stretching both before and after exercise is critical. Stretching improves flexibility and prepares stiff joints for the work out. Warming up is very important because this increases blood flow to muscles and helps reduce the possibility of injury to joints and tendons. Consult a physical therapist or an exercise physiologist about the proper stretches to do.

Working out should be done in the aerobic zone. Too vigorous a program can put you into the anaerobic range. This causes lactic acid buildup and also makes you prone to injury. The rule of thumb for a good cardiovascular workout is to get your heart rate to its target zone (subtract your age from 220. The target range is the heart rate that is between 40 to 70 per cent of that number).

Make sure you drink plenty of water. Adequate hydration means drinking an 8 ounce glass of water before you work out and then a glass of water every 15 minutes during your workout. After your workout you should continue to drink. This will help with blood circulation, removal of toxins from the system, and also helps with cooling down.

Make sure you don’t start your exercise until at least two hours after a meal. Otherwise you could be in for an uncomfortable time with abdominal cramps, nausea, and diarrhea as consequences.

If you’re using machines such as stair climbers, elliptical trainers, rowers, and such, make sure you use proper form. Leaning on the railings or not paying attention to proper posture robs you of the benefit of your exercise and also may lead to injury.

If you are flaring from your arthritis, you might want to skip your workout that day. Note: Don’t confuse the muscle soreness and mild joint pain you get after a workout with a major flare. They are different.

If you are lifting weights, always make sure you get some instruction from someone who knows what they’re doing first. Start out slow with lower amounts of weight. It’s better to use lower amounts of weight and do more repetitions than it is to use larger amounts of weight that your body is not used to. Use a spotter if you’re unsure of yourself.

Keep an exercise log. It’s a good idea for motivation to see improvement as you continue to exercise and begin to improve your fitness.

Dr. Wei (pronounced “way”) is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians. For more information on arthritis and related conditions, go to: http://www.arthritis-treatment-and-relief.com

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