The hardest sell of all is water exercise. Water exercise is particularly valuable for anyone with arthritis problems involving their back or legs. Water exercise allows the benefits of exercise without the pain of full weight bearing. Many patients with arthritic knees have been told by their orthopedist that their knee cartilages are badly worn or completely gone. These sorry creatures come to see me and with great earnestness tell me that their "cartridges" are worn out, which always reminds me of an out-of-ink printer. Water exercise is perfect for exercising those legs with worn-out cartridges, but it’s hard to get patients into this self-help mode. The list of obstacles to compliance is formidable. This type of exercise is time consuming and expensive, and it involves putting on a bathing suit.
Of course, exercise sometimes has novel side effects. One patient showed me her sore foot with a big bruise on the first metatarsophalangeal joint. "What happened?" I wondered out loud. "I dropped a Pilates bench on my foot. That sucker was heavy! You don’t suppose it’s broken, do you?" "No ma’am, I’m sure your bench is fine. Just remember how good exercise is for you!"
Dr. Greenbaum is a rheumatologist who practices in Greenwood, Ind.