Flexibility

Flexibility is a broad term that includes several concepts. At its simplest, flexibility is the ability of a joint to move through its range of motion—for example, touching the shoulder with the hand. A motion becomes more complex when it uses several joints and muscles in combination. Touching one's toes, for instance, requires flexibility in the hamstrings, hips, and low back muscles.

A primary concern of many arthritis patients is being able to perform motions that require several joints to move in several directions. Golfers must be able to rotate and extend the shoulders at the same time that they flex and rotate the trunk, if they wish to produce adequate motion for a swing. Even everyday activities such as showering require the ability to move both shoulders in combination to wash the hair or back.

Joint flexibility is often lost with arthritis, but this loss is usually due to restricting one's movements because of pain. Increasing activities may delay the loss of flexibility and maintain function in a joint (Chapman, DeVries, and Swezey 1972). If one does not move a joint through its complete range of motion, one eventually loses a portion of its total motion. I worked with a lady who came to me because she could not raise her arm above her shoulder and as a result could not fix her hair properly. I found that she had lost shoulder strength from not using the arm and had also lost motion in her shoulder joint. Because her shoulder hurt when she raised her arm, she had quit raising it. With therapy, she was able to regain most of her range of motion and the ability to fix her own hair. If she had kept using the joint, perhaps modifying the activity to reduce the pain, she would not have required prolonged therapy to restore lost motion. The old axiom of “use it or lose it” rings true for one's physical abilities.

Related to flexibility is the concept of stiffness, one of the hallmarks of arthritis. Stiffness can be described as the “feeling of discomfort or restriction of movement after a period of inactivity” (Nichols 2001). In other words, it feels as if your joints and surrounding muscles need oiling. Stiffness, however, is not a true loss of a joint's range of motion. What often happens is that as a person starts to feel stiff, he moves less and may eventually lose full range of motion. One most often has this feeling after being in the same position for a prolonged time, such as sitting at the movies. Flexibility activities involve slow, gentle movement that decreases the sensation of stiffness and allows you to get moving again. I usually tell people to get up and move around every hour or so, moving all joints; just a little movement significantly decreases their sense of stiffness. See the sidebar for other ideas for reducing stiffness.