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Лечебная физкультура при подагре

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17 августа 2019

Подагрой называют заболевание, при котором наблюдается повышенный уровень мочевой кислоты в крови. Маленькие частички кристаллов урата оседают в суставах, вызывая их частичное или полное разрушение. Лечение патологии производится разными способами, одним из которых является ЛФК при подагре.

Суть лечебной методики

Заболевание обычно начинается с суставов 1-ого пальца стопы (чаще 1-ого плюснефалангового), в последующем может затрагивать любые другие суставы и поражать внутренние органы человека (чаще всего почки).

Если продолжительное время не заниматься терапией – возможно развитие хронического тофусного артрита. Вместе эти патологии приведут к изменению структуры сустава, его разрушению, пациенту станет трудно передвигаться, как итог – полное обездвиживание.

Предотвратить негативные нарушения может ЛФК. Физические нагрузки играют важную роль. Ученые доказали, что спорт при подагре помогает людям преодолеть болезнь, избавиться от неприятных симптомов.

Лечебная физкультура позволяет:

  • Стабилизировать процессы обмена в организме.
  • Нормализовать кровообращение, состояние сосудов.
  • Укрепить мышечные ткани, связки, суставы, повысить их тонус и снять напряжение.
  • Вернуть больному способность к движениям, устранить скованность суставов.
  • Устранить болевой синдром.

Положительные эффекты достигаются при правильно подобранной системе физических упражнений при подагре.

Принципы разработки программы

Занятия назначаются специалистом с учетом степени подагры суставов, особенностей ее течения, состояния пациента. ЛФК включает в себя методики:

  • Гимнастика при подагре для общего укрепления организма.
  • Силовые тренировки.
  • Аэробика.
  • Плавание в бассейне.
  • Лечебная ходьба.
  • Йога.

Принципы построения программы занятий заключаются в подборе упражнений сначала для укрепления крупных частей тела, затем для воздействия на конкретный сустав, подвергнувшийся подагрическому процессу. Техника правильного дыхания – важный элемент занятий.

При наличии острой формы подагры физические тренировки проводятся по индивидуальному плану.

В период стойкой ремиссии они обладают профилактическим характером, поэтому возможно проведение групповых занятий под контролем инструктора.

Советы по выбору упражнений

Подбор упражнений при подагре суставов – важный этап, от которого зависит эффективность лечебной физкультуры. Специалисты дают следующие рекомендации при составлении программы занятий:

  1. В первую очередь должны идти упражнения на разогрев мышц. Для их выполнения достаточно 5 минут.
  2. Подбирать занятия нужно так, что было чередование общеукрепляющих и целевых.
  3. Нельзя выбирать упражнения при подагре, предполагающие резкие движения, чрезмерно напрягающие мышечные ткани.
  4. По мере привыкания организма надо менять занятия по принципу «от простого к сложному».
  5. Подбирать упражнения нужно с учетом позы: к примеру, человеку с патологией в ногах следует выбрать лежачее положение.

В качестве общеукрепляющей гимнастки при подагре специалисты предлагают следующий комплекс:

  1. Сесть на стул, вращать стопами поочередно в разные стороны по 5 раз.
  2. Встать на край ступени, зацепиться за нее пальцами, удерживаясь в таком положении несколько секунд.
  3. Встать, перекатывать стопу с пятки на носок, делая упор на пальцы ног в конце.
  4. Ходить на внешней и внутренней стороне ступни.
  5. Сесть на стул, упереться стопой в брусок и перекатывать его с помощью пальцев ног.

Целевые упражнения

Водные тренировки

ЛФК в воде имеет главное преимущество перед наземными упражнениями – устранение болевых ощущений. Движения в бассейне снимают напряжение, нормализуют кровообращение, улучшают обменные процессы.

Лечебное принятие водных процедур предполагает действия:

  1. Гулять по воде, зайдя по пояс. Ноги должны уверенно касаться поверхности. Сначала делайте медленные шаги, затем постепенно увеличивайте темп. При ходьбе высоко поднимайте колени – это придаст большей эффективности.
  2. Зайти в воду по талию, встать спиной к стене бассейна, подняться на цыпочки и удерживаться в таком положении на несколько секунд. Затем полностью расслабиться. Выполнять движение 10 раз.
  3. Погрузиться в воду до груди, одной рукой держаться за стенку бассейна, а ногами поочередно качать в стороны по 7 раз.
  4. Поднимать нижние конечности в стороны, опуская их в медленном темпе. Для начала хватит 5 упражнений.
  5. Приседать в воде, встав спиной к стенке бассейна. Начинать занятие с 5 раз, чтобы не травмировать колени.

Гимнастика в зале

Эффективны тренировки не только в воде, но и в спортивном зале. Они легкие, но проводить их желательно под присмотром специалиста. Рассмотрим целевые упражнения для ног.

Программа для воздействия на тазобедренный сустав:

  • Поднимать нижние конечности из положений стоя или лежа на спине.
  • Лечь, вместе или поочередно прижимать согнутые в коленях ноги к животу.
  • Стоя делать круговые движения бедрами и поворачивание ими – то внутрь, то наружу.

Занятия для коленного сустава:

  • Сидеть на стуле и с усилием вытягивать колено.
  • Лечь на спину, сгибать и выпрямлять ноги.
  • Сесть, выпрямить конечности, затем согнуть их в коленях с большим напряжением и опять вытянуть.
  • В положении стоя сгибать и выпрямлять ноги.

Упражнения для голеностопного сустава:

  • В сидячем положении выпрямить нижние конечности, согнуть их в области стоп, делать круговые движения ступнями.
  • В той же позе согнуть стопы, повернув их внутрь и соединив подошвами.
  • В любом положении делать сгибания пальцев. Можно всех вместе, а можно сначала сгибать с помощью руки большой палец, а потом все остальные поочередно.

Переходить на целевые упражнения нужно после общеукрепляющей лечебной гимнастики.

Все движения должны быть плавными, нельзя допускать резкости. Повторять каждое занятие нужно не более 5 раз для начала. Со временем количество подходов можно увеличивать.

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Разрешенные виды спорта

Многих пациентов интересует вопрос: «Можно ли заниматься спортом при подагре помимо лечебных гимнастических занятий?». Врачи отвечают на него полностью положительно.

Вид спорта следует выбирать в зависимости от того, какой сустав претерпел поражение, потому что для него нагрузка должна быть минимальной. Не стоит забывать, что заниматься можно только при хронической форме недуга.

Доктора разрешают пациентам следующие виды спорта:

  • Плавание. Этот тип занятий благоприятно воздействует на организм. Когда человек плавает, нагрузка на мышечные ткани и позвоночник распределяется равномерно, связки становятся эластичными. Специалисты говорят, что плаванием нужно заниматься только в теплой воде. В противном случае подагра перейдет в состояние обострения.
  • Аквааэробика. Оказывает такое же положительное влияние на организм, как и плавание. Людям с подагрой советуют заниматься по индивидуальной программе либо в группе пациентов с аналогичным диагнозом. Это связно с тем, что определенные движения способны негативно отразиться на организме при подагре суставов.
  • Езда на велосипеде. Это любимое занятие большинства людей. Пациенты, предпочитающие кататься на велосипеде, не хотят отказываться от такого удовольствия. Но не всем больным разрешается такой спорт. В острый период подагрического артрита придется забыть о езде. Остальным пациентам она пойдет на пользу, позволит улучшить питание тканей, уменьшить количество отложений соли. Если у человека поражены пальцы, то доктора советуют ставить ногу на педаль таким образом, чтобы они не нагружались.
  • Спортивная ходьба. Она разрешена всем больным. Занятие помогает держать в тонусе организм, укреплять иммунную систему, нормализовать кровообращение в тканях. При пеших прогулках главное правило – соблюдение ровного дыхания, даже если темп увеличен. В зимнее время года их можно заменить на катание на лыжах или коньках.
  • Дыхательная гимнастика. Любителям таких занятий никто не будет препятствовать. Упражнения благотворно влияют на организм.
  • Йога. Этим типом спорта заниматься при подагре можно, но только с разрешения лечащего доктора. Упражнения подбирает специалист с учетом течения болезни.

Какие бы физические нагрузки при подагре ни осуществлялись, нужно помнить одно: они не должны приносить боль. Если пациент испытывает неприятные ощущения при движениях, то надо сразу остановить тренировку.

При дискомфорте в мышцах следует сделать легкий массаж пораженного сустава ноги.

Таким образом, заниматься спортом при подагре необходимо. Благодаря физической нагрузке происходит повышение двигательной активности суставов, предотвращается обострение патологии, улучшается общее состояние здоровья. Такого эффекта можно достичь, если правильно разработать программу и соблюдать все рекомендации лечащего врача.

ЛФК при подагре зачастую используется в комплексе консервативного лечения. Лечебная физкультура используется совместно с медикаментозной терапией и диетой, при таком подходе удается достаточно быстро купировать обострение заболевания и перевести его в стадию стойкой ремиссии.

Польза ЛФК при подагре

Лечебная гимнастика при подагре помогает нормализовать обмен веществ

Гимнастика при подагре помогает ускорить процесс выздоровления. Она оказывает на организм многогранное действие:

  • нормализует обменные процессы. Именно сбои в обмене веществ зачастую провоцируют развитие суставной патологии.
  • Способствует уменьшению выраженности болевого синдрома. На начальных стадиях заболевания ЛФК при подагре помогает обходиться без обезболивающих средств.
  • Ускоряет кровообращение в организме, улучшает кровоснабжение суставов.
  • Способствует улучшению двигательной функции конечности, а также устраняет суставную скованность.
  • Укрепляет мышечно-связочный аппарат, снимает мышечное напряжение и нормализует тонус мышц.
  • Улучшает работоспособность сердечно-сосудистой системы.
  • Способствует активному выводу уратов из организма.
  • Восстанавливает нормальное функционирование опорно-двигательного аппарата.
  • Увеличивает подвижность диафрагмы и грудной клетки.

Все перечисленные эффекты достижимы только при комплексном подходе, когда занятия лечебной физкультурой применяются совместно с другими способами лечения.

Противопоказания

Занятия лечебной физкультурой разрешены не всем людям. ЛФК имеет ряд абсолютных противопоказаний. Кроме того, существуют состояния, при которых заниматься физическими упражнениями необходимо с осторожностью.

К абсолютным противопоказаниям относятся следующие:

  • Интоксикация любого типа.
  • Повышенная температура тела.
  • Наличие злокачественных опухолей.
  • Повышенное артериальное давление.
  • Ярко выраженный болевой синдром.
  • Увеличение СОЭ в крови по неизвестным причинам.
  • Инфекционные и воспалительные заболевания в острой форме.
  • Наличие кровотечения или угроза его развития.
  • Тромбозы.
  • Нарушение психического состояния пациента.
  • Общее тяжелое состояние пациента.

При тяжелом состоянии пациента ЛФК противопоказана

Ограничивающими факторами к занятиям ЛФК выступают следующие:

  • Отклонения в физическом развитии пациента.
  • Остеопороз и иные системные костные патологии.
  • Аневризма сердца или аорты.
  • Сопутствующие заболевания, которые влияют на подбор комплекса упражнений при подагре.

Начинать занятия лечебной физкультурой разрешается только после консультации врача. Только специалист сможет подобрать наиболее подходящий комплекс упражнений, учитывая степень поражения суставов и общее состояние пациента.

Лучшие комплексы ЛФК при подагре

При составлении комплекса физических упражнений необходимо учитывать следующие факторы:

  • Степень воздействия на пораженные суставы.
  • Стабилизация и нормализация дыхательных процессов.
  • Укрепление связок и мышечного корсета.

Китайская гимнастика

Ушу – китайская гимнастика, омолаживающая организм

Китайская гимнастика направлена на оздоровление всего организма, также она широко применяется при подагрических заболеваниях. Методика китайской гимнастики способствует омоложению организма и ускорению процессов регенерации. Регулярные занятия позволят значительно улучшить общее состояние пациента и снизить вероятность развития острого приступа подагры.

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Основными упражнениями являются следующие:

  1. Поднятие руки. Упражнение выполняется стоя, необходимо сделать глубокий вдох, затем медленно поднять руку до уровня плеч. Руки необходимо округлить, имитируя держание большого шара. Развернуть кисти рук от себя и медленно поднять над головой.
  2. «Лодка». Согнуть ноги и наклониться вперед. Руки отвести назад, затем выпрямить колени. Выполнять круговые движения ногами.
  3. Разработка плечевого сустава. Опустить левую руку вниз, правую поднять вверх. На два счета отводить руки назад, сменить положение и выполнить упражнение повторно. На каждую руку по 10 повторов.
  4. Бросок. Встать прямо, медленно прогнуться назад. Поднять одну руку так, чтобы ее ладонь находилась на уровне лба. А вторую ладонь разместить противоположно. Вдохнуть и резко сделать движение, имитирующее бросок.

Заниматься китайской гимнастикой рекомендуется через день. Если присутствуют ограничения по состоянию здоровью, то достаточно выполнять комплекс 2-3 раза в неделю.

Упражнения при подагре колена

Подагра зачастую поражает коленные суставы. В этом случае рекомендуется выполнять следующие упражнения:

  1. Лечь на спину и выпрямить ноги, лежать необходимо только на твердой поверхности. Колени максимально прижать к полу, напрячь ноги. Зафиксироваться в таком положении на 10 секунд, затем расслабиться. Повторять упражнение рекомендуется 3-4 раза с отдыхом на 5 секунд между подходами.
  2. Сесть на стул, согнуть ноги под прямым углом. Развести стопы на расстояние 50 см друг от друга, начать поднимать носки так высоко, насколько это возможно. Опираться необходимо на пятки. Повторить 6 раз, затем выполнять аналогичное упражнение, но упор делать на носки и приподнимать пятки. Упражнение выполняется плавно, оно не должно причинять боли и дискомфортных ощущений.
  3. Лечь на спину и выпрямить ноги, расположить руки вдоль тела, совершать медленные вдохи и выдохи, в такт дыхания сгибать и разгибать пальцы обеих конечностей. Повторить 10 раз. При первых упражнениях достаточно выполнить 2-3 раза, постепенно количество подходов увеличивая до 10 раз.

Занятия по Бубновскому

Доктор Бубновский разработал специальный комплекс упражнений для пораженных суставов

Комплекс упражнений по Бубновскому необходимо выполнять ежедневно, только так можно достичь положительного результата. Упражнения направлены на оздоровление всего организма, они эффективны при подагрических поражениях суставов, позволяют восстановить подвижность и снизить болевой синдром. Комплекс включает в себя следующие упражнения:

  • Лечь на спину, согнуть ноги в коленях, а руки разместить за головой. Поднимать корпус к коленям, сгибая руки. Делать это нужно плавно, избегая возникновения болевых и дискомфортных ощущений.
  • Сесть на пол, ноги выпрямить перед собой. Согнуть ногу и взяться руками за носок, выпрямлять ногу. Повторить аналогичное движение с другой ногой.
  • Встать на четвереньки. Растянуть позвоночник и опуститься к полу, совершать движения, имитирующие шаг, одновременно рукой и ногой. Повторить на обе стороны. Количество повторов должно составлять 25-30 раз.
  • Лечь на спину, зафиксировать ноги так, чтобы они находились выше головы. Согнуть ноги в коленях, а руки разместить за головой. Под поясницу рекомендуется положить что-нибудь холодное. Отрывать корпус плавно от пола и стремиться к ногам.
  • Встать на четвереньки. Округлять спину и прогибать ее. Имитировать кошачьи потягивания. Количество повторений может составлять сколько угодно, пока человеку комфортно.

Упражнения при подагре назначают в зависимости от стадии заболевания.

Подагра — это устойчивое увеличение мочевой кислоты в крови. Мелкие частицы кристаллов урата откладываются в суставах, что впоследствии приводит к частичному или полному разрушению сустава.

Симптомами подагры могут быть обыкновенные артриты, воспаление суставов, наиболее часто встречается на суставах большого пальца на ноге, голеностопа и коленей. При подагре, усиление болей наблюдается утром и вечером (ближе к ночи), также сопровождается покраснением, отечностью сустава, повышается температура тела в области покраснения.

В целях профилактики и лечения подагры назначают лечебную физкультуру (ЛФК) и специальную диету.

При назначении ЛФК (лечебной физкультуры) необходимо учитывать стадию заболевания: хроническая или подострая, в каком состоянии находятся суставы и сердечно-сосудистоя система. Лечебные упражнения при подагре проводятся группами или индивидуально со специалистом.

Групповые занятия ЛФК показаны больным с нормальным состоянием сердечно-сосудистой системы и без болей в суставах, в индивидуальном порядке – с пациентами, страдающими подострой формой заболевания и при наличии деформации суставов, контрактуры, болезненные ощущения.

При первой группе больным показаны уроки ЛФК (лечебной физкультуры), включая: порядковые, подготовительные, корригирующие, дыхательные, вольные и прикладные упражнения, а также игры — лыжи и коньки, гребля, плавание. Выполняя лечебные упражнения при подагре дозировку необходимо увеличить осторожно, упражнения усложнять постепенно, интенсивность упражнений повышать по мере адаптации больного в работу. При проведении занятий ЛФК при подагре большое значение необходимо уделять дыхательным упражнениям. В комплекс лечебных упражнений следует включать и прикладные упражнения.

При подагре, больным, занимающимся индивидуально, включаются упражнения "дыхательные" и ходьба, а также гимнастика на суставы. После того, как исчезнут боли, больного можно допустить к занятиям ЛФК в группе.

Выполняя определенные упражнения при подагре очень важно контролировать правильность дыхания, глубокий и полный вдох и выдох, каждое из упражнений и движений выполняем как можно напряженно, с увеличенной, но доступной амплитудой и, ускоряясь. Заканчиваются упражнения «рывком» с целью воздействия на суставную сумку.

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Если у больного имеются мочекислые отложения и образовались узлы, то используется суставной комплекс упражнений с целью усиления мускулатуры, окружающей ущемлённости в своей подвижности суставы и растяжка мышц плечевого пояса.

Лечебные упражнения при подагре

Упражнения, сконцентрированные на плечевой сустав

  1. Начинаем упражнение медленно и напряженно вытягиваем руки вперед перед собой и ладонями внутрь, далее снова разводим в стороны – 3-4 раза.
  2. Также, продолжаем упражнение, медленно и напряженно, вытянув обе руки в стороны на уровне плеч, ладони при этом внизу и затем опускаем – 3-4 раза.
  3. Руки развели в стороны. Начинаем выполнять упражнение с коротких и энергичных махов руками то вверх, то в вниз – делаем 4-5 раз.
  4. Положение рук аналогично упражнению №2. Повороты и выпрямление рук в одну сторону и в другую – 3-4 раза.
  5. Вытягиваем руки вперед и поднимаем над головой – пов-ть упражнение 3-4 раза.
  6. На различных уровнях вращаем руки в плечевых суставах – 3-4 раза.
  7. Стоя вплотную лицом к стене, руки развели в стороны. Начинаем выполнять упражнение перебирая пальцами по стенке, затем поднять руки вверх, насколько позволит подвижность суставов — 4-5 раз.
  8. Для этого упражнения необходимо встать, руку с поврежденным плечом заведены за спину, повернули ладонь назад, и взять палку. Далее берем свободной рукой другой конец палки и тянем его вверх и в сторону делаем 3-4 раза.
  9. Данное упражнение выполняется по желанию (по самочувствию) с положения, стоя или сидя. Укладываем пораженную руку на затылок, далее поднимаем ее над головой, затем вытягиваем вперед и положить под локоть больной руки стопку книг или любых предметов, увеличивая тем самым растяжку связки плеча.
  10. Упражнение, вис на кольцах и на специальной гимнастической стенке, брусьях, увеличивая растяжку напряженного сустава, выполняем в течение 30 секунд — 2 раза.

При таком упражнении, как отведение и разгибание нужно доводить движения до максимального размаха (до первой боли). Все динамичные движения происходят при содействии максимального напряжения мышц плечевого пояса. Точно такие же движения очень важно проводить и в виде не активных упражнений.

Упражнения, направленные на локтевой сустав

  1. Упражнение, на сгибание и разгибание рук в локтевых суставах с блоками, с гантелями и без сопротивления – делаем 4-5 раз.
  2. Упражнение на сгибание рук: поднимаем локти сначала в стороны, затем отводим локти назад – 3-4 раза.
  3. Повиснуть на кольцах, брусьях, гимнастической стенке до 30 секунд.
  4. Сидя, локоть больного на столе или на руках помощника и начинает сгибать и разгибать локтевой сустав. Это упражнение следует выполнять медленно, спокойно и ровно – выполняем 3-4 минуты.

Упражнения, сосредоточены на лучезапястный сустав

  1. Упражнение, выполняем как с сопротивлением, так и без сопротивления. Сгибание и разгибание кистей рук — 3-4 раза.
  2. Отведение кистей рук и приведение, также выполняем с сопротивлением и без – 3-4 раза.

Несколько специальных упражнений, направленных для пальцев рук

  1. Упражнение, на сгибание пальцев рук в кулак.
  2. Упражнение, на сгибание отдельных фаланг.
  3. Упражнение, на отведение пальцев.
  4. Упражнение, на приведение пальцев.
  5. Упражнение для любого пальца: сгибаем оба сустава и вытягиваем их, далее отвести и привести палец, вращение в разные стороны.
  6. Для этого упражнения необходимо большим пальцем коснуться кончиков других пальцев этой руки, а затем и остальных суставов.
  7. Вытягиваем большой палец и соединяем его с остальным, чтобы в итоге получилась буква "О".

Для пальцев рук, выполнять упражнения следует активно, пассивно, и с сопротивлением. Для оказания помощи больному в сгибании и разгибании верхней фаланги, помощник придерживает свой палец под сгибом.

Ряд упражнений, для тазобедренного сустава

  1. Упражнение, будем выполнять из положения удобного для Вас (стоя или лежа на спине). Начнем с подъема ног — выполняем 3-4 раза.
  2. Положение аналогичное первому упражнению. Прижимаем бедра к животу – выполняем 3-4 раза.
  3. Также, положение выбираем для себя наиболее удобное. Повороты бедра внутрь и наружу – 3-4 раза.

Несколько полезных упражнений, для коленных суставов

  1. Начинаем упражнение из положения, сидя. Вытягиваем колено с сопротивлением и без – 2 раза.
  2. Теперь, необходимо лечь на спину и согнуть колено. С сопротивлением и без сопротивления выпрямляем ногу – 4-5 раз.
  3. Сейчас следует сесть, ноги вытянуть. С напряжением сгибаем ногу в колене и снова вытягиваем – 2-3 раза.
  4. Для этого упражнения необходимо встать. Согнули ногу в колене, выпрямляем и далее поставили – повторяем 2 раза.

Упражнения, направленные на голеностопный сустав

  1. Усаживаемся на низкую скамейку, скрещиваем ноги, чтобы правое колено было над левым, правой рукой необходимо обхватить щиколотку правой ноги, а левой — пальцы и нижнюю часть правой стопы, тем самым большой палец нажимает на свод стопы. Оттянуть стопу вниз, повернуть вверх, вовнутрь, наружу – 2 раза.
  2. Для этого упражнения положение остается прежним. Вытягиваем ноги вперед, стопы согнуты внутрь, подошвы соединить. Стопа может быть, как согнута, так и выпрямлена: выполняем сгибание и разгибание пальцев.

Все предложенные упражнения можно делать как динамично, так и пассивно и могут быть при лечении больных полиартритом.

Перед лечением, людям страдающим подагрой делают все антропометрические измерения и функциональные пробы.

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